Diagnostic value of Procalcitonin, C-reactive protein-to-lymphocyte ratio (CLR), C-reactive protein and neutrophil-to-lymphocyte ratio (NLR) for predicting patients with Bacteraemia in the intensive care unit
An erratum to this article was published (J Crit Care, Jun 2026 ↗)
Authors' conclusion
The PCT, CLR, CRP, and NLR can all predict the occurrence of bacteremia. The PCT had the highest sensitivity and specificity in predicting bacteremia in ICU patients.
Study context
- Population
- Intensive care unit (ICU) patients with suspected bacteremia (bacteremia n = 152, control n = 207), September 2018 to April 2023152 bacteremia, 207 controls
- Participants
- 359 patients
- Comparison
- Procalcitonin (PCT) vs CLR vs C-reactive protein (CRP) vs NLR for predicting bacteraemia
- Outcome
- Prediction of bacteremia (ROC analysis)
Methodological detailscase-control
- Case-control
Performance
As reported in the abstract
Prediction of bacteremia in the ICU
| Test or model | AUC | Optimal threshold | Sensitivity | Specificity |
|---|---|---|---|---|
| PCT | 0.991 (95%CI: 0.974-0.998) | 0.248 ng/mL | 95.4 (95%CI: 90.7-98.1) | 95.7 (95%CI: 91.9-98.0) |
| CLR | 0.960 (95%CI: 0.935-0.978) | 47.52 mg/109 | 88.2 (95%CI: 81.9-92.8) | 90.8 (95%CI: 86.0-94.4) |
| CRP | 0.955 (95%CI: 0.928-0.974) | 48.32 mg/L | 87.5 (95%CI: 81.2-92.3) | 90.3 (95%CI: 85.5-94.0) |
| NLR | 0.898 (95%CI:0.862-0.927) | 6.51 | 86.8 (95%CI:80.4-91.8) | 85.0 (95%CI:79.4-89.6) |
AUC
PCT0.991 (95%CI: 0.974-0.998)
CLR0.960 (95%CI: 0.935-0.978)
CRP0.955 (95%CI: 0.928-0.974)
NLR0.898 (95%CI:0.862-0.927)
Optimal threshold
PCT0.248 ng/mL
CLR47.52 mg/109
CRP48.32 mg/L
NLR6.51
Sensitivity
PCT95.4 (95%CI: 90.7-98.1)
CLR88.2 (95%CI: 81.9-92.8)
CRP87.5 (95%CI: 81.2-92.3)
NLR86.8 (95%CI:80.4-91.8)
Specificity
PCT95.7 (95%CI: 91.9-98.0)
CLR90.8 (95%CI: 86.0-94.4)
CRP90.3 (95%CI: 85.5-94.0)
NLR85.0 (95%CI:79.4-89.6)
Further findings
| Outcome | PCT | CRP | NLR |
|---|---|---|---|
| Bacteremia due to E. coli infection (subgroup) | |||
| Specificity | 100 | — not stated in the abstract | — not stated in the abstract |
| Sensitivity | — not stated in the abstract | — not stated in the abstract | 100 |
| Bacteremia due to non-Enterobacer infection (subgroup) | |||
| Sensitivity | — not stated in the abstract | 100 | — not stated in the abstract |
— not stated in the abstract
Bacteremia due to E. coli infection (subgroup)
- Sensitivities of PCT, CLR, CRP and NLR over 90%
Original publication
Diagnostic value of Procalcitonin, C-reactive protein-to-lymphocyte ratio (CLR), C-reactive protein and neutrophil-to-lymphocyte ratio (NLR) for predicting patients with Bacteraemia in the intensive care unit. J Crit Care. Published 13 February 2024. doi:10.
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