Low Serum Procalcitonin Level Accurately Predicts the Absence of Bacteremia in Adult Patients with Acute Fever

Chirouze, Catherine; Schuhmacher, H.; Rabaud, Christian; Gil, H.; Khayat, N.; Estavoyer, J.M.; May, Thierry; Hoën, Bruno

doi:10.1086/341023

Cited by 189 publications

(122 citation statements)

References 21 publications

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“…Serum procalcitonin (PCT) level is also helpful for ruling out infection in patients with chronic inflammatory diseases and for distinguishing infections from systemic inflammatory diseases in the initial evaluation of patients presenting with acute fever [6]. The PCT level seems to be a reliable tool for predicting bacteremia in patients.…”

Section: Introductionmentioning

confidence: 99%

Clinical features and serum profile of inflammatory biomarkers in patients with brucellosis

Liu

Zhao

2017

J Infect Dev Ctries

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Introduction: Brucellosis is a zoonosis caused by Brucella, a highly infectious Gram-negative coccobacillus that has been isolated from a variety of mammals. Brucella melitensis is considered the most common cause of human brucellosis. The aim of this retrospective study was to evaluate the diagnostic value of serum parameters that relate to Brucella melitensis infection. Methodology: This investigation retrospectively analyzed the clinical laboratory tests and symptoms of brucellosis, which was confirmed by microbiological and serological methods. A total of 36 patients (31 males, 5 females; mean age 49.17 ± 13.56 years) admitted with brucellosis were included in the study over a three-year period between 2012 and 2015 in Peking University People's Hospital (PKUPH). Results: A statistically significant increase was observed in C-reactive protein and erythrocyte sedimentation rate in patients with low titers of serum antibody when compared with those with high titers. No difference was observed between the two groups with respect to the other serum parameters such as procalcitonin or white blood cell count. Two blood culture systems also yielded different results. Conclusions: In this study, we demonstrated that culture can be improved by using multiple blood culture systems to isolate Brucella melitensis. We also found the different role of inflammatory markers play during the process of brucellosis. The present study may be a helpful reference in the diagnosis of brucellosis.

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Section: Introductionmentioning

confidence: 99%

Clinical features and serum profile of inflammatory biomarkers in patients with brucellosis

Liu

Zhao

2017

J Infect Dev Ctries

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“…Procalcitonin (PCT) has been proposed as a useful diagnostic marker in the emergency department, although PCT may fail to rule out BSI (3,9,10).…”

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confidence: 99%

Clinical Evaluation of Multiple Inflammation Biomarkers for Diagnosis and Prognosis for Patients with Systemic Inflammatory Response Syndrome

