Measurement of Procalcitonin Levels in Children with Bacterial or Viral Meningitis

Gendrel, D.; Raymond, Josette; Assicot, M.; Moulin, F.; Iniguez, Jean-Luc; Lebon, Pierre; Bohuon, C

doi:10.1086/513633

Cited by 255 publications

(158 citation statements)

References 6 publications

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“…Others have found sensitivity and specificity values for procalcitonin in similar ranges (Table 3) [2,5,11,14,21,26,29,30,33]. However, the results reported by Worthington et al were quite different: serum procalcitonin did not help distinguish between infectious and noninfectious causes of prosthetic hip loosening [41].…”

Section: Discussionmentioning

confidence: 91%

“…Numerous studies have shown procalcitonin is elevated in cases of bacterial infection or sepsis and levels are considerably higher in bacterial infections than in viral infections [2,5,11,14,21,26,29,30,33]. Procalcitonin increases 2 to 4 hours after the onset of sepsis, which is later than proinflammatory cytokines, such as interleukin 6 (IL-6), but considerably earlier than CRP [31].…”

Section: Introductionmentioning

confidence: 99%

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Novel Biomarkers to Detect Infection in Revision Hip and Knee Arthroplasties

Glehr

Friesenbichler

Hofmann

et al. 2013

Clinical Orthopaedics &Amp; Related Research

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Background A periprosthetic joint infection is one of the most challenging complications associated with THA and TKA. In the diagnostic process for detecting a periprosthetic joint infection, one of the most important steps is analysis of laboratory infection biomarkers. Questions/purposes We investigated the sensitivity and specificity of the biomarkers procalcitonin, interleukin 6 (IL-6), and interferon a (IFN-a) as compared with conventional biomarkers (C-reactive protein [CRP], leukocyte level) for a periprosthetic joint infection associated with revision arthroplasties. Methods We prospectively included and analyzed 84 patients (124 revision arthroplasties). The blood parameters of interest were procalcitonin, IL-6, IFN-a, leukocyte level, and CRP. Samples were taken preoperatively and on the first, third, and seventh postoperative days. The sensitivity and specificity of these biomarkers then were calculated. Results Considering the preoperative values of 84 patients (124 operations), procalcitonin, IL-6, CRP, and leukocyte level correlated with periprosthetic joint infection, whereas IFN-a did not. A procalcitonin cut-off level of 0.35 ng/mL revealed a sensitivity of 80% and specificity of 37%. An IL-6 cut-off level of 2.55 pg/mL had a sensitivity of 92% and specificity of 59%. Conclusions In this study procalcitonin and IL-6 were helpful for detecting periprosthetic joint infections in revision arthroplasties, although CRP generally was superior. Procalcitonin and IL-6 may be considered adjuvant tests when the diagnosis of a periprosthetic joint infection is in doubt. This study showed, in addition to conventional biomarkers such as CRP and leukocyte level, procalcitonin and IL-6 were helpful for detecting infections associated with revision arthroplasties.

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Section: Discussionmentioning

confidence: 91%

Section: Introductionmentioning

confidence: 99%

Novel Biomarkers to Detect Infection in Revision Hip and Knee Arthroplasties

Glehr

Friesenbichler

Hofmann

et al. 2013

Clinical Orthopaedics &Amp; Related Research

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“…PCT has been proven to be valuable in differentiating between bacterial and viral meningitis when determined in serum (Dubos et al., 2008; Gendrel et al., 1997; Viallon et al., 2011). However, the usefulness of PCT in serum of patients with bacterial meningitis after neurosurgical intervention is limited (Choi & Choi, 2013).…”

Section: Introductionmentioning

confidence: 99%

Procalcitonin in cerebrospinal fluid in meningitis: a prospective diagnostic study

Alons¹,

Verheul²,

Kuipers³

et al. 2016

Brain and Behavior

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ObjectivesBacterial meningitis is a severe but treatable condition. Clinical symptoms may be ambiguous and current diagnostics lack sensitivity and specificity, complicating diagnosis. Procalcitonin (PCT) is a protein that is elevated in serum in bacterial infection. We aimed to assess the value of PCT in cerebrospinal fluid (CSF) in the diagnosis of bacterial meningitis.MethodsWe included patients with bacterial meningitis, both community acquired and post neurosurgery. We included two comparison groups: patients with viral meningitis and patients who underwent lumbar punctures for noninfectious indications. We calculated mean differences and 95% confidence intervals of procalcitonin in CSF and plasma in patients with and without bacterial meningitis.ResultsAverage PCT concentrations in CSF were 0.60 ng mL−1 (95% CI: 0.29–0.92) in the bacterial meningitis group (n = 26), 0.81 (95% CI: 0.33–1.28) in community‐acquired meningitis (n = 16) and 0.28 (95% CI: 0.10–0.45) in postneurosurgical meningitis (n = 10), 0.10 ng mL−1 (95% CI: 0.08–0.12) in the viral meningitis group (n = 14) and 0.08 ng mL−1 (95% CI: 0.06–0.09) in the noninfectious group (n = 14). Mean difference of PCT‐CSF between patients with community‐acquired bacterial meningitis and with viral meningitis was 0.71 ng mL−1 (95% CI: 0.17–1.25) and 0.73 ng mL−1 (95% CI: 0.19–1.27) for community‐acquired bacterial meningitis versus the noninfectious group. The median PCT CSF: plasma ratio was 5.18 in postneurosurgical and 0.18 in community‐acquired meningitis (IQR 4.69 vs. 0.28).ConclusionProcalcitonin in CSF was significantly higher in patients with bacterial meningitis when compared with patients with viral or no meningitis. PCT in CSF may be a valuable marker in diagnosing bacterial meningitis, and could become especially useful in patients after neurosurgery.

