Procalcitonin - Influence of Temperature, Storage, Anticoagulation and Arterial or Venous Asservation of Blood Samples on Procalcitonin Concentrations

Meisner, Michael; Tschaikowsky, K.; Schnabel, Stephan; Schmidt, Joachim; Katalinic, Alexander; Schüttler, J.

doi:10.1515/cclm.1997.35.8.597

Cited by 62 publications

(59 citation statements)

References 3 publications

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“…Its serum level starts to increase 4-6 hours after the beginning of inflammation. The serum level is parallel to the degree of tissue damage (33). In studies in which CRP levels were evaluated by focus of infection in febrile neutropenia, Fleischhack et al (34) found that CRP levels were significantly higher in subjects with Gram-negative bacteremia compared with the FUO group, and similar to the subjects with CDIs.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of febrile neutropenic attacks of pediatric hematology-oncology patients

Kar¹,

Özdemir²,

Bör³

2018

Turk Pediatri Ars

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Aim: Febrile neutropenia is an important cause of mortality and morbidity in hematology-oncology patients undergoing chemotherapy. The objective of this study was to evaluate febrile neutropenic episodes in children with malignancy. Material and Methods:Sixty-eight children who received chemotherapy for malignancy between 2010 and 2015 were retrospectively reviewed. The demographic characteristics, laboratory data, infection foci, and frequency of microorganisms grown in culture were examined. Also, the frequency of febrile neutropenic attacks was investigated according to the chemotherapy periods.Results: Of the total 200 episodes, 81 (40.5%) were clinically documented, and 73 (36.5%) were microbiologically documented infections. Fever of unknown origin was observed in 46 (23%) episodes. The most frequently clinically documented focus were mucositis (33.4%) and pneumonia (24.7%). Blood culture was positive in 55 (75.3%) episodes of microbiologically documented infections. The most commonly isolated microorganisms in blood culture were Gram-negative bacteria (47.2%). C-reactive protein levels in microbiologically documented infections were higher than in clinically documented infections, and fever of unknown origin (p<0.05, for both). The most common underlying malignancy was acute lymphoblastic leukemia (73.5%). The highest proportions (34.6%) of febrile neutropenic episodes were observed during the reinduction period for these children. Nine (13.2%) children died of neutropenic sepsis. Conclusions:Febrile neutropenia continues to be an important cause of mortality in pediatric patients with malignancy. C-reactive protein levels may be an indicator for predicting bacterial infection in children with febrile neutropenia without apparent focus. The most frequently isolated agents in our center were Gram-negative microorganisms. Determining the microbial flora of each center may be beneficial to improving survival rates.

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Section: Discussionmentioning

confidence: 99%

Evaluation of febrile neutropenic attacks of pediatric hematology-oncology patients

Kar¹,

Özdemir²,

Bör³

2018

Turk Pediatri Ars

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“…PCT values have been reported as various levels: in bacterial infections with systemic findings as sepsis up to 1,000 ng/ ml, in localized infections, viral infections and inflammation reactions except infections mostly below 5 ng/ml, in patients with serious bacterial infections between 20 and 200 ng/ml and in normal populations like blood donors between 0 and 0.5 ng/ml [18,19]. CRP is one of the acutephase proteins and many studies are designed to compare it.…”

Section: Discussionmentioning

confidence: 99%

Procalcitonin and C-Reactive Protein in Infective Endocarditis: Correlation with Etiology and Prognosis

Kocazeybek¹,

Küçükoğlu²,

Öner

2003

Chemotherapy

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Background: The aim of this study was to investigate the diagnostic values of serum procalcitonin (PCT) and C-reactive protein (CRP) levels in infective endocarditis (IE) and to correlate them with the etiology of the disease and the prognosis of the patients. Methods: Fifty patients who were diagnosed as having IE based on Duke criteria (major and/or minor) were included in the study at the Istanbul University Cardiology Institute and Florence Nightingale Hospital. Forty patients with bacteremia (non-IE) and 50 healthy blood donors were also included in the study as the control group. During the 45 days of medical follow-up, in those patients who had a response to medical therapy based on the results of left ventricular function tests, transesophageal echocardiography (TEE) and culture, among other factors, PCT and CRP levels were measured in 5-cm³ blood samples obtained without anticoagulant when they were first admitted (day 0), as well as 24 h and 15, 30 and 45 days after admission. In the patients who had valve replacement, 5-cm³ blood samples without anticoagulant were similarly obtained on the day of admission, after 24 h and/or on the 15th day, and 1 day before and on the 2nd and 5th days after the operation. Results: In this study, a significant difference (p < 0.001) was found between the IE group and the healthy control group with respect to their serum PCT and CRP levels at the time of admission. No significant difference was found between IE and non-IE groups (p > 0.05). The sensitivity of PCT in comparison to CRP was found to be lower (84 vs. 100%); however, its specificity was determined to be higher (88 vs. 72%). The median values of serum PCT in the nonoperated and operated cases at the time of admission, after 24 h and on the 15th day were 3.71, 5.35 and 0.44, and 2.45, 4.28 and 4.22 ng/ml, respectively, and those of CRP were 9.30, 10.95 and 10.65, and 9.5, 10.9 and 10.2 mg/dl, respectively. The median values of serum PCT were found to be higher in cases with IE and non-IE related to gram-negative bacteria than those related to gram-positive bacteria (p < 0.02). This was found to be insignificant for CRP (p > 0.05). Conclusions: As a result, this study suggests that in the diagnosis of IE, it would be beneficial to use PCT, besides TEE, culture and other clinical criteria, for its high specificity and positive predictive value in comparison to CRP. This study also suggests that in determining the response to medical treatment in the follow-up period, PCT could be a more valuable parameter than CRP, as PCT has a high prognostic value and is a good indicator for valve replacement in addition to the major criteria. Furthermore, serum PCT levels may help the physician to decide on the antimicrobial therapy combination before obtaining the culture results, or in situations in which the agent could not be isolated yet.

