An evaluation into the use of procalcitonin levels as a biomarker of bacterial sepsis to aid the management of intrapartum pyrexia and chorioamnionitis

Walker, S; Harding, I; Soomro, Kamran; Bamber, AR; Carrick, S; Waheed, AH; Liebling, RE

doi:10.1016/j.xagr.2022.100064

Cited by 3 publications

(30 citation statements)

References 31 publications

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“…Sepsis is a relatively common infectious disease that poses a serious threat to the quality of daily life and the health of patients. If timely diagnosis can be made at an early stage in patients with sepsis and early effective treatment can be taken for them, the treatment effect can be significantly improved and the morbidity and mortality rate of patients with sepsis can be reduced [ 17 ]. In the medical clinical tests for sepsis patients, the results of biological methods such as blood culture and urine culture are slow and therefore the degree of application is relatively low.…”

Section: Discussionmentioning

confidence: 99%

C-Reactive Protein, Procalcitonin, and a Novel Pathogenesis and Therapeutic Target of Thrombocytopenia in Sepsis

2022

Emergency Medicine International

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Objective. The aim of the study is to analyze the clinical characteristics, pathogen distribution, and drug sensitivity information of adult sepsis, and to provide reference for empirical clinical use; to explore the relationship between C-reactive protein (CRP) and calcitonin (PCT) The clinical value in the diagnosis of adult sepsis. Methods. We collected 455 cases of hospitalized patients with positive blood culture, including 352 cases with sepsis and 103 cases without sepsis; 1609 cases of hospitalized patients with suspected infection and negative blood culture, including 287 cases of sepsis, and 518 cases of non-infectious systemic inflammatory response syndrome (SIRS) and 804 cases of local infection. Age, gender, route of admission, admission status, CRP, PCT, and white blood cell (WBC) levels were collected from the patients. The differences between the factors were statistically analyzed, and the receiver operating characteristic curve (ROC curve) was plotted to obtain the optimal cut-off values of CRP and PCT and their area under the curve (AUC), and to compare the CRP, PCT and PCT, and the CRP + PCT tandem to diagnose sepsis sensitivity and specificity. Results. (1) 387 pathogenic strains were isolated from blood cultures of patients with sepsis, 71.06% Gram-negative, 26.87% Gram-positive and 2.07% fungi. (2) Among Gram-positive bacteria, Staphylococcus aureus was 87.5% resistant to penicillin and sensitive to vancomycin, milantropine, and teicoplanin; among Gram-negative bacteria, Escherichia coli was resistant to piracillin The resistance rate was 73.1%, fully susceptible to viraemia (100%) and resistant to imipenem, amikacin, and lacillin/tazole. (3) Among patients with positive blood cultures, CRP and PCT levels were higher in patients with sepsis than in those without sepsis. Pairwise comparison of ROC curves showed that the diagnostic value of PCT was greater than that of CRP ( P = 0.016 ). Conclusion. CRP and PCT have a good reference value for diagnosis of sepsis patients and determination of the degree of infection in septic patients, especially PCT is more valuable for diagnosis of sepsis.

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Section: Discussionmentioning

confidence: 99%

C-Reactive Protein, Procalcitonin, and a Novel Pathogenesis and Therapeutic Target of Thrombocytopenia in Sepsis

2022

Emergency Medicine International

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“…UHBW ethics committee approved the research and the department provided the funding. 10 All neonates born to women treated for suspected intrapartum sepsis over a 4-month period (June-October 2020) were included in the study. At UHBW all neonates born to women treated for suspected intrapartum sepsis routinely have blood collected within an hour of birth for full blood count, CRP, and blood cultures and intravenous antibiotics are commenced, 10 according to local and national guidelines.…”

Section: Methodsmentioning

confidence: 99%

“…To investigate PCT levels in full-term neonates managed for suspected EOS due to probable maternal intrapartum sepsis and to determine if PCT could be utilized to optimize diagnosis and management. 10…”

Section: Study Objectivementioning

confidence: 99%

“…8.9,10 In sepsis, biomarkers can play a role to provide a timely diagnosis, differentiate from other noninfectious inflammatory pathologies, predict clinical severity, and guide antibiotic management. 10 C-reactive protein (CRP) which is known to be highly nonspecific for infection versus inflammation, is the most frequently employed biomarker used in the neonatal population. 10,11,5 There are large numbers of asymptomatic neonates (with risk factors such as maternal intrapartum pyrexia) who undergo investigations and receive longer courses of antibiotics because of a raised CRP.…”

