New procalcitonin semi-quantitative rapid test in the diagnosis of community-acquired pneumonia in patients with hyperglycemia

• Sabina S. Bayramova
• Oksana V. Tsygankova
• Konstantin Yu. Nikolaev
• Olga V. Timoshchenko

Abstract

The course of pneumonia against the background of carbohydrate metabolism disorders is associated with higher mortality, since it is often characterized by an erased clinical picture. The study of new markers for the diagnosis of community-acquired pneumonia (CAP) in patients with various forms of hyperglycemia is an important area of modern therapy.

Aim. To assess the diagnostic significance of a new procalcitonin semi-quantitative rapid test (PCT RT) in patients with CAP, depending on the presence or absence of carbohydrate metabolism disorders.

Material and methods. A cross-sectional comparative study included 123 consecutive patients admitted to a hospital with a confirmed diagnosis of CAP. On the first day from the moment of admission to the start of antibiotic therapy, a general clinical examination, a plain chest radiography, and a new semi-quantitative immunochromatographic rapid test were performed to determine the level of plasma procalcitonin. Along with this, the quantitative concentration of PCT in plasma was determined by enzyme-linked immunosorbent assay. Of all the examined patients, 36 people [age 56 (32; 75) years] had hyperglycemia or a history of carbohydrate metabolism disorders, the comparison group consisted of 87 patients without such abnormalities [age 44 (32; 63) years]. Patients with gestational diabetes and type 1 diabetes were not included in the study.

Results. Plasma glucose levels in patients with impaired carbohydrate metabolism and euglycemia were 8.3 (6.5; 10.4) and 5.2 (4.8; 5.8) mmol/l, respectively (p=0.001). In the group of patients with CAP and hyperglycemia, positive results of PCT RT were recorded 3.6 times more often – in 66.7 and 18.4%, respectively (p=0.001) and 6.5 times more often very high rates of PCT RT – 22.2 and 3.4% (p=0.001). On the contrary, the group without carbohydrate disorders was characterized by negative PCT values for RT. In both study groups, significant positive correlations were established between PCT RT and respiratory rate, heart rate, respiratory failure, quantitative PCT indices and CRB‑65 scores (сonfusion, respiratory rate, blood pressure, age), negative correlations with levels of systolic and diastolic blood pressure and blood oxygen saturation. In the group of patients with CAP and hyperglycemia, positive correlations were additionally found between PCT RT and the level of leukocytes, ESR (erythroсyte sedimentation rate), creatinine, and negative correlations with erythrocytes and fibrinogen.

Conclusion. Patients with CAP and hyperglycemia, compared with individuals with a normal state of carbohydrate metabolism, are characterized by higher values of PCT, determined using a new semi-quantitative rapid method, which correlate with indicators of the infectious syndrome and organ dysfunction.

Keywords:community-acquired pneumonia; diabetes mellitus; hyperglycemia; diagnostics; procalcitonin; procalcitonin rapid test

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