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Boletín Médico del Hospital Infantil de México

2006, Número 1

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Bol Med Hosp Infant Mex 2006; 63 (1)


Procalcitonina semicuantitativa (PCT-Q) como prueba diagnóstica y marcador pronóstico en niños con sepsis bacteriana

Gómez-Rivera N, Molina-Moreno FA, García-Zárate MG, Castillo-Ramos J, García-Hernández RJ, Vázquez-Pizaña E, Cano-Rangel MA, Fonseca-Chon I

Idioma: Español
Referencias bibliográficas: 37
Paginas: 8-17
Archivo PDF: 108.96 Kb.


RESUMEN

Introducción. El presente trabajo evalúa la utilidad de la prueba para diagnóstico temprano de infección bacteriana, en pacientes con criterios de síndrome de respuesta inflamatoria sistémica (SRIS) por el método semicuantitativo (PCT-Q®), con otro grupo de pacientes que presenta SRIS sin infección bacteriana. Objetivo: probar el poder diagnóstico de este nuevo marcador PCT-Q® en pacientes con infecciones bacterianas en una fase temprana, además como marcador pronóstico y mortalidad.
Material y métodos. Diseño: prueba diagnóstica. Se seleccionaron 2 grupos, uno con 22 pacientes con criterios de SRIS con infección bacteriana, demostrados con hemocultivos positivos (sepsis), y otro con 18 pacientes con criterios de SRIS sin infección bacteriana. Las variables estudiadas: PCT-Q® con punto de corte de ≥ 10 ng/mL y mortalidad.
Resultados. Primer día en el grupo de estudio resultaron positivos 18 casos y 2 casos en el grupo de control, con un valor de P =0.00063, altamente significativo. En la mortalidad, al séptimo día, se presentaron 8 casos en el grupo de estudio y 1 caso en el grupo control, con un valor de P =0.04, significativo. En la distribución de sexos, en el grupo de estudio se presentaron 15 casos del sexo masculino, y 5 casos en el grupo control, en el sexo femenino 7 casos en el grupo de estudio y 13 casos en el grupo control, con un valor de P =0.01104 altamente significativo, con un riesgo relativo de 2.1428. La sensibilidad y especificidad en este estudio fue 82 y 89%; VPP de 90% y VPN de 80%. Índice de mortalidad de 44.4%.
Conclusiones. La PCT-Q® es una herramienta útil en detectar pacientes con sepsis bacteriana en una fase temprana. Niveles persistentes ≥ 10 ng/mL de PCT-Q® en pacientes con sepsis, ponen en correlación la gravedad de la enfermedad y muerte.


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