Procalcitonin reflects bacteremia and bacterial load in urosepsis syndrome: a prospective observational study

Nieuwkoop, Cees van; Bonten, Tobias N; Wout, J. W. Van’t; Kuijper, Ed J.; Groeneveld, Geert H.; Becker, Martin; Koster, Ted; Wattel-Louis, G Hanke; Delfos, Nathalie M; Ablij, Hans C; Leyten, Eliane M. S.; Dissel, Jaap T. van

doi:10.1186/cc9328

Cited by 161 publications

(141 citation statements)

References 36 publications

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“…Although sepsis was a concern from the date of presentation, the degree of PCT elevation in this patient may suggest another etiology. PCT levels reported in the literature of patients with urinary tract infections report maximum PCT levels far lower than those observed in our patient, for example Van Nieuwkoop et al, reported a maximum of 9.07 ug/L [4] . In our patient, the PCT was observed to dramatically increase after cardiac arrest and recurrent external defibrillations and thus seemed correlative.…”

Section: Discussioncontrasting

confidence: 81%

Markedly Elevated Procalcitonin After Cardiac Arrest: A Case Report

Akamine¹,

Internationals²

2015

JHC

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A 70-year-old Caucasian male with a past medical history of hypertension and alcohol abuse presented to a local community hospital emergency department (ED) after a syncopal episode earlier that evening. He admitted to heavy drinking daily for several months. Imaging of the head and cervical spine were negative for any trauma. In the ED he became unresponsive and the electrocardiogram showed polymorphic ventricular tachycardia (PMVT). He was defibrillated with return of normal sinus rhythm but had recurrent episodes of ventricular fibrillation (VF) and received 10 consecutive external defibrillations. He was transferred to our hospital and on arrival his temperature was 101.0°F and the remainder of his vital signs were within normal limits. Physical examination was unremarkable except for a right wrist splint and edema of the left ankle. Chest X-ray demonstrated left lower lobar atelectasis. He was hypokalemic (potassium of 2.2 mMol/L) and his cardiac enzymes were mildly elevated, Troponin T was 0.05 ng/mL, CK 210 U/L and CKMB 2.4 ng/mL. His lactate was elevated at 3.0 mMol/L and he had a markedly elevated procalcitonin at 45.98 ug/L. His blood ethanol level was < 0.010 g/dL. Blood and urine cultures demon- Markedly Elevated Procalcitonin after AbstractBackground: Procalcitonin (PCT) is an amino acid prohormone of calcitonin that is released by various tissues in response to infection, systemic inflammation or sepsis [1] . High levels of PCT have been described in circumstances other than sepsis or infection, including major surgery, trauma, acute coronary syndromes, cardiogenic shock and cardiac arrest [2,3] .

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Section: Discussioncontrasting

confidence: 81%

Markedly Elevated Procalcitonin After Cardiac Arrest: A Case Report

Akamine¹,

Internationals²

2015

JHC

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“…13 As to other inflammation marker, some studies show that serum procalcitonin has a role in more accurate prediction of bacterial infection 14 and bacteremia with febrile UTI 15 than CRP and WBC count. Our data showed significantly more cases of shock with urinary tract occlusion that required stenting.…”

Section: E107mentioning

confidence: 99%

Shock due to urosepsis: A multicentre study

Yamamichi

Shigemura

Kitagawa

et al. 2017

CUAJ

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Introduction: Urosepsis is a severe infection that can cause shock afterwards. The purpose of this study is to investigate the clinical and bacterial risk factors for shock in those cases with urosepsis caused by urinary tract infection in a multicentre study. Methods: Our study included 77 consecutive urosepsis cases from four hospitals. We examined factors such as patient characteristics, underlying disease, serum white blood cell (WBC) count, platelet count, C-reactive protein (CRP) level at the time of diagnosis of urosepsis, urinary tract occlusion, causative bacteria, and bacterial antibiotic susceptibilities. Statistical analyses were performed to assess the potential risk factors for shock during the clinical course of urosepsis by a multivariate analysis. Results: We had 38 male and 39 female patients aged 25-104 (median 73). Underlying diseases included cancers (n=22, 28.6 %) and diabetes mellitus (n=17, 22.1 %). Positive blood culture was seen in 74 cases; these involved 88 bacterial strains, of which Escherichia coli was the most common (34 strains, 38.6 %). There were 31 cases with shock (40.3 %) and multivariate analyses demonstrated that serum CRP was the only clinical risk factor for shock due to urosepsis. Conclusions: Our study demonstrated that serum CRP was a risk factor for shock during urosepsis in a multicentre analysis. Further prospective studies with a greater number of patients are needed to draw more definitive conclusions.

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“…A level >0.25 ug/L predicted bacteremia, and for bacteremic subjects procalcitonin level correlated with bacterial load measured as time to positive culture [32]. Of 136 bacteremic patients, 29 (21%) had urine cultures which were negative, contaminated, or grew an organism different from that isolated from the blood [33].…”

Section: Complicated Urinary Tract Infectionmentioning

confidence: 99%

Update in Adult Urinary Tract Infection

Nicolle

2011

Curr Infect Dis Rep

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Urinary tract infection remains a common problem for many populations. Recent studies have expanded our understanding of the host innate immune response and its role in the familial association observed for recurrent uncomplicated urinary tract infection in healthy women. Therapeutic management for uncomplicated infection has been compromised by increasing antimicrobial resistance, particularly global dissemination of the CTXM-15 extended spectrum β-lactamase (ESBL) producing Escherichia coli ST-131 strain. Prevention strategies exploring non-antimicrobial approaches continue to show limited promise, and approaches to limit empiric antimicrobials are now being explored. For complicated urinary tract infection, increasing antimicrobial resistance limits therapeutic options for many patients. In addition to ESBL producing E. coli, NDM-1 E. coli and Klebsiella pneumoniae and other resistant Gram negatives, such as Acinetobacter species, are being isolated more frequently. There has been renewed interest in catheter-acquired urinary tract infection, the most common health-care associated infection, with several recent evidence-based guidelines for infection prevention available. However, technologic progress in development of adherence-resistant catheter materials remains disappointing.

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Procalcitonin reflects bacteremia and bacterial load in urosepsis syndrome: a prospective observational study

Cited by 161 publications

References 36 publications

Markedly Elevated Procalcitonin After Cardiac Arrest: A Case Report

Markedly Elevated Procalcitonin After Cardiac Arrest: A Case Report

Shock due to urosepsis: A multicentre study

Update in Adult Urinary Tract Infection

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