Diagnostic and prognostic performances of serum procalcitonin in patients with bloodstream infections: A parallel, case-control study comprising adults and elderly

Shokouhi, Behrooz; Bookani, Kaveh Rezaei; Ghasemi, Hossein Ali; Khalouei, Mahmoud; Rezaei, Naghmeh Javanshir; Samani, Simin

doi:10.1590/1806-9282.63.06.521

Cited by 7 publications

(16 citation statements)

References 37 publications

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Section: Discussionmentioning

confidence: 99%

“…In recent years, multiple studies have been regulated in detecting the role of inflammatory mediators in diagnosing sepsis in severely ill trauma patients. In miscellaneous studies, the mean age of significantly ill traumatic patients suffering from sepsis ranged from 40 to 71 years, making it prevalent in the middle-aged and elderly population [4,8,10,11]. Sepsis in sufferers of trauma displayed genetic affinity towards males compared to females [8,10,11].…”

Section: Discussionmentioning

confidence: 99%

“…In numerous studies, levels of PCT, C-reactive protein (CRP), neutrophil-lymphocyte ratio (NLR), and total leukocyte count (TLC) were significantly elevated in patients with positive bacterial growth cultures compared to negative cultures [4,8,11]. Escherichia coli and Staphylococcus aureus were prominently isolated organisms within cultures reported by various studies [4,8]. In a study conducted by Zheng et al, the accuracy of inflammatory markers in diagnosing sepsis was compared within patients suffering from hospital-acquired pneumonia (HAP), and among those with no infection, the levels of PCT, CRP, NLR, and TLC were raised prominently in patients with HAP along with frequent admissions in ICUs and comorbidities, while the increased frequency of malignancies was suffered by patients with no infections.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, skin contamination may mislead physicians in some cases [7]. As a result, because the ambiguous omission of sepsis from the differential diagnosis list in acute stages is undesirable, the use of empiric antibiotics is typically unavoidable and has untoward consequences [8].…”

Section: Introductionmentioning

confidence: 99%

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Accuracy of Procalcitonin Levels for Diagnosis of Culture-Positive Sepsis in Critically Ill Trauma Patients: A Retrospective Analysis

Bakhtiar¹,

Kazmi²,

Asghar³

et al. 2021

Cureus

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Background Abdominal trauma and intra-abdominal sepsis are associated with significant morbidity and mortality. Microcirculation in the gut is disrupted in hemorrhagic and septic shock leading to tissue hypoxia, and the damaged gut acts as a reservoir rich in inflammatory mediators and provides a continual source of inflammation to the systemic circulation leading to sepsis. Sepsis is defined as the presence (probable or documented) of infection together with a systemic inflammatory response to infection. Blood culture is commonly considered to be the preferred approach for diagnosing sepsis, although it is time-consuming, that is, reports are normally available only after 12-48 hours. Procalcitonin levels (PCT) have recently emerged as a promising biomarker in the diagnosis of sepsis. The aim of the present study is to determine the diagnostic accuracy of PCT levels in predicting sepsis in critically ill trauma patients. Methodology This was designed as a validation study conducted in the Indoor Department of General Surgery, Liaquat National Hospital, Karachi. The sample size was calculated by taking the estimated frequency of sepsis in suspected patients at 62.13%, expected sensitivity of PCT at 70.83%, and specificity at 84.21% and the desired precision level of 12% for sensitivity; the calculated sample size was 96. The non-probability consecutive sampling method was used to recruit participants who were diagnosed with sepsis on clinical assessment. Blood culture samples were sent for the enrolled patients and a final diagnosis was made on the blood culture report. PCT levels were measured in these suspected patients on the same day of sending blood culture. Diagnostic accuracy of PCT size was measured using the receiver operating characteristic (ROC) curve. ROC curve was formulated for PCT levels against culture-proven sepsis to determine the ideal cut-off value of PCT levels. Two different cut-offs were determined to obtain the highest sensitivity and highest specificity accordingly. Results A total of 97 individuals met the inclusion criteria with a mean age of 34.89 ± 10.52 years. Mean PCT levels were 0.96 ± 0.59, with a gender predilection towards females (p < 0.001). No age difference was documented among gender (p = 0.655). The mean duration of intensive care unit stay was 11.73 ± 3.56 days. Culture-proven sepsis was identified in 67.0% of the study participants with a higher PCT level (p < 0.001). Among the 52.6% males included in the study, half were reported to have culture-positive sepsis, but among the 47.4% females culture was positive in 87% (p < 0.001). ROC revealed PCT was predictive for culture-positive sepsis at a cut-off value 0.47 ng/mL (p < 0.001), with a sensitivity of 92.3%, specificity of 68.7%, positive predictive value (PPV) of 85.7%, and negative predictive value (NPV) of 81.5%. By increasing the cut-off value to 0.90 ng/mL at area under the curve of 0.816, the specificity increased to 81.3% and sensitivity became 66.2%, ...

