The Role of Serum Procalcitonin Level as an Early Marker of Ascitic Fluid Infection in Post Hepatitic Cirrhotic Patients

Rahma, Mohamed Zakaria Abu; Mahran, Zainab Gaber; Shafik, Engy A; Mohareb, Dina A; el‐Rady, Nessren M. Abd; Mustafa, M. A.; Khalil, Mahmoud; Abo-Amer, Yousry Esam-Eldin

doi:10.2174/1871523019666200303104932

Cited by 4 publications

(3 citation statements)

References 22 publications

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“…In our study, ascitic fluid procalcitonin was significantly elevated in patients with SBP than non-SBP, with a positive correlation with PMNL, which is the gold standard for the diagnosis of SBP. These results agree with the result from previous studies that reported high ascitic fluid procalcitonin in SBP patients [24,28]. Also, Yang et al [29] analyzed 339 patients with SBP from seven previous publications reporting serum procalcitonin levels is a relatively sensitive and specific test for the diagnosis of SBP.…”

Section: Discussionsupporting

confidence: 91%

MCP1, CRP and Procalcitonin as Novel Diagnostic Markers in Cirrhotic Patients with Spontaneous Bacterial Peritonitis

Mohamed¹,

Salah²,

Hassan³

et al. 2022

TOBIOMJ

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Background & Aims: The aim of the study was to evaluate serum c-reactive protein (CRP), ascitic procalcitonin (PCT) and monocyte chemotactic protein-1 (MCP-1) in the diagnosis of spontaneous bacterial peritonitis (SBP) in cirrhotic patients. Methods: A cross-sectional analytic study that included 199 patients with decompensated cirrhosis (101 with SBP and 98 without SBP). Patients were classified according to Child-Pugh criteria. Ascitic PCT and MCP-1 were measured by enzyme-linked immunosorbent assay. Serum CRP, liver and renal functions were assessed. Results: Three markers are significantly elevated in SBP patients than those without ascites. Using the ROC curve at AUC 0.883 and a cut-off value of >186 ng/ml, the diagnostic performance of ascitic MCP-1 level was higher than CRP (AUC 0.562) and ascitic fluid procalcitonin (AUC 0.751) in the diagnosis of SBP. The sensitivity and specificity were 86.15% and 79.59% at the cutoff of 186 ng/ml for MCP-1, 65.4 and 75.5 at ≥ 1 ng/ml for PCT, and 52.5 and 64.3, respectively for at 11.2 mg/dl CRP. Conclusion: Ascitic MCP-1 has a better diagnostic value with higher sensitivity and specificity in diagnosis SBP compared to CRP and procalcitonin which has higher diagnostic accuracy than CRP. Further studies with a large number will be necessary to evaluate the usefulness of these markers in diagnosis, follow-up and relation to morbidity and mortality of SBP patients.

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Section: Discussionsupporting

confidence: 91%

MCP1, CRP and Procalcitonin as Novel Diagnostic Markers in Cirrhotic Patients with Spontaneous Bacterial Peritonitis

Mohamed¹,

Salah²,

Hassan³

et al. 2022

TOBIOMJ

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“…Yang et al, evaluated the diagnostic role of serum procalcitonin concentrations in patients with spontaneous bacterial peritonitis, where their results showed sensitivity 0.82 (95% C.I 0.79-0.87), specificity 0.86 (95% C.I 0.82-0.89), positive likelihood ratio 4.94 (95% C.I 2.28-10.70), negative likelihood ratio 0.22 (95% C.I 0.10-0.52), and diagnostic odds ratio 22.55 (95% C.I 7.01-108.30). The area under the curve was 0.92 [19,36]. Wu et al, found that serum procalcitonin levels in advanced liver cirrhotic patients with spontaneous bacterial peritonitis were significantly higher than those with (culturenegative neurolytic ascites).…”

Section: Discussionmentioning

confidence: 99%

The Role of MicroRNAs (miRNA 155, miRNA-146b) and Procalcitonin as Novel Markers for the Diagnosis of Spontaneous Bacterial Peritonitis

