Serum Procalcitonin as an early marker of diabetic foot sepsis in Shebin Elkom Teaching hospital

Asmaa M Soliman, Fellow of Biochemistry National Nutrition Institute
Shimaa M W Kalama, Fellow of General Surgery Shebin El kom Teaching Hospital
Rania T H Gebba, MD of Clinical Pathology Shebin El kom Teaching Hospital
Randa I. Ahmed Elshiha, Fellow of Clinical Pathology National Nutrition Institute
Samah Mohammed Abdelmonem Abu sholaa, Msc, FEBR in diagnostic radiology Shebin El kom Teaching Hospital
Elham T Awwad, Professor of Medical Microbiology and Immunoogy Shebin El kom Teaching Hospital
Mohamed Ramzy Alawy, Fellow of Internal MedicineShebin El kom Teaching Hospital
Mohamed Abdel Samie Abdelkhalek Elbahat, Fellow of Vascular and Endovascular Surgery Shebin El kom Teaching HospitalFollow

Article Type

Original Study

Subject Area

Vascular surgery

Abstract

Background Diabetic foot infections are a serious consequence of diabetes mellitus, frequently resulting in major health problems such as amputation. Traditional diagnostic markers such as C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) have limitations, spurring more research into procalcitonin (PCT) as a possibly more reliable predictor of infection severity and consequences. Objectives To compare the efficacy of (PCT) to standard inflammatory indicators (ESR and CRP) in predicting outcomes of acute diabetic foot infections (DFI) and to determine its potential benefits in clinical settings. Patient and Methods A cross-sectional study was undertaken at Shebin Elkom Teaching Hospital between December 2023 and April 2024. Patients with acute DFI were classified using the Infectious Diseases Society of America (IDSA) standards. Data were collected from 122 diabetic patients, divided into four groups: (1) patients without diabetic foot (n=50), (2) patients with non-infected diabetic foot (n=36), (3a) patients with infected diabetic foot before debridement (n=36), and (3b) patients with infected diabetic foot after debridement. Comprehensive baseline data were collected, including demographic information, clinical characteristics, and laboratory assessments of blood glucose levels, HbA1c, CRP, PCT, ESR and routine parametes. Also CT and duplexes were done to exclude osteomylities and determine the degree of ulcer. Results PCT levels significantly differentiated between groups, with markedly elevated in patients with infected diabetic foot (Group 3a) compared to non-infected groups (Groups 1 and 2) and post-debridement groups (Group 3b), with statistical significance (p0.05 for several comparisons). Conclusions PCT and CRP are a more effective marker for predicting the severity of acute DFI compared to ESR and WBCs. Elevated PCT levels are strongly associated with severe infection and may guide clinical decision-making, especially in differentiating between infected and non-infected diabetic foot conditions.

IRB Number

HSH00073

Keywords

Serum Procalcitonin, early marker, diabetic foot sepsis

Recommended Citation

Soliman, Asmaa M; Kalama, Shimaa M W; Gebba, Rania T H; Elshiha, Randa I. Ahmed; sholaa, Samah Mohammed Abdelmonem Abu; Awwad, Elham T; Alawy, Mohamed Ramzy; and Elbahat, Mohamed Abdel Samie Abdelkhalek (2024) "Serum Procalcitonin as an early marker of diabetic foot sepsis in Shebin Elkom Teaching hospital," Journal of Medicine in Scientific Research: Vol. 8: Iss. 2, Article 2.
DOI: https://doi.org/10.59299/2537-0928.1429