Diagnostic Markers for Identifying Sepsis in Patients with Systemic Inflammatory Response Syndrome (SIRS): A Prospective Study

Pavāre, Jana; Grope, Ilze; Eihvalde, Linda; Gardovska, Dace

doi:10.2174/1874309900903010001

Cited by 7 publications

(3 citation statements)

References 31 publications

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“…Pavare J et al, demonstrated 50% positive culture. 15 In present study authors analyzed the acute phase reactants like CRP, procalcitonin in differentiating between culture positive and culture negative group at 0 hours and 24hours after admission. Procalcitonin had the best sensitivity and specificity among two.…”

Section: Discussionmentioning

confidence: 99%

Study of serum levels of CRP and procalcitonin as early marker of sepsis in children with sepsis above neonatal age group

Kumar¹,

Neelannavar²

2019

Int J Contemp Pediatr

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Background: Sepsis caused by infection remains a major cause of mortality and morbidity among children. Blood culture though gold standard requires lot of time for diagnosis, hence it’s necessary to rely on early diagnostic markers such as blood counts, micro-ESR, CRP, Procalcitonin. The objective of this study is to evaluate the serum levels of CRP, Procalcitonin as reliable and as early marker of sepsis in pediatric patients above neonatal age group.Methods: Children aged above neonatal age group with clinically suspected sepsis as per the definition given by the International Paediatric sepsis Consensus Conference were selected. Patients were classified as those with sirs, sepsis, severe sepsis and septic shock. Patients were divided into two groups one with culture proven sepsis and the other with non-culture proven sepsis. All patients had CRP, Procalcitonin levels measured at admission and 24hrs after admission. The primary outcome was to determine reliable marker in differentiating between the culture proven and non-culture proven sepsis, and to determine the early marker of sepsis.Results: Total 104 patients formed the study group, of which 42 belonged to SIRS group, 26 were sepsis, 19 were severe sepsis and 17 were septic shock. A total of 36 cases had culture positive. In present study PCT was found to be more reliable marker of sepsis as the sensitivity and specificity of PCT was more than CRP and AUC for PCT was significantly higher than CRP. PCT was found to be early marker as the AUC for CRP at 24hrs was significantly more than AUC for CRP at admission and there was no statistically significant difference between AUC for PCT at admission and 24 hours after admission.Conclusions: Both CRP and PCT levels have favourable test performance but PCT is more reliable. PCT is earlier to rise compared to CRP.

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Section: Discussionmentioning

confidence: 99%

Study of serum levels of CRP and procalcitonin as early marker of sepsis in children with sepsis above neonatal age group

Kumar¹,

Neelannavar²

2019

Int J Contemp Pediatr

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“…12 Mengingat hasil kultur yang lama sementara penderita perlu penanganan yang cepat dan tepat agar tidak jatuh dalam keadaan yang lebih berat, maka perlu ada pemeriksaan yang dapat menentukan dengan cepat penyebab sepsisnya. 13 Petunjuk yang sering digunakan sebagai petanda sepsis antara lain procalcitonin (PCT) dan interleukin-6 (IL-6). 8,14,15 PCT merupakan prohormon calcitonin yang dihasilkan oleh sel C kelenjar tiroid, yang terdiri dari 116 asam amino dan 3 peptida.…”

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Procalcitonin Dan Interleukin-6 Pada Sepsis Dengan Gejala Systemic Inflammatory Response Syndrome (Sirs)

Ks¹,

Dm²,

Emma³

2018

Indonesian J. Clin. Pathol. Med. Lab.

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Sepsis is the cause of patient’s death in the intensive care unit. Sepsis is an inflammatory response to infections. Infection whencontinued can cause systemic inflammatory response syndrome (SIRS). Clinical signs and pathology of SIRS are similar to sepsis, thusclinical as well as laboratory examination is needed to distinguish these. Culture result usually can be seen at least 24 hours aftersampling. In this case a test is needed to diagnose sepsis quickly so that the patient does not experience more severe conditions. Theindicator used in the diagnostic procedure is to know the diagnostic value of procalcitonin (PCT) levels as well as of interleukin-6 (IL-6)for the diagnosis of sepsis. Thirty-two blood samples of patients treated in the Department of SIRS. Dr. Kariadi Semarang were takenconsecutively from November 2011 up to January 2012. PCT levels are determined by ELFA, levels of IL-6 were determined by ELISAmethod. To determine the sensitivity, specificity, positive predictive value and negative predictive value, 2 × 2 table was used. The ROCcurve (receiver operating characteristic) showed an area under the curve of PCT of 0.83 (95% CI = 0.66 to 0.99), cut-off 5.1 ng/mL wasused as an indicator of sepsis. PCT diagnostic test results showed 88.9% sensitivity, 73.9% specificity, 57.1% positive predictive value andnegative predictive value of 94.4%. The area under the curve for IL-6 was 0.67 (95% CI = 0.47 to 0.86), cut off 47.2 pg/mL as an indicatorof sepsis. Diagnostic tests results showed 77.8% sensitivity, 60.9% specificity, 43.7% positive predictive value and negative predictive valueof 87.5%. It can be concluded that the examination of serum PCT levels can be used as a diagnostic test (screening test) for sepsis.

