Procalcitonin as a reliable bio marker for detection of surgical site infection following orthopaedic surgery

Background: Early detection of SSI is very important to prevent morbidity and complications.At present there is a lack of biomarker which can accurately diagnose such infections. Serum Procalcitonin (PCT), at 0.09 ng/ml is found to be an accurate marker for early detection of bacterial infections. The objective of this research was to assess the diagnostic significance of procalcitonin as a emerging biomarker in early identification of SSI as other markers like ESR, CRP, WBC may not reliably differentiate between systemic inflammatory response and bacterial infection. Material andMethods: Patients of all age groups (n = 249) who had undergone orthopaedic surgery were prospectively included in this study. Any patient who developed post operative wound discharge were followed up for the presence SSI. Serum levels of procalcitonin was measured on the day of wound discharge. So at the end of the study, patients were classified into 2 groups: Group 1 = wound discharge with culture positive (Confirmed SSI, n = 10); Group 2=wound discharge with culture negative (No SSI, n=19). The serum levels of PCT was compared among above two groups and results were drawn. Results: Out of 249 patients 29 patients developed wound discharge in the post-operative period. Only 10 patient showed growth of infective agent. Group 1 had higher mean PCT levels than Group 2 (p < 0.05). PCT, at 0.09ng/ml, was 80% sensitive and 94.7% specific in diagnosing SSI. Conclusion: Serum Procalcitonin, at a cut – off of 0.09 ng/ml, is a sensitive and specific marker in the diagnosis of SSI and helps to differentiate patients with infective wound discharge from non-infective wound discharge. Level of evidence-4

Ali Mohammed P, Deep Sharma, Dilip Kumar Patro, Jagdish Menon, Pooja Dhiman and Harikrishna, M.
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Int J Inf Res Rev
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