Ability of procalcitonin to diagnose bacterial infection and bacteria types compared with blood culture findings

Abstract

Procalcitonin (PCT) and C-reactive protein serve as biomarkers of infection in patients with sepsis/bacteremia. The present study assessed the clinical characteristics of 280 patients with suspected sepsis who were admitted to Tohoku Medical and Pharmaceutical University Hospital between January 2012 and December 2013. Among the patients, 133 and 147 were positive and negative for PCT, respectively. Patients who were PCT positive were older and more frequently male, had reduced levels of platelets and albumin, and increased levels of aspartate aminotransferase, alanine aminotransferase, blood urea nitrogen, creatinine, and C-reactive protein. Patients who were PCT positive had significantly higher blood culture positivity compared with those who were PCT negative, and the sensitivity and specificity of PCT for detecting positive blood cultures were 74.5% and 59.1%, respectively. Escherichia coli was detected in PCT-positive patients, whereas Staphylococcus epidermidis and Staphylococcus lugdunensis were frequently detected in PCT-negative patients. Levels of PCT were higher in the patients infected with gram-negative rods than those with gram-positive cocci. Furthermore, extended-spectrum β-lactamase (ESBL)-producing bacteria cases showed higher levels of PCT than those of non-ESBL cases. These results suggest that PCT may be a useful biomarker of sepsis, and it might serve as a strong tool to detect patients with severe gram-negative rod bacteremia including ESBL-producing bacteria cases early due to its relative high sensitivity.

The effect of malaria rapid diagnostic tests results on antimicrobial prescription practices of health care workers in Burkina Faso

“…Although viral febrile infections do not need antibiotic treatment, they can also be a cause of over prescriptions as there is fear of overlooking potential bacterial infections. A rapid diagnostic test (or combination of tests) that can broadly differentiate between bacterial and viral infections would be very helpful in this respect [37–39].…”

Mechanisms and Managements of Influenza and its Related Pneumonia

“…Pneumonia caused by the involvement of bacterial infections (influenza virus-associated bacterial pneumonia). [7][8][9] Known risk factors for these forms of pneumonia or susceptibility to aggravation include aging, underlying pulmonary disease, diabetes, obesity, and pregnancy, which are also listed in the several guidelines (Table 1). [1][2][3] Primary influenza viral pneumonia is caused by viruses alone and is commonly referred to as pure viral pneumonia.…”

“…We have also confirmed the aggravation of such infections in an experiment conducted using a mouse model of co-infection by pneumococci and Haemophilus influenzae. 8,[16][17][18] Moreover, influenza virus-associated bacterial pneumonia is characterized by a high prevalence of coinfection by Staphylococcus aureus. 2,3 This is thought to be attributable to the bacterial protease of Staphylococcus aureus, which promotes the cleavage of surface protein hemagglutinin (HA) on influenza virus, leading to viral activation.…”

A Novel Combination of Biomarkers to Herald the Onset of Sepsis Prior to the Manifestation of Symptoms

“…In patients whose PCT scores exceeded the cutoff for suspicion of sepsis, the most common bacteria isolated from their blood were Escherichia coli including extended-spectrum beta-lactamase types, Klebsiella pneumoniae and varieties of Staphylococcus . Higher PCT levels correlated with Gram-negative rods, which release LPS and thus directly trigger symptoms of sepsis ( 34 ). In addition, antibiotic-resistant bacteria appeared to induce higher levels of PCT than either Gram-positive cocci or Gram-negative rods, and increased levels were also associated with increased bacteremia and sepsis symptoms ( 34 ).…”

“…Higher PCT levels correlated with Gram-negative rods, which release LPS and thus directly trigger symptoms of sepsis ( 34 ). In addition, antibiotic-resistant bacteria appeared to induce higher levels of PCT than either Gram-positive cocci or Gram-negative rods, and increased levels were also associated with increased bacteremia and sepsis symptoms ( 34 ).…”