Diagnostic and prognostic role of procalcitonin (<scp>PCT</scp>) and <scp>MR</scp>‐pro‐Adrenomedullin (<scp>MR</scp>‐pro<scp>ADM</scp>) in bacterial infections

Angeletti, Silvia; Spoto, Silvia; Fogolari, Marta; Cortigiani, Marco; Fioravanti, Marta; Florio, Lucía; Curcio, B; Cavalieri, Danilo; Costantino, Sebastiano; Dicuonzo, Giordano

doi:10.1111/apm.12406

Cited by 64 publications

(60 citation statements)

References 36 publications

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“…A diagnostic index with good sensitivity and specificity is highly essential in clinical settings to detect intracranial infection and guide clinicians to take necessary interventions, improve the prognosis of patients, and reduce the hospitalization time and economic burden. PCT has been widely studied in recent years for the early diagnosis of bacterial infection severity, treatment effect, disease prognosis and as reference for antibiotic use (24 –26). …”

Section: Discussionmentioning

confidence: 99%

Diagnostic and prognostic value of procalcitonin for early intracranial infection after craniotomy

2017

Braz J Med Biol Res

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Intracranial infection is a common clinical complication after craniotomy. We aimed to explore the diagnostic and prognostic value of dynamic changing procalcitonin (PCT) in early intracranial infection after craniotomy. A prospective study was performed on 93 patients suspected of intracranial infection after craniotomy. Routine peripheral venous blood was collected on the day of admission, and C reactive protein (CRP) and PCT levels were measured. Cerebrospinal fluid (CSF) was collected for routine biochemical, PCT and culture assessment. Serum and CSF analysis continued on days 1, 2, 3, 5, 7, 9, and 11. The patients were divided into intracranial infection group and non-intracranial infection group; intracranial infection group was further divided into infection controlled group and infection uncontrolled group. Thirty-five patients were confirmed with intracranial infection after craniotomy according to the diagnostic criteria. The serum and cerebrospinal fluid PCT levels in the infected group were significantly higher than the non-infected group on day 1 (P<0.05, P<0.01). The area under curve of receiver operating characteristics was 0.803 for CSF PCT in diagnosing intracranial infection. The diagnostic sensitivity and specificity of CSF PCT was superior to other indicators. The serum and CSF PCT levels have potential value in the early diagnosis of intracranial infection after craniotomy. Since CSF PCT levels have higher sensitivity and specificity, dynamic changes in this parameter could be used for early detection of intracranial infection after craniotomy, combined with other biochemical indicators.

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Section: Discussionmentioning

confidence: 99%

Diagnostic and prognostic value of procalcitonin for early intracranial infection after craniotomy

2017

Braz J Med Biol Res

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“…In a landmark study of Angeletti et al[42] level of PCT and mid-regional pro-adrenomedullin (MR-proADM) were found to be significantly higher in patients with sepsis caused by Gram-negative than Gram-positive strains. These data are also confirmed by other studies[43-45].…”

Section: Discussionmentioning

confidence: 99%

Presepsin teardown - pitfalls of biomarkers in the diagnosis and prognosis of bacterial infection in cirrhosis