Section: Introductionmentioning

confidence: 99%

“…PCT also has a short half-life, helping guide antibiotic therapy and monitor response. 10,14,15 The use of PCT levels for neonatal sepsis is controversial and reference values in neonates are yet to be established. 15 PCT levels can increase physiologically during the first few days of life, which interfere with the interpretation of PCT levels.…”

Section: Introductionmentioning

confidence: 99%

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An Evaluation into Procalcitonin Levels in Full-Term Neonates Managed for Suspected Early Onset Sepsis due to Probable Maternal Intrapartum Sepsis

Walker

Hettiarachchi²,

Soomro

et al. 2023

Journal of Neonatology

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Purpose To investigate procalcitonin (PCT) levels in full-term neonates managed for suspected early onset sepsis (EOS) due to probable maternal intrapartum sepsis. Methods Prospective longitudinal observational study at University Hospitals of Bristol NHS Foundation trust. Included were a total of 117 neonates managed for suspected EOS from June to October 2020. In addition to routine full-blood-counts and c-reactive protein (CRP) tests, serum PCT levels were also measured as part of the septic screen and follow-up blood tests. Placentas were sent for histopathology analysis. Neonatal parameters were used to categorize cases into: “high-suspicion bacterial sepsis (BS),” “equivocal BS” and “low-suspicion BS.” Statistical test Kruskal-Wallis compared categories with biomarker values and placental histopathology scores. Results A higher percentage of PCT levels showed elevation in comparison to CRP levels in the initial testing (55.3% versus 5.9%) and follow-up testing (98.9% versus 35%). There was a significant difference between the “low-suspicion BS” and “high-suspicion BS” categories for both the initial and follow-up PCT results. 71.2% of placentas showed varying degrees of chorioamnionitis. Conclusion This study provides evidence to the physiological rise in PCT during the first few days of life. The significant difference in PCT levels according to clinical severity shows that PCT could be utilized in calculating odds for EOS, but as a standalone test will have limited use.

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Evaluation of Puerperal and Postpartum Infections after Cesarean Section and Their Clinical Outcomes

Feruza,

Wang

2023

OJIM

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Puerperal and postpartum infections after cesarean section are a leading cause of maternal and neonatal morbidity and mortality worldwide. Postpartum infections account for a significant, and often preventable, portion of the global healthcare burden. Puerperal sepsis is one of the top five causes of maternal deaths worldwide and accounts for 10% -15% of deaths in the postpartum period. Postpartum infections also present a significant social burden: they increase maternal anxiety and the risk of postpartum depression, interfere with bonding, and negatively impact breastfeeding. To prevent complications and improve outcomes, the evaluation of these infections must be accurate and prompt. This review provided a summary of causes, clinical presentation, laboratory tests, imaging modalities, treatment options, complications, and prognosis of puerperal and postpartum infections following cesarean section. Future directions in the evaluation of these infections were also discussed, including the development of novel diagnostic assays, the use of point-of-care testing and risk factors responsible for the onset of infections. This review emphasized the significance of early diagnosis and prompted treatment of these infections in order to prevent complications and enhance maternal and neonatal outcomes. This article also provided an exhaustive overview of the evaluation and management of puerperal and postpartum infections and the clinical outcome of infections for both mother and neonate.

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An evaluation into the use of procalcitonin levels as a biomarker of bacterial sepsis to aid the management of intrapartum pyrexia and chorioamnionitis

Cited by 3 publications

References 31 publications

C-Reactive Protein, Procalcitonin, and a Novel Pathogenesis and Therapeutic Target of Thrombocytopenia in Sepsis

C-Reactive Protein, Procalcitonin, and a Novel Pathogenesis and Therapeutic Target of Thrombocytopenia in Sepsis

An Evaluation into Procalcitonin Levels in Full-Term Neonates Managed for Suspected Early Onset Sepsis due to Probable Maternal Intrapartum Sepsis

Evaluation of Puerperal and Postpartum Infections after Cesarean Section and Their Clinical Outcomes

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