Procalcitonin: Uses in the Clinical Laboratory for the Diagnosis of Sepsis

Jin, Ming; Khan, Adil I.

doi:10.1309/lmq2grr4qlfkhch9

Cited by 99 publications

(68 citation statements)

References 28 publications

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“…17 Differences in the case mix (a higher proportion of surgical subjects were included) and critical severity (a higher proportion of septic shock and higher Sequential Organ Failure Assessment scores) may contribute to higher procalcitonin concentrations. [30][31][32] Second, procalcitonin kinetics within the first 72 h was also found to be significantly different because a decrease of Ն 26.2% was expected in the improved subjects and was regarded as an independent predictor of clinical efficacy. As a result, patient management might be reassessed if procalcitonin levels fall slowly (such as Ͻ 26.2% between days 0 and 3).…”

Section: Discussionmentioning

confidence: 99%

Procalcitonin Kinetics and Nosocomial Pneumonia in Older Patients

Shi

Xu²,

Rui

et al. 2013

Respir Care

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BACKGROUND: Early identification of treatment failure for nosocomial pneumonia remains a major challenge. The goal of this study was to test whether procalcitonin kinetics can be used to assess the clinical efficacy in older critically ill patients with nosocomial pneumonia. METHODS: A prospective observational study was conducted with 60 subjects (> 65 y old) admitted to the ICU with severe nosocomial pneumonia. Serum procalcitonin was measured on days 0, 3, and 7 and at the end of treatment. The procalcitonin time course was analyzed according to the therapeutic efficacy. RESULTS: Procalcitonin levels were elevated in all subjects (n ‫؍‬ 60) on day 0, and the median level (range) was 2.5 (0.85-42.7) g/L. There were no differences in procalcitonin between the improved subjects (n ‫؍‬ 41) and those without improvement (n ‫؍‬ 19) on day 0 (P > .05). However, lower procalcitonin levels on days 3 and 7 and at the end of treatment (all P < .05) and greater rates of procalcitonin decline between days 0 and 3 (⌬PCT d3 %; 29.5 ؎ 10.8% vs 15.1 ؎ 5.9%, P ‫؍‬ .009) were observed in the improved subjects compared with those with no improvement. ⌬PCT d3 % was the best single predictor of efficacy (area under the curve of 0.79, P < .001) and had a sensitivity of 75.7% and a specificity of 72.0% with a threshold of 26.2%. By comparison, traditional parameters and absolute procalcitonin failed to predict treatment response (P > .05). Indeed, the combination of ⌬PCT d3 % > 26.2% and a modified Clinical Pulmonary Infection Score of < 6 points improved the predictive value (area under the curve of 0.89, sensitivity of 81.3%, specificity of 86.5%). CONCLUSIONS: Procalcitonin levels were not influenced by aging, and procalcitonin kinetics might help to identify treatment failure. ⌬PCT d3 % in combination with the Clinical Pulmonary Infection Score has been shown to be a marker of clinical efficacy at an earlier stage.

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Section: Discussionmentioning

confidence: 99%

Procalcitonin Kinetics and Nosocomial Pneumonia in Older Patients

Shi

Xu²,

Rui

et al. 2013

Respir Care

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“…Only 10% to 15% of all blood cultures (BCs) show growth, and approximately half of these grow contaminants. 8 The term sepsis can be used when systemic inflammatory response syndrome (SIRS) is present and the infection is proven. 5 Lysis centrifugation method of BCs, immunofluorescence and enzyme-linked immunoabsorbent assays for antigen detection, polymerase chain reaction, and detection of microbial heat production (calorimetry) are further methods for identifying bacteremia, but the best method is not available for detection of bacteremia.…”

mentioning

confidence: 99%

Is Procalcitonin a Diagnostic and/or Prognostic Marker in Sepsis?

Afşar¹,

Şener²

2015

Infectious Diseases in Clinical Practice

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Millions of patients in the world are being increasingly exposed to sepsis every year, and the rate of sepsis mortality remains high. If effective antibiotic therapy is started early, morbidity and mortality levels decrease in infections. Many previous studies indicated that the prohormone procalcitonin (PCT) is an excellent marker for sepsis and its related conditions. Procalcitonin is synthesized by a large number of tissues and organs in response to the invasion by pathogenic microorganisms and the use of PCT as a marker to improve the diagnosis of bacterial infections and guide antibiotic therapy. Procalcitonin also correlates with the extent and severity of infection, and it can be used for a prognostic marker. The aim of this review was to discuss whether serum PCT levels could be a diagnostic and/or prognostic marker in sepsis.

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“…The kit has been designed for the quantitative determination of PCT in human serum. 9 The method can be used for samples over the range of 0.01-100 ng / ml. The test has to be performed on the fully-auto chemiluminiscence immune assay (CLIA) analyzer Maglumi 600.…”

Section: Methodsmentioning

confidence: 99%