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“…In recent years, several studies have focused on the use of CRP in bacterial and viral respiratory infections in children, but the results have been inconsistent [6±8]. Therefore, most children with pneumonia are treated with antibiotics without knowledge of the causative agent.Procalcitonin (PCT) is a newly recognized marker of bacterial infection [9], it contributes to the differentiation between septic and other infections in neonates [10] and older paediatric patients [11]. In a panel of children in which the aetiology of infection was assessed [12], it was examined whether PCT can be applied for the discrimination between bacterial and especially pneumococcal pneumonia and viral aetiology of pneumonia.…”

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confidence: 99%

Serum procalcitonin in pneumococcal pneumonia in children

Korppi

Remes

2001

Eur Respir J

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Serum procalcitonin in pneumococcal pneumonia in children. M. Korppi, S. Remes. #ERS Journals Ltd 2001. ABSTRACT: Serum procalcitonin (PCT), a marker of bacterial infection, was measured in children with pneumonia to examine whether PCT can be used to screen pneumococcal (PNC) from viral pneumonia.The number of patients was 132; mean age 3.0 yrs, and 64% were males. In all cases, pneumonia was radiologically con®rmed, being alveolar in 46 and interstitial in 86 cases. The aetiology of infection was studied by a panel of serological tests for PNC, for ®ve other respiratory bacteria and for seven common respiratory viruses. PNC infection was found in 25, mixed viral-PNC infections in 13 and viral infection in 17 cases.In general, serum PCT was not associated with the type or aetiology of pneumonia. PCT values were >1.0 mg . L -1 in 40% of PNC cases, as compared to 12±15% in viral or mixed cases, respectively (p<0.05). PCT values were signi®cantly higher in >2 yrs old children than in younger ones. The cut-off limits of 0.5 ng . mL -1 , 1.0 ng . mL -1 and 2.0 ng . mL -1 were tested for screening between PNC and viral pneumonia. The highest sensitivity of 55% was found at the 0.5 ng . mL -1 cut-off level, whereas the highest speci®city of 88% was reached at the level of 1.0 ng . mL -1 . The likelihood ratios, however, were far from optimal for both the positive and negative results.Although marginally higher in pneumococcal pneumonia than in viral pneumonia, serum procalcitonin cannot be used to discriminate between these two types of pneumonia. Community-acquired pneumonia is a common clinical problem in childhood. Bacterial pneumonia cannot be differentiated from viral pneumonia on the basis of clinical or chest radiographic ®ndings [1±3]. In young children, the most important problem is how to differentiate between pneumonia caused by respiratory viruses and Streptococcus pneumoniae [1,4]. In addition, mixed infections caused by viruses and bacteria, especially respiratory syncytial virus (RSV) and pneumococci (PNC), are common [5]. Leukocyte count, serum C-reactive protein (CRP) concentration or another nonspeci®c laboratory ®nding sometimes helps to differentiate between either bacterial or viral aetiology. In recent years, several studies have focused on the use of CRP in bacterial and viral respiratory infections in children, but the results have been inconsistent [6±8]. Therefore, most children with pneumonia are treated with antibiotics without knowledge of the causative agent.Procalcitonin (PCT) is a newly recognized marker of bacterial infection [9], it contributes to the differentiation between septic and other infections in neonates [10] and older paediatric patients [11]. In a panel of children in which the aetiology of infection was assessed [12], it was examined whether PCT can be applied for the discrimination between bacterial and especially pneumococcal pneumonia and viral aetiology of pneumonia. Material and methods Study subjectsIn the course of a prospective study in 1981±1982, 195 children wer...

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Measurement of Procalcitonin Levels in Children with Bacterial or Viral Meningitis

Cited by 255 publications

References 6 publications

Novel Biomarkers to Detect Infection in Revision Hip and Knee Arthroplasties

Novel Biomarkers to Detect Infection in Revision Hip and Knee Arthroplasties

Procalcitonin in cerebrospinal fluid in meningitis: a prospective diagnostic study

Serum procalcitonin in pneumococcal pneumonia in children

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