et al. 2014

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A multiplexed biomarker bundle consisting of nine different inflammation markers was evaluated regarding their diagnostic and prognostic performances in 159 adult systemic inflammatory response syndrome (SIRS) patients enrolled at the emergency department. Fibronectin, interleukin-8 (IL-8), biotin, and neutrophil gelatinase-associated lipocalin (NGAL) were the most robust markers but were not superior to the already established markers IL-6, C-reactive protein (CRP), procalcitonin (PCT), and soluble urokinase plasminogen activator receptor (suPAR). Bloodstream infection (BSI) in patients with systemic inflammatory response syndrome (SIRS) is associated with substantial morbidity and mortality (1). Early and reliable diagnosis for appropriate treatment is essential for improving the prognosis of infected patients. While so far, no single biomarker was able to replace time-consuming blood cultures, some, like procalcitonin (PCT), C-reactive protein (CRP), and interleukin-6 (IL-6), are commonly used for additional assessments (2, 3).Recently, a new CE-marked in vitro diagnostic (IVD)-approved multiplex analysis system (Anagnostics Bioanalysis GmbH, Vienna, Austria) for testing inflammatory biomarkers was introduced to the market, using competitive and sandwich immunoassays. This test system is a fully automated instrument that may provide extended and rapid inflammation monitoring in a single run; the time to result is 3 min per sample, and 8 samples can be measured consecutively in one run.The objective of this study was to evaluate the diagnostic (for positive blood cultures caused by Staphylococcus aureus, Escherichia coli, or Candida spp.) and prognostic performances of the biomarker bundle in patients fulfilling the SIRS criteria (all patients had fever and fulfilled one or more additional SIRS criteria) at the emergency department (ED).(This paper was presented in part at the 54th Interscience Conference on Antimicrobial Agents and Chemotherapy [ICAAC], 5 to 9 September 2014, Washington, DC [14].)The biomarkers were evaluated in 159 adult patients who were included consecutively at the Medical University of Graz, Austria, between June 2012 and March 2013. All the biomarker levels (routinely tested and multiplexed) and blood culture results originated from blood samples taken when patients presented to the emergency department, before anti-infective treatment was initiated. The additional inclusion criteria were (i) no anti-infective treatment during the 5 days before blood samples were obtained, (ii) informed consent (approved by the ethics committee, Medical University Graz, Austria, no. 21-469 ex 09/10), (iii) positive blood culture results with growth of S. aureus, E. coli, or Candida spp., or negative blood culture results, and (iv) the anticipated limit of about 50 patients in each study group had not been reached. Inclusion criteria (iii) and (iv) were applied only for retrospective testing of the biomarker bundle (see details below).

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“…Therefore, surrogate biomarkers are needed to make the appropriate choice more rapidly. In other studies, some authors have previously shown that in a population with proven sepsis, PCT was significantly higher in patients with bacteremia than in those without proven sepsis [9][10][11]. PCT levels have been shown to distinguish between bacteremia and noninfectious inflammatory states quickly and accurately in critically ill patients [5].…”

Section: Discussionmentioning

confidence: 94%

Procalcitonin, c-reactive protein, leukocyte, mean platelet volume levels in bloodstream infections

İrvem¹

2018

Ann Clin Anal Med

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Aim: Levels of Serum Procalcitonin (PCT), C-Reactive Protein (CRP), Leukocyte (WBC) and Mean Platelet Volume (MPV) were evaluated in sepsis patients. We evaluated the diagnostic accuracy of different inflammatory markers to discriminate sepsis caused by different pathogens. Material and Method: In this study we included 126 episodes of bacteremia from 126 patients with sepsis. Medical records of patients who had bacteremia caused by Gram-negative bacteria (GN), Gram-positive bacteria (GP) or yeast were reviewed, and information about PCT and other inflammatory markers was recorded. Mann-Whitney U test and Spearman's correlation analysis were used for statistical analysis. Results: 60.4% of the cases (n=76) were GN, 31.7% (n=40) were GP and 7.9% (n=10) were yeast. There was a statistically significant difference between PCT, CRP, and MPV levels according to the microorganism (p=0.001, p<0.01). There was no statistically significant difference between WBC measurements according to the microorganism (p>0.05). Discussion: According to the microorganism, gram positivity cutoff points were determined for PCT as (≤12.17), CRP as (≤9.70) and MPV as (≤9.32). In bilateral comparisons, there was a significant increase in GN and yeast sepsis, while a significantly low level was found in GP sepsis. There was no significant difference between GN and yeast. When the measurements of PCT according to bacterial species are examined, the highest measurement was 44.6 ng/ml with Escherichia coli bacteria, followed by Candida bacteria with 12.6 ng/ml.

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Low Serum Procalcitonin Level Accurately Predicts the Absence of Bacteremia in Adult Patients with Acute Fever

Cited by 189 publications

References 21 publications

Clinical features and serum profile of inflammatory biomarkers in patients with brucellosis

Clinical features and serum profile of inflammatory biomarkers in patients with brucellosis

Clinical Evaluation of Multiple Inflammation Biomarkers for Diagnosis and Prognosis for Patients with Systemic Inflammatory Response Syndrome

Procalcitonin, c-reactive protein, leukocyte, mean platelet volume levels in bloodstream infections

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