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Indonesian Journal of Clinical Pathology and Medical Laboratory

ISSN 0854-4263

Vol. 19 / No. 2 / Published : 2013-01

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Original Article :

Eosinopenia and procalcitonin in sepsis

Author :

  1. Danny Luhulima*1
  2. W. Hidayati*2
  3. IGAAP. Rejeki*3
  4. R. Permatasari *4
  1. Bag PK FK-UNAIR/RSU Dr. Soetomo Surabaya
  2. Bag PK FK-UNAIR/RSU Dr. Soetomo Surabaya
  3. Bag PK FK-UNAIR/RSU Dr. Soetomo Surabaya
  4. Bag PK FK-UNAIR/RSU Dr. Soetomo Surabaya

Abstract :

Sepsis is one of the common causes of morbidity and mortality in the ICU. Clinicians need to know and realize of good diagnostic markers to identify sepsis as early as possible. The role of eosinopenia as a marker of sepsis has recently been evaluated.The aim of this study was to test the value of eosinopenia as a diagnostic marker of sepsis in comparison to Procalcitonin. A cross sectional study was performed in 61 adult patients with SIRS, and blood of all patients were cultured. Further examinations were done for comparing the eosinophil count with the Procalcitonin levels if the blood culture was positive or when there were clinical signs which supported for sepsis. In this study there were fourty two patients enrolled. Procalcitonin level yielded a sensitivity of 90.0%, specificity of 83.3%, a positive predictive value (PPV) of 93.1% and a negative predictive value (NPV) of 76.9% at cut-off value of 2.75 ng/mL. The eosinophil (cut off  £ 50 cells/uL) produced a sensitivity of 80.0%, specificity of 75.0%, PPV of 88.9%, and NPV of 60.0%. based on this study Procalcitonin appeared to be a more accurate diagnostic of sepsis than eosinopenia, but eosinopenia is still  a helpful tool for clinicians, and may also be used as a diagnostic marker of sepsis, because it is highly sensitive, moderately specific , easy to measure, rapid and inexpensive as well.     Sepsis merupakan penyebab tersering meningkatnya angka kematian dan kesakitan di ICU. Klinisi memerlukan petanda sepsis yang ideal. Akhir-akhir ini diteliti tentang eosinopenia sebagai petanda sepsis. Tujuan kajian ini ialah meneliti nilai eosinopenia yang dapat digunakan sebagai petanda sepsis dibandingkan dengan Procalcitonin. Penelitian ini menggunakan kajian potong silang terhadap 61 penderita SIRS dewasa. Semua penderita diambil sampel darah, kemudian dikultur. Jika hasil kultur darah terdapat pertumbuhan kuman dan terbukti  ada sepsis, maka selanjutnya dibandingkan dengan jumlah eosinofil dan kadar PCT (Procalcitonin). Didasari pemeriksaan 61 penderita yang termasuk dalam patokan SIRS, diperoleh hasil PCT dengan kepekaan sebanyak 90%, kekhasan sebanyak 83,3%. Ditemukan pula nilai ramalan positif sebesar 93,1%, nilai ramalan negatif sebesar 76,9%, dalam cut-off 2,75 ng/mL. Di samping itu dalam jumlah eosinofil 50 sel/uL didapatkan kepekaan sebanyak 80%, kekhasan sebanyak 75%, nilai ramalan positif 88,9% dan nilai ramalan negatif 60%. PCT lebih tepat dalam mendiagnosis sepsis, dibandingkan dengan eosinopenia tetapi eosinopenia masih dapat digunakan sebagai petanda keadaan tersebut dengan kepekaan yang tinggi, kekhasan sedang, dan tidak memerlukan biaya yang mahal.  

Keyword :

Eosinopenia, procalcitonin, sepsis,


References :

  1. 1. Abidi K, Khoudri I, Belayachi J, Madani N, Zekraoui, Zeggwagh, Abouqal, (2008). Eosinopenia is a reliable marker of sepsis on admission to medical intensive care units. USA : critical care
  2. Aryana I, (2006). Konsep Baru Kortikosteroid Pada Penanganan Sepsis. Denpasar : bagian/SMF Ilmu Penyakit Dalam FK UNUD/RS Sanglah Denpasar Dexa Medica
  3. Budianto, (2011). Pengaruh Penambahan Deksametason Dosis Tinggi Sampai 2 Hari Dalam Menurunkan Mortalitas Sepsis, Mempercepat Hilangnya SIRS dan Memperpanjang Hari Kematian Sepsis. Palembang : http://papdiplg.multiply.com/journal/item/6/Pengaruh_ Penambahan_Deksametason_Dosis_Tinggi_Pada_Sepsis_KOPAPDI_XIII
  4. Burdette SD, (2011). Systemic Inflamatory Response Syndrome. emedicine : http ://emedicine. medscape.com
  5. Kresno SB, (2009). Aspek Biologi Molekuler Sepsis. Jakarta : Departemen Patologi Klinik Fakultas Kedokteran Universitas Indonesia


   


Archive Article

Cover Media Content

Volume : 19 / No. : 2 / Pub. : 2013-01
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  7. Procalcitonin and interleukin-6 in sepsis systemic inflammatory response syndrome (sirs)
  8. Gram negative and gram positive aerobic bacteria identification using conventional and automatic method
  9. Immature platelet fraction (ipf) and thrombopoietin in liver cirrhosis
  10. Eosinopenia and procalcitonin in sepsis
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