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Accuracy of Procalcitonin Levels for Diagnosis of Culture-Positive Sepsis in Critically Ill Trauma Patients: A Retrospective Analysis

Bakhtiar¹,

Kazmi²,

Asghar³

et al. 2021

Cureus

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“…Four papers focused on patients with speci c sepsis, such as patients with acute abdominal sepsis [37] , ventilator-associated pneumonia [47] , and postoperative sepsis [45,62] . Two articles addressed elderly patients with sepsis (aged > 65 [55] and > 85 years [60] ), whereas another study [52] included patients aged ≤ 65 and > 65 years. Two studies [18,33] reported separately cases of positive and negative blood cultures.…”

Section: Study Characteristicsmentioning

confidence: 99%

Diagnostic value of neutrophil CD64, procalcitonin, and interleukin-6 in sepsis: A meta-analysis

Wang

Cong

et al. 2020

Preprint

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The aim of the study was to conduct a meta-analysis to evaluate the accuracy of neutrophil CD64, procalcitonin (PCT), and interleukin-6 (IL-6) for the diagnosis of sepsis. The sample articles were searched in various databases to collect published studies on the diagnosis of sepsis by neutrophil CD64, PCT, and IL-6. By using the Stata SE 15.0 software, forest plots and the area under the summary receiver operating characteristic curves were drawn. The pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic odds ratio, and area under the curve (AUC) were calculated. 54 articles were included in the study. The number of studies that evaluated the diagnostic value of neutrophil CD64, PCT, and interleukin-6 were 20, 39, and 15, respectively. The pooled sensitivity, specificity, and AUC of neutrophil CD64 for the diagnosis of sepsis were 0.88 [95% confidence interval (CI), 0.81–0.92], 0.88 (95% CI, 0.83–0.91), and 0.94 (95% CI, 0.91–0.96), respectively. The pooled sensitivity, specificity, and AUC of PCT for the diagnosis of sepsis were 0.82 (95% CI, 0.78–0.85), 0.78 (95% CI, 0.74–0.82), and 0.87 (95% CI, 0.83–0.89), respectively. Subgroup analysis showed that the AUC for PCT diagnosis of intensive care unit (ICU) sepsis was 0.86 (95% CI, 0.83–0.89) and the AUC for PCT diagnosis of non-ICU sepsis was 0.82 (95% CI, 0.78–0.85). The pooled sensitivity, specificity, and AUC of IL-6 for the diagnosis of sepsis were 0.72 (95% CI, 0.65–0.78), 0.70 (95% CI, 0.62–0.76), and 0.77 (95% CI, 0.73–0.80), respectively. Of the three biomarkers studied, neutrophil CD64 showed the highest diagnostic value for sepsis, followed by PCT, and IL-6. On the other hand, PCT showed a better diagnostic value for the diagnosis of sepsis in patients with severe conditions compared with that in patients with non-severe conditions.

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Investigation of procalcitonin and beta‐defensin2 in the serum and feces of dogs with acute diarrhea

Neumann

Steingräber

Herold

2022

Veterinary Clinical Pathol

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Background Acute diarrhea is a common clinical condition where clinical parameters are used to assess disease severity, course, and prognosis. Objectives The aim of this study was to investigate procalcitonin (PCT) and beta‐defensin2 (Bdef2) as biomarkers for disease severity, course, and prognosis of dogs with acute diarrhea. Methods Dogs with acute diarrhea (enteritis group [EG], n = 35) were compared with 30 healthy controls. The dogs in the EG were scored using the Canine Acute Diarrhea Severity (CADS) index and grouped by bacterial fecal culture results. Procalcitonin and Bdef2 were analyzed in serum and feces. Results Dogs with acute diarrhea showed higher serum PCT concentrations (P < 0.0001) and lower fecal Bdef2 concentrations (P = 0.0001) than unaffected dogs. Serum PCT was moderately and positively related to the extent of disease classified by the CADS score. Dogs with Clostridium perfringens or hemolyzing Escherichia coli as predominant pathogen had increased serum Bdef2 concentrations (P < 0.01). Differentiation between uncomplicated (≤3 days) and complicated (>3 days) disease courses, determined by receiver operating characteristic (ROC) curves, resulted in a sensitivity of 0.74 and a specificity of 0.69 for serum PCT at a cutoff of 3.9 ng/mL. The serum PCT and fecal Bdef2 quotient resulted in a sensitivity of 0.80 and a specificity of 0.92, with a cutoff of 80.5. Conclusions The results of the present study indicate that PCT and Bdef2 are potential biomarkers that can provide information on the severity, course, and prognosis of acute diarrhea in dogs.

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Diagnostic and prognostic performances of serum procalcitonin in patients with bloodstream infections: A parallel, case-control study comprising adults and elderly

Cited by 7 publications

References 37 publications

Accuracy of Procalcitonin Levels for Diagnosis of Culture-Positive Sepsis in Critically Ill Trauma Patients: A Retrospective Analysis

Accuracy of Procalcitonin Levels for Diagnosis of Culture-Positive Sepsis in Critically Ill Trauma Patients: A Retrospective Analysis

Diagnostic value of neutrophil CD64, procalcitonin, and interleukin-6 in sepsis: A meta-analysis

Investigation of procalcitonin and beta‐defensin2 in the serum and feces of dogs with acute diarrhea

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