Serum procalcitonin and C-reactive protein concentrations to distinguish mildly infected from non-infected diabetic foot ulcers: a pilot study

Abstract

Measurement of only two inflammatory markers, CRP and procalcitonin, might be of value for distinguishing between infected and non-infected foot ulcers in subgroups of diabetic patients, to help ensure the appropriate allocation of antibiotic treatment. Nevertheless, external validation of the diagnostic value of procalcitonin and CRP in diabetic foot ulcers is needed before routine use can be recommended.

Microbiological and clinical characteristics of diabetic foot infections in northern India

“…Application of advanced techniques, such as rDNA PCR, ERIC PCR, etc., to evaluate the infection status and bacterial diversity of the isolates in diabetic foot wounds was suggested in the literature [18,20,21]. Measurement of inflammatory markers has also been used for distinguishing infected and noninfected foot ulcers in subgroups of diabetic patients [22]. However, the positive results of culture sensitivity will always receive priority over the molecular study results for the selection of antibiotics.…”

Wound Fluid Diagnostics in Diabetic Foot Ulcers

“…The classical markers in this context include leukocyte count and C-reactive protein (CRP) as well as the erythrocyte sedimentation rate. Additionally, systemic markers specific to bacterial infection -such as procalcitonin, a peptide precursor of calcitonin, orosomucoid and haptoglobin-have been evaluated in serum of diabetic foot ulcers patients for the determination of infection (Jeandrot et al 2008). Consecutively, a variety of immune mediators -including acute phase proteins, cytokines and chemokines-were examined in the plasma of patients with diabetic foot syndrome.…”

“…CRP was discover e d t o b e o f a h i g h e r p e r f o r m a n c e t h a n procalcitonin, probably triggered by TNF , IL-6 and IL-1 derived from the site of inflammation (Jeandrot et al 2008). Still, the diagnosis of infection was principally determined by clinical assessment and the treatment was chosen accordingly.…”

One small step for diabetic podopathy

“…It is against this background that Jeandrot et al [1] provide further evidence to underpin the use of antibiotics, by examining the response of inflammatory markers to different clinical grades of infection in the foot. These grades of infection have been proposed by the Infectious Diseases Society of America (IDSA) and by the International Working Group on the Diabetic Foot (IWGDF) [2,3].…”

“…They could provide a basis for comparisons of treatment outcomes in different centres, and could prove useful in prospective research. The grades themselves are straightforward in that they simply rank clinical episodes by severity, but the study by Jeandrot et al [1] shows that this ranking is reflected by differences in levels of inflammatory markers, including Creactive protein (CRP), procalcitonin, and total white cell and neutrophil counts. Very high levels of response are no surprise in those with systemic symptoms and signs, of course, but the real interest of this study lies in the distinction it makes between those with no clinical signs and those with mild or moderate infection.…”