COMPARISON OF INTERLEUKIN-6, PROCALCITONIN AND C-REACTIVE PROTEIN AS A DIAGNOSTIC BIOMARKER IN PATIENTS UROSEPSIS

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Published 2020-07-20
Trisno Fajar Nursanto M. Ayodhia Soebadi Doddy M Soebadi

Abstract

Objective: To compare the diagnostic value of Interleukin-6 (IL-6), Procalcitonin (PCT) and C-Reactive Protein (CRP) in detecting urosepsis. Material & Methods: This study is an analytical descriptive cross-sectional study about the diagnostic value of IL-6, PCT, and CRP to determine the diagnosis of urosepsis. The study sample consisted of all SIRS patients with urological disorders. The entire sample was examined by IL-6, PCT, CRP, and urine culture as the gold standard diagnosis. Data were analyzed using 2x2 table analysis and ROC curve to obtain AUC value. Results: There are a total of 36 samples in this study. With a cut-off 140 pg/ml, IL-6 provides a sensitivity, specificity, Positive Predictive Value (PPV), Negative Predictive Value (NPV), Positive Likelihood Ratio (+LR) and Negative Likelihood Ratio (-LR) was 95.8%, 83.3%, 92%, 90%, 5.75, and 0.05 with AUC 90.8% (95% IK 80.2% -100%, p<0.001). Sensitivity and specificity for PCT with cut off 0.65 ng/ml were 75% and 83.3%. The sensitivity and specificity for CRP with cut off 41 mg/l was 70.8% and 58.3%. The AUC of PCT and CRP was 81.1% and 66.5%. Conclusion: IL-6 has the best diagnostic value followed by PCT and CRP in urosepsis cases. IL-6 can be used as a biomarker diagnostic of urosepsis.


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Keywords

IL-6, PCT, CRP, Urine Culture, Diagnostic Value

References

Bonkat G, Pickard R, Bartoletti R, Bruyere F, Geerlings SE, Wagenlehner F, Wult B. EAU Guidelines on Urological Infections. European Association of Urology. 2017; p.22-6.

Singer M, Deutschman CR, Seymour CW, Hari MS, Annane D, Bauer M, Bellomo R, Bernard GR, Chiche JD, Coopersmith CM, Hotchkiss RS, Levy MM, Marshal JC, Martin GS, Opal SM, Rubenfeld GD, Poll TVD, Vincent JL, Angus DC. The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA. 2016; 315(8): 801-10.

Rica AS, Gilsanz F, Maseda E. Epidemiologic Trends of Sepsis in Western Countries. Ann Transl Med. 2016; 4(17): 325.

Gotts JE, Matthay MA. Sepsis: Pathophysiology and Clinical Management. BMJ. 2016; 353: 1585.

Marshal JC, Reinhart K. Biomarkers of Sepsis. Crit Care Med. 2009; 37(7): 2290-8.

Guntur A. Sepsis. In: Sudoyo AW, Setiyohadi B, Alwi I, Simadibrata M, Setiati S. PAPDI Tropik Infeksi 5 Ed. Jakarta: Internal Publishing; 2009. p.2889-95.

Remick DG, Bolgos G, Copeland S, Siddiqui J. Role of Interleukin in Mortality from Physiologic Response to Sepsis. Infection and Immunity. 2005; 73(5): 2751-7.

Dahlan MS. Penelitian Diagnostik. Jakarta: Salemba Medika; 2009. p.1-152

Royblat L, Rachinsky M, Fisher A, Greemberg L, Shapira Y, Douvdevani A, Gelman S. Raised Interleukin-6 Level in Obese Patients. Obesity Research. 2000; 8(9): 673-5.

Alecu M, Geleriu L, Coman G, Galatescu L. The Interleukin-1, Interleukin-2, Interleukin-6 and Tumor Necrosis Factor Alpha Serological Levels in Localised and Systemic Sclerosis. Rom J Intern Med. 1998; 36(3-4): 251-9.

Gouel-Cheron A, Allouchiche B, Guignant C, Davin F, Floccard B, Monneret G. Early Interleukin-6 and Slope of Monocyte Human Leukocyte Antigen-DR: A Powerful Association to Predict the Development of Sepsis after Major Trauma. PLoS ONE. 2011; 7(3): 33095.

Schaeffer AJ, Matulewicz RS, Klump DJ. Infections of The Urinary Tract. In: Wein AJ, Kavoussi LR, Partin AW, Peters CA. Campbell – Walsh Urology, 11 Ed. Philadelphia: Saunders Elsevier; 2016. p.237-303.

Harbarth S, Holeckova K, Froidevaux C, Pittet D, Ricou B, Grau GE, Vadas L, Pugin J. Diagnostic Value of Procalcitonin, Interleukin-6, and Interleukin-8 in Critical Ill Patients Admitted with Suspected Sepsis. Am J Respir Crit Care Med. 2001; 164: 396-402.

Li HX, Liu ZM, Zhao SJ, Zhang D, Wang SJ, Wang YS. Measuring Both Procalcitonin and C-Reactive Protein for A Diagnosis of Sepsis in Critically Ill Patients. Journal of International Medical Research. 2014; 42(4): 1050-9.

Tsalik EL, Jaggers LB, Glickman SW, Langley RJ, Velkinburgh JCV, Park LP, Fowler VG, Cairns CB, Kingsmore SF, Wood CW. Discriminative Value of Inflammatory Biomarkers for Suspected Sepsis. J Emerg Med. Jul 2012; 43(1): 97-106.

Nguyen HT. Bacterial Infections of The Genitourinary Tract. In: McAninch JW, Lue TF, Smith&Tanago’s General Urology, 18 Ed. New York: McGraw – Hill Companies; 2013. p.197-222.

Bartoletti R, Cai T, Wagenlehner FM, Naber K, Johansen TEB. Treatment of Urinary Tract Infections and Antibiotic Stewardship. European Urology Supplements. 2016; 15: 81-7.

Lin S, Huang Z, Wang M, Weng Z, Zeng D, Zhang Y, Zhu Y, Jiang J. Interleukin-6 as An Early Diagnostic Marker for Bacterial Sepsis in Patients with Liver Cirrhosis. J Crit Care. 2015; 30 (4): 732-8.

Jekarl DW, Lee SY, Lee J, Park YJ, Kim Y, Park JH, Wee JH, Choi SP. Procalcitonin as A Diagnostic Marker and IL-6 as A Prognostic Marker for Sepsis. Diagnostic Microbiology and Infectious Disease. 2013; 75(4): 342-7.

Wu Y, Wang M, Zhu Y, Lin S. Serum Interleukin-6 in The Diagnosis of Bacterial Infection in Cirrhotic Patients. Medicine. 2016; 95: 41 (e5127).

Nasution AS, Soebadi DM, Aryati, Pudjirahardjo WJ, Hardjowijoto S. Nilai Uji Diagnostik Prokalsitonin sebagai Deteksi Kasus Urosepsis Dini. Indonesian Journal of Urology. 2012; 19(1): 34-41.

Liu A, Bui T, Nguyen HV, Ong B, Shen Q, Kamalasena D. Serum C-Reactive Protein as A Biomarker for Early Detection of Bacterial Infection in The Older Patient. Age and Aging. Sep 2010; 39(5): 559-65.

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Department of Urology, Faculty of Medicine/Airlangga University