Papp¹,

Tornai²,

Vitális³

et al. 2016

WJG

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AIMTo evaluate the diagnostic and prognostic value of presepsin in cirrhosis-associated bacterial infections.METHODSTwo hundred and sixteen patients with cirrhosis were enrolled. At admission, the presence of bacterial infections and level of plasma presepsin, serum C-reactive protein (CRP) and procalcitonin (PCT) were evaluated. Patients were followed for three months to assess the possible association between presepsin level and short-term mortality.RESULTSPresent 34.7 of patients had bacterial infection. Presepsin levels were significantly higher in patients with infection than without (median, 1002 pg/mL vs 477 pg/mL, P < 0.001), increasing with the severity of infection [organ failure (OF): Yes vs No, 2358 pg/mL vs 710 pg/mL, P < 0.001]. Diagnostic accuracy of presepsin for severe infections was similar to PCT and superior to CRP (AUC-ROC: 0.85, 0.85 and 0.66, respectively, P = NS for presepsin vs PCT and P < 0.01 for presepsin vs CRP). At the optimal cut-off value of presepsin > 1206 pg/mL sensitivity, specificity, positive predictive values and negative predictive values were as follows: 87.5%, 74.5%, 61.8% and 92.7%. The accuracy of presepsin, however, decreased in advanced stage of the disease or in the presence of renal failure, most probably because of the significantly elevated presepsin levels in non-infected patients. 28-d mortality rate was higher among patients with > 1277 pg/mL compared to those with ≤ 1277 pg/mL (46.9% vs 11.6%, P < 0.001). In a binary logistic regression analysis, however, only PCT (OR = 1.81, 95%CI: 1.09-3.01, P = 0.022) but neither presepsin nor CRP were independent risk factor for 28-d mortality after adjusting with MELD score and leukocyte count.CONCLUSIONPresepsin is a valuable new biomarker for defining severe infections in cirrhosis, proving same efficacy as PCT. However, it is not a useful marker of short-term mortality.

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“…Angeletti et al (66) studied the behavior of PCT and MR-proADM at income and evolutionarily biomarkers in a group of patients with sepsis and one with localized infection. They evaluated the diagnostic capacity, response to antibiotics and prognostic value of these biomarkers individually and combined.…”

Section: Utility Of Pct and Mr-proadm Combined In The Diagnosis And Pmentioning

confidence: 99%

New role of biomarkers: mid-regional pro-adrenomedullin, the biomarker of organ failure

et al. 2016

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Mid-regional pro-adrenomedullin (MR-proADM) has a good biomarker profile: its half-life is several hours, and its plasma concentrations can be determined in clinical practice, it is essentially irrelevant, but proportionally represents the levels and activity of adrenomedullin (ADM). ADM synthesis is widely distributed in tissues, including bone, adrenal cortex, kidney, lung, blood vessels and heart. Its fundamental biological effects include vasodilator, positive inotropic, diuretic, natriuretic and bronchodilator. It has been described high levels in septic patients, interacting directly with the relaxation of vascular tone, triggering hypotension of these patients. It is also found high levels in other diseases such as hypertension, heart failure, respiratory failure, renal failure, cirrhosis and cancer. MR-proADM has been identified as a prognostic marker, stratifying the mortality risk in patients with sepsis in emergency department (ED) and ICU. Evolutionary MR-proADM levels and clearance marker to the 2nd-5th days of admission help to determine the poor performance and the risk of mortality in patients with severe sepsis admitted to the ICU. The MR-proADM levels are more effective than procalcitonin (PCT) and C-reactive protein (CRP) levels to determine an unfavorable outcome and the risk of mortality in patients with sepsis admitted to the ICU. It has also proved useful in patients diagnosed with organ dysfunction of infectious etiology. MR-proADM levels are independent of the germ conversely it is related to the magnitude of organ failure and therefore severity. We consider advisable incorporating the MR-proADM the panel of biomarkers necessary for the diagnosis and treatment of critically ill patients admitted to the ICU with severe sepsis. The combined PCT and MR-proADM levels could represent a valid tool in the clinical practice to timely identify patients with bacterial infections and guide the diagnosis and treatment of sepsis and septic shock.

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Diagnostic and prognostic role of procalcitonin (PCT) and MR‐pro‐Adrenomedullin (MR‐proADM) in bacterial infections

Cited by 64 publications

References 36 publications

Diagnostic and prognostic value of procalcitonin for early intracranial infection after craniotomy

Diagnostic and prognostic value of procalcitonin for early intracranial infection after craniotomy

Presepsin teardown - pitfalls of biomarkers in the diagnosis and prognosis of bacterial infection in cirrhosis

New role of biomarkers: mid-regional pro-adrenomedullin, the biomarker of organ failure

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