Diagnostic Value of Routine Biomarkers in Predicting Septicaemia in Hospitalised Patients: A Cross-sectional Study

Abstract

Introduction: Sepsis is a potentially fatal condition that leads to alterations in coagulation, immunosuppression, and multiorgan failure. Predicting the risk of septicaemia before the onset of organ dysfunction poses a challenge. Prompt diagnosis, coupled with triaged management, is crucial in determining disease outcomes. Aim: To assess the role of routinely employed biomarkers in the early identification of septicaemia in patients. Materials and Methods: A cross-sectional study was conducted on 564 blood samples from Jaipur National University Institute of Medical Sciences and Research Centre (JNUIMSRC) in Jaipur, Rajasthan, India, over a period of six months (July 2019-December 2019). Blood culture, identification, and antimicrobial sensitivity testing were performed for all the samples following the Clinical and Laboratory Standards Institute (CLSI- M100) guidelines. Standard septic markers, such as Erythrocyte Sedimentation Rate (ESR), C-Reactive Protein (CRP), Serum Glutamic Pyruvic Transaminase (SGPT), Serum Glutamic Oxaloacetic Transaminase (SGOT), serum urea, serum creatinine, Haemoglobin (Hb), and Total Lymphocyte Count (TLC), were studied. The culture-positive patients were compared with a negative control group. The t-test and logistic regression were used for analysis. Results: Out of 564 patients suspected of sepsis, 135 (23.94%) were culture positive, with a male-to-female ratio of 1.41. No significant differences were found in septic markers {TLC (p-value=0.261), ESR (p-value=0.186), SGPT (p-value=0.336), SGOT (p-value=0.264), Hb (p-value=0.179), serum urea (p-value=0.350), and serum creatinine (p-value=0.155)} between the culture-positive group (135/564, 23.93%) and the culture-negative group (429/564, 76.06%), except for CRP (p-value=0.006). The results of logistic regression also showed that CRP was a significant predictor of septicaemia (p-value=0.009). Amikacin, doxycycline, and piperacillintazobactam were found to be sensitive. Conclusion: Currently used blood markers do not provide sufficient evidence for the prediction of septicaemia, although CRP may be preliminarily useful. There is an urgent need to combine them with novel markers for the early detection of septicaemia.