Role of procalcitonin in the fight against bacterial resistance. The case of the Cliniques Universitaires de Lubumbashi

Introduction. Procalcitonin, one of the precursors of calcitonin, is a peptide of 116 amino acids. Procalcitonin circulates in very low quantities (˂ 0.05 ng/ml) in the blood of healthy subjects, and is secreted mainly by the para-follicular cells of the thyroid gland. In the absence of high-performance diagnostics that can rapidly identify the etiology of fever, and given the high morbidity and mortality associated with delayed antimicrobial treatment of bacterial infection, it is necessary to diagnose with procalcitonin in order to institute preventive treatment before bacterial culture and antibiotic susceptibility testing. 

Objective. The aim of our study was to contribute to the improvement of the health of the population through a better knowledge of the use of procalcitonin in the fight against bacterial resistance in the laboratory of the Cliniques Universitaires de Lubumbashi. 

Methodology. This was a cross-sectional descriptive study, with prospective data collection over a one-year period. Our sample size was 49 patients selected on the basis of our inclusion and non-inclusion criteria. 

Results. The maximum procalcitonin value was 16.88 ng/ml with a minimum value of 0.1 ng/ml, giving a range of over 16.78 ng/ml. Escherichia coli was the most isolated germ, with a percentage of over 30%. A high rate of resistance to aminopenicillins was recorded (amoxicillin 92% and ampicillin 80%).

Conclusion. Procalcitonin alone does not appear to be the absolute diagnostic marker of bacterial infection, and it is therefore necessary to combine it with other parameters to confirm the bacterial origin of an infection. PCT release is part of the host's response to aggression. Any situation generating inflammation with systemic repercussions appears to be a source of elevated PCT.