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“…In vivo koşullarda çok stabil bir protein olup, yarılanma süresi 25-30 saat kadardır. Oda ısısında stabil olması, sıcağa, donmaya ve erimeye dayanıklı olması ve basit laboratuvar tekniklerinin mevcut olması tanımlanmasını kolaylaştırır (10,11,21). Sağlıklı bireylerde PCT'nin plazma konsantrasyonları pikogram kadar düşük düzeylerdedir ve mevcut PCT ölçüm yöntemlerinin belirleyebileceği düzeylerin altındadır (<0.1 ng/ml).…”

Section: İrdelemeunclassified

The Evaluation of Procalcitonin as a Diagnostic and Prognostic Marker of Bacterial Infections in Febrile Neutropenic Patients

Yetkin¹,

Şenol²,

Yalcin³

et al. 2011

Klimik Dergisi

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ÖzetAmaç: Maligniteli hastalardaki febril nötropeni ataklarında prokalsitonin (PCT)'in bakteriyel infeksiyonların tanısal ve prognostik bir göstergesi olarak standard bir parametre olan C-reaktif protein (CRP) ile karşılaştırılıp değerlendirilmesi amaçlandı. Yöntemler: Kemoterapiye bağlı 37 hastadaki 40 febril nötropenik atak üç gruba ayrıldı: nedeni bilinmeyen ateş (NBA), mikrobiyolojik olarak tanımlanmış infeksiyon ve klinik olarak tanımlanmış infeksiyon. Nötropeni başlangıcında, ateşin ilk ve üçüncü günü, ateşin düştüğü gün ya da tedaviye yanıtsız hastalarda tedavinin 5-7. günü olmak üzere toplam dört kan örneği alındı. Bulgular: Tüm ataklarda nötropeni başlangıcında PCT düzeyleri normal değerlerde bulunurken, CRP düzeyleri normal değerlerin üzerinde saptandı. Ateşin üçüncü günü PCT'deki yüksekliğin tanımlanmış infeksiyonu olan gruplarda, NBA grubuna göre daha fazla olduğu gözlendi (p<0.05). Sepsisi olan ve olmayan gruplarda PCT düzeyleri farklı bulundu (p<0.001) ve en yüksek değerle-rine sepsis grubunda ateşin 3. gününde ulaştı. Tedaviye yanıtsız grupta PCT düzeylerindeki artış anlamlı ölçüde sürerken, tedaviye yanıtı olan grupta, ateşin düşmesi ile birlikte hızla normal değer-lere geriledi (p<0.001). Sonuçlar: Bu bulgular ışığında, febril nötropenik hastalarda PCT'nin, dokümante infeksiyonların erken tanısında, infeksiyonun şiddetini ve tedaviye yanıtı belirlemede yararlı olacağı ve CRP'den daha üstün olduğu sonucuna varıldı. AbstractObjective: The aim of this study was to evaluate the role of procalcitonin (PCT) in the diagnosis, prognosis and follow-up of bacterial infections in febrile neutropenic patients in comparison to the standard parameter, C-reactive protein (CRP). Methods: 40 febrile neutropenic episodes of 37 patients with cancer undergoing chemotherapy were classified as fever of unknown origin (FUO), microbiologically or clinically documented infection. Four sequential serum samples were obtained at the onset of neutropenia, on the first and third days of fever and on the day of defervescence, or on day 5 or 7 of an unresolved fever. Results: At the onset of neutropenia, the PCT levels were found to be normal whereas CRP levels were found to be elevated in all patients. With the febrile episode, PCT levels were elevated in all types of infections which were significantly higher for documented infections compared to FUO (p< 0.05). Procalcitonin levels differed significantly between patients with and without severe sepsis (p<0.001), and the highest levels were seen on the third day of fever. PCT levels decreased rapidly in afebrile patients treated successfully, whereas they remained significantly higher for patients unresponsive to therapy (p<0.001). Conclusions: In conclusion, PCT could be suggested as a useful marker, and was superior to CRP for early diagnosis of documented infections, assessment of the severity of infection and response to therapy in febrile neutropenic patients.

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Procalcitonin - Influence of Temperature, Storage, Anticoagulation and Arterial or Venous Asservation of Blood Samples on Procalcitonin Concentrations

Cited by 62 publications

References 3 publications

Evaluation of febrile neutropenic attacks of pediatric hematology-oncology patients

Evaluation of febrile neutropenic attacks of pediatric hematology-oncology patients

Procalcitonin and C-Reactive Protein in Infective Endocarditis: Correlation with Etiology and Prognosis

The Evaluation of Procalcitonin as a Diagnostic and Prognostic Marker of Bacterial Infections in Febrile Neutropenic Patients

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