Hepcidin vs Procalcitonin: Which biomarker best predicts bacteremia in the medical ICU?

Sepsis is a life-threatening condition caused by a dysregulated host response to infection, necessitating early diagnosis and intervention. While traditional diagnostics like blood cultures are crucial, they often delay treatment decisions. This study evaluates and compares the diagnostic and prognostic efficacy of Procalcitonin (PCT) and Hepcidin-two emerging biomarkers-in patients with bacteremia admitted to the Medical Intensive Care Unit (MICU) of a tertiary care centre.

A prospective, analytical study was conducted on 86 blood culture-positive MICU patients at SRM Medical College Hospital and Research Centre, Chennai. Serum PCT and Hepcidin levels were measured using Chemiluminescent Microparticle Immunoassay (CMIA) and sandwich ELISA techniques, respectively. The diagnostic value of each biomarker was assessed, and statistical analysis was performed using Chi-square tests with p < 0.05 considered significant.

Serum Hepcidin and PCT levels were elevated in 84.8 % and 82.6 % of sepsis patients, respectively, with statistically significant associations (p < 0.05). Hepcidin showed a more consistent and gradual decline during recovery (96 % normalization) compared to PCT (77 % normalization). Both biomarkers correlated strongly with microbial profiles, particularly in Gram-negative infections, and demonstrated no significant variation with patient demographics or comorbidities.

Hepcidin emerges as a promising biomarker, demonstrating diagnostic and prognostic potential comparable to PCT, with a more consistent response during sepsis resolution. When used in conjunction, these markers can enhance early detection, guide treatment, and improve clinical outcomes in sepsis management.