Procalcitonin and C‐reactive protein as biomarkers for neonatal bacterial infection

Quadir, Ashfaque; Britton, Philip N

doi:10.1111/jpc.13931

Cited by 12 publications

(12 citation statements)

References 20 publications

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“…Perhaps one of the most hotly debated acute phase reactants, procalcitonin, is the latest diagnostic darling in inpatient circles. Procalcitonin (the biologic precursor to calcitonin) reaches measurable serum concentrations quickly and reliably in the setting of bacterial infection 27–29. Dozens of trials have reliably demonstrated procalcitonin’s strong performance in decision support for antibiotic initiation or cessation; however, in the most salient ED investigation—the Procalcitonin Consensus Trial (ProACT) —procalcitonin failed miserably in limiting unnecessary antibiotic use 30.…”

Section: Resultsmentioning

confidence: 99%

Evidence-Informed Practice: Diagnostic Questions in Urinary Tract Infections in the Elderly

Pescatore

Niforatos

Rezaie³

et al. 2019

WestJEM

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An abnormal urinalysis in an elderly patient presenting to the emergency department (ED) with non-specific symptoms represents one condition that requires an evidence-informed approach to diagnosis and management of either asymptomatic bacteriuria or urinary tract infection (UTI). The emergency provider often will not have access to urine cultures, and the risks associated with antibiotic use in the elderly are not without potentially significant side effects. Methods: We performed a historical and clinical review of the growing body of literature suggesting measurable differences in the systemic immune response manifest among patients with asymptomatic pyuria and UTI, including increases in the pro-inflammatory cytokine interleukin-6 and the acute phase reactant procalcitonin. Results: Serum procalcitonin, a peptide that undergoes proteolysis into calcitonin, has been demonstrated to quickly and reliably rise in patients with severe bacterial infections, and may serve as a potentially sensitive and specific marker for identification of bacterial illness. Conclusion: In the absence of validated risk scores for diagnosing UTI in elderly patients presenting to the ED, there may be a role for the use of procalcitonin in this patient population.

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Section: Resultsmentioning

confidence: 99%

Evidence-Informed Practice: Diagnostic Questions in Urinary Tract Infections in the Elderly

Pescatore

Niforatos

Rezaie³

et al. 2019

WestJEM

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“…PCT is a protein, which increased in the SSI patients (OR = 220.746, P < 0.05). Its levels in the plasma rose in severe bacterial, fungal and parasitic infections as well as sepsis [28]. Bacterial endotoxin played an important role in the induction process [29].…”

Section: Discussionmentioning

confidence: 99%

Nomogram prediction of surgical site infection of HIV-infected patients following orthopedic surgery: a retrospective study

et al. 2020

BMC Infect Dis

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Background Surgical site infection (SSI) is a devastating complication of orthopedic surgery, related with increased morbidity and mortality. This study was performed with the aim to compare the SSI rate in human immunodeficiency virus HIV-positive patients, to identify other risk factors for SSI and to establish a nomogram model to predict the risk of SSI. Methods A total of 101 HIV-positive individuals following orthopedic surgery patients admitted to Beijing Ditan Hospital. Their characteristics were gathered. The univariate and multiple logistic regression analysis were performed to explore the risk factors of SSI. And the Nomogram prediction model was constructed and verified. Results The independent predictive factors of SSI included CD4 (Odds ratio [OR], 0.041; P = 0.040), erythrocyte sedimentation rate (ESR) (OR, 89.773; P = 0.030), and procalcitonin (PCT) (OR, 220.746; P = 0.006). The scoring nomogram model was as follows: Logit (SSI) = − 2.63589–0.00314*CD4 < 430.75 = 1) + 0.04695*(ESR < 17.46 = 1) + 2.93694*(PCT < 0.22 = 1). The area under the Receiver Operating Characteristic (ROC) curve was 0.946. The cutoff score was − 2.1026 with a sensitivity of 93.33% and a specificity of 84.88%. Conclusions CD4, ESR, PCT might affect the occurrence of SSI after orthopedic surgery. The nomogram model constructed in this study is helpful for predicting the probability of SSI.

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“…Blood culture remains the gold standard for the diagnosis of neonatal sepsis, but results are delayed and have low sensitivity due to maternal antibiotic treatment, small sample volumes, and low bacteremia 18,19 . Other tests routinely used for the diagnosis of neonatal sepsis, such as C-reactive protein (CRP) and blood count (total and differential white blood cell counts, absolute and immature neutrophil counts, and the ratio of immature to total neutrophils), are respectively non-speci c and non-sensitive [20][21][22][23] . Procalcitonin (PCT) has been shown to be an excellent marker for severe bacterial infection in newborn [24][25][26] .…”

Section: Introductionmentioning

confidence: 99%

Host Immunity Biomarkers of Neonatal Sepsis: A Prospective, Multicentre Study in Sub Saharan Africa

Ezinmègnon

Mommert²,

Bartolo³

et al. 2021

Preprint

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Few biomarkers for sepsis diagnosis are commonly used in neonatal sepsis. Whilst host response is increasingly recognized in sepsis pathogenesis and prognosis, there is a need for evaluating the accuracy of new biomarkers targeting host response in regions where sepsis burden is high and medico-economic resources are scarce. The objective of the study is to evaluate diagnostic and prognostic accuracy of biomarkers of neonatal sepsis in Sub Saharan Africa. This prospective multicentre study included newborn infants delivered in the Abomey-Calavi region in South Benin and their follow-up from birth to 3 months of age. Accuracy of transcriptional (CD74, CX3CR1), proteic (PCT, IL-6, IL-10, IP-10) biomarkers and clinical characteristics to diagnose and prognose neonatal sepsis were measured. At delivery, cord blood from all consecutive newborns were sampled and analysed, and infants were followed for a 12 weeks’ period. Five hundred and eighty-one newborns were enrolled. One hundred and seventy-two newborns developed neonatal sepsis (29.6%) and death occurred in forty-nine infants (8.4%). Among all tested biomarkers and clinical criteria, CD74/IP-10 ratio showed the best accuracy for neonatal sepsis diagnosis, while PCT accuracy was low. Among biomarkers and clinical criteria studied, only CD74 and PCT were independently associated with mortality, with CD74 showing an elevated predictive accuracy. These results suggest that cord blood PCT had a low accuracy for diagnosing early onset neonatal sepsis in Sub Saharan African neonates, while CD74/IP-10 ratio had the best diagnostic accuracy. CD74 expression at birth had the best accuracy in prognosing sepsis mortality.Trial registration: Clinicaltrial.gov registration number: NCT03780712. Registered 19 December 2018. Retrospectively registered.

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Procalcitonin and C‐reactive protein as biomarkers for neonatal bacterial infection

Abstract: Further research is required before definitive recommendations can be made about the utility of procalcitonin compared with CRP as a diagnostic marker for neonatal sepsis and bacterial infection in clinical practice.

Cited by 12 publications

References 20 publications

Evidence-Informed Practice: Diagnostic Questions in Urinary Tract Infections in the Elderly

Evidence-Informed Practice: Diagnostic Questions in Urinary Tract Infections in the Elderly

Nomogram prediction of surgical site infection of HIV-infected patients following orthopedic surgery: a retrospective study

Host Immunity Biomarkers of Neonatal Sepsis: A Prospective, Multicentre Study in Sub Saharan Africa

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