Procalcitonin: The marker of pediatric bacterial infection

Memar, Mohammad Yousef; Varshochi, Mojtaba; Shokouhi, Behrooz; Asgharzadeh, Mohammad; Kafil, Hossein Samadi

doi:10.1016/j.biopha.2017.11.149

Cited by 47 publications

(39 citation statements)

References 83 publications

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“…As we known, when inflammation or tissue damage happens, CRP can be significantly increased in serum, which is usually used as a unique inflammatory marker in the current clinical practice 22 . On the other hand, PCT, as the precursor of calcitonin, is a kind of glycoprotein without hormone activity, which is significantly higher in bacterial infection, but remain normal or slightly increased in viral infection 22,23 . Consistently, our study shows that CRP and PCT are markedly increased in severe and very severe COVID-19, and significantly higher in very severe COVID-…”

Section: Discussionmentioning

confidence: 99%

Utility of Ferritin, Procalcitonin, and C-reactive Protein in Severe Patients with 2019 Novel Coronavirus Disease

She

Wang

et al. 2020

Preprint

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Objectives It is of clinical significance to evaluate the disease severity and investigate possible biomarkers of 2019 Novel coronavirus disease (COVID-19). In this study, we aim to describe the clinical characteristics of infection makers in severe and very severe patients with COVID-19. Methods This is a single center, observational analysis. We enrolled 48 in-hospital severe patients with COVID-19 admitted to the West District of Union Hospital of Tongji Medical College and analyzed infection biomarkers in 20 patients who had been tested for ferritin, PCT, CRP, etc. Results The median age was 59yrd (inter quartile range [IQR]:46-61) among severe COVID-19 group and 57yrd (IQR:45-71.5) among very severe group. We noted significantly increased CRP (1.48mg/L [IQR: 16.69-2.74] vs. 57.98mg/L [IQR: 38.335-77.565], P<0.05), PCT(0.05ng/ml [IQR: 0.03-0.06] vs. 0.21ng/ml [IQR: 0.11-0.42], P<0.05) and ferritin (291.13ng/ml [IQR: 102.1-648.42] vs. 1006.16ng/ml [IQR: 408.265-1988.25]). For blood count, significant increase was noticed in neutrophil percentage (67.6% [IQR: 61.8-76.4] vs. 86.7% [IQR: 82-92.35], P<0.01) and neutrophil count (3.75*10^9/L [IQR: 3.42-4.93] vs. 8.11*10^9/L [IQR: 5.675-8.905], P<0.05); and decrease was seen in lymphocyte percentage (22.7% [IQR: 17.4-27.4] vs. 8% [IQR: 4.85-13], P<0.05), lymphocyte count (1.62*10^9/L [IQR: 0.7-1.73] vs. 0.68*10^9/L [IQR: 0.385-1.04], P<0.05), and platelet count (214*10^9/L [IQR: 184-247] vs. 147*10^9/L [IQR: 126-202.5], P<0.05). Conclusions The serum levels of CRP, PCT and ferritin are markedly increased in very severe compared with severe COVID-19. Increased CRP, PCT and ferritin level might correlate to secondary bacterial infection and associated with poor clinical prognosis.

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Section: Discussionmentioning

confidence: 99%

Utility of Ferritin, Procalcitonin, and C-reactive Protein in Severe Patients with 2019 Novel Coronavirus Disease

She

Wang

et al. 2020

Preprint

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“…Procalcitonin (PCT), as a calcitonin precursor, is involved in the systemic reaction induced by the circulating endotoxins and inflammatory cytokines 4,5 . Several studies showed PCT serum level is significantly higher in patients with bacterial infections, such as pneumonia, than in those with viral infections and non-infectious diseases and is used as a diagnostic marker for bacterial infections 6 . Therefore, our study investigates the prospect of using PCT as a critical biomarker for making a differential diagnosis between ARP and BP.…”

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confidence: 99%

The role of procalcitonin in differential diagnosis between acute radiation pneumonitis and bacterial pneumonia in lung cancer patients receiving thoracic radiotherapy

Wang

Huo

et al. 2020

Sci Rep

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Acute Radiation Pneumonitis (ARP) is one of the most common dose-limiting toxicities of thoracic radiotherapy. The accurate diagnosis of ARP remains a challenge because of the lack of a rapid biomarker capable of differentiating ARP from bacterial pneumo (BP). The aim of this study was to investigate the potential usefulness of procalcitonin (PCT) in the differential diagnosis of ARP and BP. Lung cancer patients who had undergone thoracic radiotherapy within 6 months and were admitted to hospital for ARP or BP were retrospectively analyzed. The serum levels of PCT, C-reactive protein (CRP) and white blood cells (WBC) were compared between the two groups. Receiver operating characteristic (ROC) curve was used to assess the diagnostic value of PCT, CRP and WBC in the differential diagnosis of ARP and BP and determine the best cutoff values. One hundred eighteen patients were included. Among them, seventy-seven patients were diagnosed with ARP, and 41 patients were diagnosed with BP. The PCT concentrations for patients diagnosed with ARP group were significantly lower than those in the BP group (P < 0.001). There were no differences in CRP and WBC between the two groups. The areas under the ROC curves (AUC) for PCT, CRP and WBC were 0.745, 0.589 and 0.578, respectively. The best cutoff values of PCT, CRP and WBC were 0.47 μg/L, 54.5 mg/L and 9.9 × 10 9 /L, respectively. Low serum PCT levels are associated with ARP. PCT is a useful biomarker to distinguish ARP from BP. Radiotherapy has been widely used for the curative and palliative treatment of lung cancer. Radiation-induced lung injury (RILI) is the most common dose-limiting toxicity of thoracic radiotherapy 1. RILI includes acute radiation pneumonitis (ARP) and pulmonary fibrosis. ARP often occurs about 1 to several months after radiotherapy. Commonly, ARP is relatively mild with patients, exhibiting no obvious symptoms except for imaging abnormalities. However, ARP can be a very serious event, especially after large volume radiotherapy. The incidence of grade 3-5 ARP can reach about 20% according to a recent study 2. When symptoms are more severe, patients cannot be managed as outpatients and require hospitalization. Continued progression of symptomatic ARP can cause respiratory failure and even death. Early and timely intervention can prevent the progression of ARP, improve patient symptoms, and potentially reduce post-radiation pulmonary fibrosis. However, accurate diagnosis of ARP remains difficult. The most important issue for radiation oncologists is to differentiate them from the bacterial pneumonia (BP) which are common in lung cancer patients 3. ARP and BP share many of the same symptoms such as cough and fever and both can be identified by changes in imaging. ARP can usually be identified by the positional relationship between the shapes of the radiation field and the

