Procalcitonin and C-reactive protein in differantiating to contamination from bacteremia

Öksüz, Lütfiye; Somer, Ayper; Salman, Nuran; Erk, Osman; Gürler, Nezahat

doi:10.1590/s1517-83822014000400036

Cited by 17 publications

(14 citation statements)

References 29 publications

(56 reference statements)

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“…The biofilm assay revealed that 94.3% (33/35) of the isolated P. mirabilis strains are biofilm producers. Our findings are consistent with those reported by Kwiecinska-Piróg 48 . The biofilm is one of the most important virulence determinants of bacteria.…”

Section: Discussionsupporting

confidence: 94%

atpD gene sequencing, multidrug resistance traits, virulence-determinants, and antimicrobial resistance genes of emerging XDR and MDR-Proteus mirabilis

Algammal

Hashem

Alfifi

et al. 2021

Sci Rep

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Proteus mirabilis is a common opportunistic pathogen causing severe illness in humans and animals. To determine the prevalence, antibiogram, biofilm-formation, screening of virulence, and antimicrobial resistance genes in P. mirabilis isolates from ducks; 240 samples were obtained from apparently healthy and diseased ducks from private farms in Port-Said Province, Egypt. The collected samples were examined bacteriologically, and then the recovered isolates were tested for atpD gene sequencing, antimicrobial susceptibility, biofilm-formation, PCR detection of virulence, and antimicrobial resistance genes. The prevalence of P. mirabilis in the examined samples was 14.6% (35/240). The identification of the recovered isolates was confirmed by the atpD gene sequencing, where the tested isolates shared a common ancestor. Besides, 94.3% of P. mirabilis isolates were biofilm producers. The recovered isolates were resistant to penicillins, sulfonamides, β-Lactam-β-lactamase-inhibitor-combinations, tetracyclines, cephalosporins, macrolides, and quinolones. Using PCR, the retrieved strains harbored atpD, ureC, rsbA, and zapA virulence genes with a prevalence of 100%, 100%, 94.3%, and 91.4%, respectively. Moreover, 31.4% (11/35) of the recovered strains were XDR to 8 antimicrobial classes that harbored blaTEM, blaOXA-1, blaCTX-M, tetA, and sul1 genes. Besides, 22.8% (8/35) of the tested strains were MDR to 3 antimicrobial classes and possessed blaTEM, tetA, and sul1genes. Furthermore, 17.1% (6/35) of the tested strains were MDR to 7 antimicrobial classes and harbored blaTEM, blaOXA-1, blaCTX-M, tetA, and sul1 genes. Alarmingly, three strains were carbapenem-resistant that exhibited PDR to all the tested 10 antimicrobial classes and shared blaTEM, blaOXA-1, blaCTX-M, tetA, and sul1 genes. Of them, two strains harbored the blaNDM-1 gene, and one strain carried the blaKPC gene. In brief, to the best of our knowledge, this is the first study demonstrating the emergence of XDR and MDR-P.mirabilis in ducks. Norfloxacin exhibited promising antibacterial activity against the recovered XDR and MDR-P. mirabilis. The emergence of PDR, XDR, and MDR-strains constitutes a threat alarm that indicates the complicated treatment of the infections caused by these superbugs.

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Section: Discussionsupporting

confidence: 94%

atpD gene sequencing, multidrug resistance traits, virulence-determinants, and antimicrobial resistance genes of emerging XDR and MDR-Proteus mirabilis

Algammal

Hashem

Alfifi

et al. 2021

Sci Rep

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“…Several studies found that PCT showed good discrimination between BSI and contamination with an AUC of 0.86 [22, 24]. Additionally, in a PCR diagnostic (SeptiFast) test, a PCT value of <0.37 ng/ml had a 99% negative predictive value for this assay [25].…”