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“…4,5 Pada infeksi bakteri, terjadi pelepasan sitokin inflamasi, seperti tumor necrosis factor (TNF)-, Interleukin (IL)-1 , IL-8, dan IL-6, 6 yang akan mencetuskan produksi Creactive protein oleh hepatosit yang dapat ditemukan dalam darah. [7][8][9] C-reactive protein berperan penting pada respon imun innate dan telah dikenal merupakan salah satu petanda inflamasi. Individu tanpa inflamasi biasanya memiliki kadar CRP <1 mg/L, kadar CRP bisa meningkat sampai 100 kali lipat nilai normal pada kasus inflamasi akut, seperti infeksi, trauma, keganasan dan pembedahan.…”

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High Sensitivity C-Reactive Protein sebagai Parameter Diagnostik dan Prediktor Luaran Sepsis pada Anak yang Menderita Systemic Inflammatory Response Syndrome

Sarmen

Mayetti

Bachtiar

2016

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Latar belakang. Sepsis merupakan salah satu penyebab morbiditas dan mortalitas pada anak. Diagnosissepsis ditegakkan berdasarkan gejala Systemic Inflammatory Response Syndrome (SIRS) dan penemuan bakteripada kultur darah. Kultur bakteri darah memiliki sensitifitas yang rendah dan membutuhkan waktu yanglama sehingga sering menyebabkan terjadinya overdiagnosis dan overtreatment. C-reactive protein adalahreaktan fase akut yang kadarnya meningkat pada keadaan infeksi. High sensitivity C-reactive protein (hs-CRP) adalah metode yang lebih sensitif untuk mengukur kadar CRP dalam jumlah kecil.Tujuan. Mengetahui peran hs-CRP sebagai parameter diagnostik dan prediktor luaran sepsis pada anakyang menderita SIRS.Metode. Penelitian uji diagnostik dengan desain potong lintang terhadap 85 anak dengan gejala SIRS berusia1 bulan sampai dengan 15 tahun dan dirawat di bangsal anak RS.Dr.M.Djamil Padang sejak Juni sampaiNovember 2012. Pemeriksaan hs-CRP dilakukan dengan metode enzyme-linked immunosorbent assay (ELISA).Data dianalisis dengan SPSS serta dilakukan uji diagnostik. Baku emas sepsis adalah biakan darah.Hasil. Cut off point hs-CRP untuk menentukan sepsis adalah 15,55 ng/ml, (sensitivitas 90,9% dan spesivisitas53,8%). Kadar rata-rata hs-CRP meningkat sesuai dengan beratnya penyakit.Kesimpulan. High sensitivity C-reactive protein dapat dijadikan sebagai parameter diagnostik sepsis padapasien SIRS dengan cut off point 15,55 ng/ml, serta dapat dipakai sebagai prediktor luaran sepsis.

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Diagnostic Markers for Identifying Sepsis in Patients with Systemic Inflammatory Response Syndrome (SIRS): A Prospective Study

Cited by 7 publications

References 31 publications

Study of serum levels of CRP and procalcitonin as early marker of sepsis in children with sepsis above neonatal age group

Study of serum levels of CRP and procalcitonin as early marker of sepsis in children with sepsis above neonatal age group

Procalcitonin Dan Interleukin-6 Pada Sepsis Dengan Gejala Systemic Inflammatory Response Syndrome (Sirs)

High Sensitivity C-Reactive Protein sebagai Parameter Diagnostik dan Prediktor Luaran Sepsis pada Anak yang Menderita Systemic Inflammatory Response Syndrome

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