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“…In the literature, there are numerous studies to report that PCT has a high diagnostic value for bacterial infections [17][18][19][20][21] . Shimetani et al published a study which showed CRP, Serum Amiloid A(SAA) protein and PCT levels in serum and CSF in 30 patients with bacterial, viral and mycotic meningitis 22 .…”

Section: Discussionmentioning

confidence: 99%

Ventrikülostomi sonrası gelişen enfeksiyon tanısında prokalsitoninin C-reaktif protein, beyaz küre ve ateşle karşılaştırılması

Arslan

Olguner

Açık

et al. 2019

Cukurova Medical Journal

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The aim of this study was to evaluate the effect of neurosurgical procedures on procalcitonin levels and the role of procalcitonin in distinguishing the inflammatory reaction due to surgery and postoperative infection. Materials and Methods: This study was performed on 27 patients with hydrocephalus. Among these patients, 10 patients had ventricular drainage while 17 had ventriculoperitoneal shunt. The changes in the values of procalcitonin, white blood cell count, C-reactive protein and body temperature were examined in the preoperative 1 st and during postoperative 7 days. Results: All the patients had statistically significant increase in the body temperature values of the postoperative 1 st day compared to preoperative values. Creactive protein peaked in the postoperative 2 nd day and, after that, followed a regular kinetic to show a decrease pattern. C-reactive protein was found to be 3 times higher in the postoperative 5 th day compared to the preoperative value. Procalcitonin was found to remain in normal limits in all the patients that did not develop infection while the same was observed to increase in patients with infection. Conclusion: Procalcitonin will be a serious and safer parameter for the follow-up of the systemic complications following surgery upon the conclusions obtained with studies that include a higher number of patients and varying types of operations. Amaç: Bu çalışmada beyin cerrahisinin prokalsitonin düzeylerine etkisini ve prokalsitoninin beyin cerrahisinin yaratmış olduğu enflamatuar reaksiyonla, postoperatif gelişen enfeksiyonu ayırt etme özelliği araştırılmıştır. Gereç ve Yöntem: Çalışmamız 10'unda ventriküler drenaj, 17'sinde ventriküloperitoneal şant uygulanan 27 hidrosefalili hastada yapılmıştır. Preoperatif 1 ve postoperatif 7 gün boyunca Prokalsitonin, Beyaz küre sayısı, C-reaktif protein ve ateş değerlerindeki değişimler incelenmiştir. Bulgular: Tüm hastalarda postoperatif 1. günde preoperatif değerlere göre ateş değerlerinde anlamlı yükseklik tespit edilmiştir. C-reaktif proteinin postoperatif 2. günde pik yaptığı ve daha sonra azalma paterni gösteren düzenli bir kinetik izlediği gözlenmiştir. Postoperatif 5. günde, C-reaktif proteinin halen preoperatif değerinin 3 katı kadar yüksek olduğu tespit edilmiştir. Prokalsitoninin enfeksiyon gelişmeyen tüm hastalarda postoperatif normal sınırları aşmadığı, enfeksiyon gelişen hastalarda ise arttığı gözlenmiştir. Sonuç: Gelecekte daha fazla hasta sayısı ve farklı operasyon türlerini de içeren gruplarla yapılacak çalışmaların sonuçlarıyla prokalsitoninin beyin cerrahi sonrası sistemik komplikasyonları takipte ciddi ve güvenli bir parametre olacağını düşünmekteyiz.

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Procalcitonin: The marker of pediatric bacterial infection

Cited by 47 publications

References 83 publications

Utility of Ferritin, Procalcitonin, and C-reactive Protein in Severe Patients with 2019 Novel Coronavirus Disease

Utility of Ferritin, Procalcitonin, and C-reactive Protein in Severe Patients with 2019 Novel Coronavirus Disease

The role of procalcitonin in differential diagnosis between acute radiation pneumonitis and bacterial pneumonia in lung cancer patients receiving thoracic radiotherapy

Ventrikülostomi sonrası gelişen enfeksiyon tanısında prokalsitoninin C-reaktif protein, beyaz küre ve ateşle karşılaştırılması

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