Section: Introductionmentioning

confidence: 99%

Procalcitonin-guided diagnosis and antibiotic stewardship revisited

Sager

Kutz

Müeller

et al. 2017

BMC Med

235

181

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Several controlled clinical studies have evaluated the potential of the infection biomarker procalcitonin (PCT) to improve the diagnostic work-up of patients with bacterial infections and its influence on decisions regarding antibiotic therapy. Most research has focused on lower respiratory tract infections and critically ill sepsis patients. A clinical utility for PCT has also been found for patients with urinary tract infections, postoperative infections, meningitis, and patients with acute heart failure with possible superinfection (i.e., pneumonia). In these indications, PCT levels measured on hospital admission were found to substantially reduce the initiation of antibiotic treatment in low-risk situations (i.e., bronchitis, chronic obstructive pulmonary disease exacerbation). For more severe infections (i.e., pneumonia, sepsis), antibiotic stewardship by monitoring of PCT kinetics resulted in shorter antibiotic treatment durations with early cessation of therapy. Importantly, these strategies appear to be safe without increasing the risk for mortality, recurrent infections, or treatment failures. PCT kinetics also proved to have prognostic value correlating with disease severity (i.e., pancreatitis, abdominal infection) and resolution of illness (i.e., sepsis). Although promising findings have been published in these different types of infections, there are a number of limitations regarding PCT, including suboptimal sensitivity and/or specificity, which makes a careful interpretation of PCT in the clinical context mandatory. This narrative review aims to update clinicians on the strengths and limitations of PCT for patient management, focusing on research conducted within the last 4 years.

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“…PCT is an important acceptable biomarker during severe bacterial infections and sepsis (13). PCT can be used in not only diagnosis of infection but also in predicting severity of the underlying disease, treatment response and results (14,15). It has been stated in the literature that use of PCT for these purposes is more specific than CRP (16).…”

Section: Discussionmentioning

confidence: 99%

“…Although some studies have reported that PCT levels do not vary in presence of Gram negative and Gram positive agents, a larger number of studies have suggested that PCT levels increased more significantly in Gram negative infections (14). Inflammatory cascades are complicated processes in sepsis while Gram positive, Gram negative and fungal agents which play important roles in these processes may activate these cascades in distinct ways (16).…”

Section: Discussionmentioning

confidence: 99%

The Relationship Between Sepsis Foci and Procalcitonin Values in Intensive Care Patients

Kara¹,

Undar²,

Seven³

et al. 2020

Crit Intensive Care

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Background: Anatomic localizations of septic foci and the relationship between these localizations and procalcitonin (PCT) in the clinical picture of sepsis/septic shock induced by these foci is not a sufficiently investigated topic. We aimed to determine the relationship between sepsis foci and procalcitonin values in intensive care patients. Methods: Data of the patients who were admitted in the intensive care unit and diagnosed with sepsis/ septic shock between 2016 and 2018 were analyzed retrospectively. The patients were grouped based on the localization of the infectious foci as respiratory system, urinary system, blood-catheter, soft tissue and abdominal. Additionally, the patients were grouped also based on number of foci and growing microorganisms. Subsequently, the relationship between septic foci and routine laboratory parameters, primarily PCT, was investigated statistically. Results: Totally 630 infection periods were analyzed in 424 patients who were diagnosed with sepsis/septic shock in the intensive care unit. Incidence of sepsis/septic shock was 36.5% while mortality rate was 65.6% in these patients. A higher mortality rate was encountered in the infections with two or multiple foci (p <0.001). Multiple-focal infections revealed higher PCT values than the single focal infections (p = 0.021). A higher mortality rate was detected in the patients with microbial growth in the respiratory infections than those with urinary and abdominal infections (p <0.001). The patients with microbial growth reported from blood and abdominal cultures revealed higher PCT levels than other patients groups (p <0.001). Conclusions: Higher procalcitonin levels are related to presence of multiple foci of infection and, as well, to higher mortality rates.

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Procalcitonin and C-reactive protein in differantiating to contamination from bacteremia

Cited by 17 publications

References 29 publications

atpD gene sequencing, multidrug resistance traits, virulence-determinants, and antimicrobial resistance genes of emerging XDR and MDR-Proteus mirabilis

atpD gene sequencing, multidrug resistance traits, virulence-determinants, and antimicrobial resistance genes of emerging XDR and MDR-Proteus mirabilis

Procalcitonin-guided diagnosis and antibiotic stewardship revisited

The Relationship Between Sepsis Foci and Procalcitonin Values in Intensive Care Patients

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