El-Hassib¹,

Abo-Elmatty²,

Mesbah³

et al. 2021

TOBIOMJ

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Background: MircoRNAs are endogenous, small non-coding RNA molecules that have been recognized as important modulators of gene expression. MicroRNA is considered one of the potential biomarkers of infection and inflammation. Our study aims to identify the potential role of miRNA-155, miRNA-146b, and Procalcitonin (PCT) in the early detection of spontaneous bacterial peritonitis in cirrhotic liver patients. miRNA-155 and 146b are molecular biomarkers , while procalcitonin is a serum marker in ascites patients complicated with Spontaneous Bacterial Peritonitis (SBP) . Methods: This study was conducted on 199 patients, 101 of them have ascites complicated with spontaneous bacterial peritonitis, and 98 patients without spontaneous bacterial peritonitis (control group). Ascitic fluid samples were collected from patients with SBP undergoing paracentesis at National Hepatology Institute in Egypt. MicroRNAs were determined in the serum using qPCR (quantitative polymerase chain reaction), while procalcitonin has been assessed in serum samples using ELISA (Enzyme-linked immune assay) technique. Results: Serum levels of miRNA-146b & miRNA-155 were significantly higher (p<0.001) in spontaneous bacterial peritonitis patients (79.2% and 97.0% respectively) than ascites patients (17.3% and 7.1%, respectively). Furthermore, the serum level of procalcitonin was significantly higher (p<0.001) in spontaneous bacterial peritonitis patients than that in ascites patients (68.3% and 27.6%, respectively). Conclusion: miRNA-155, miRNA-146b and procalcitonin can be used as early markers for the detection of SBP in hepatic patients with ascites.

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“…As serum PCT levels increase earlier and normalize faster than CRP, it has benefit of earlier diagnosis of disease, as well as better follow up of the progression of the disease. Rapid identification of infection has a major effect on course, management, and outcome of critically ill intensive care unit (ICU) cases (8) .…”

Section: Introductionmentioning

confidence: 99%

Impact of Serum and Ascitic Fluid Procalcitonin on Diagnosis and Outcome of Patients with Spontaneous Bacterial Peritonitis

Saleh¹,

Khafagy²,

Hasan³

et al. 2022

The Egyptian Journal of Hospital Medicine

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Background: Cirrhosis is the main cause of ascites, where it indicates poor prognosis with approximately 50% mortality at 2 years. The risk is increased with other complications including spontaneous bacterial peritonitis (SBP). Procalcitonin (PCT) is a significant marker for sepsis because its level is usually high in septic conditions but remains low in nonspecific inflammatory diseases and viral infections. Objective: To assess the impact of serum and ascitic fluid procalcitonin on diagnosis and optimization of antibiotic therapy in SBP in cirrhotic patients. Patients and Methods: 55 patients with liver cirrhosis and ascites, 25 of them suffered from SBP and the other 30 patients free from bacterial infection were enrolled in the study. All patients were subjected to full history, examination and assessment for serum and ascitic fluid procalcitonin. Results: The median age was 60.4±10.2 years in the SBP and 61.3±10.6 years in non SBP patients. There was no statistically significant difference between non SBP and SBP groups regarding their age, sex and diabetes meelitus (DM) frequency. Ascitic fluid culture was done to the SBP group where 3 cases were sensitive to ciprofloxacin, one case sensitive to amikacin and 1 case sensitive to meropenem and one case sensitive to vancomycin. A statistically significant higher median ascitic fluid and serum PCT was found among SBP than non SBP group. with every increase one unit increases risk of SBP by 1.01 (Odds ratio= 1.01, 95% CI: 1.0 -1.01). The overall percent predicted was 87.3%. Conclusion: PCT was significantly high in the serum and ascitic fluid of SBP patients with high specificity, sensitivity, positive and negative predictive value. Ascitic fluid analysis with polymorphonuclear leukocyte (PMN) count remains the standard key to diagnose SBP.

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The Role of Serum Procalcitonin Level as an Early Marker of Ascitic Fluid Infection in Post Hepatitic Cirrhotic Patients

Cited by 4 publications

References 22 publications

MCP1, CRP and Procalcitonin as Novel Diagnostic Markers in Cirrhotic Patients with Spontaneous Bacterial Peritonitis

MCP1, CRP and Procalcitonin as Novel Diagnostic Markers in Cirrhotic Patients with Spontaneous Bacterial Peritonitis

The Role of MicroRNAs (miRNA 155, miRNA-146b) and Procalcitonin as Novel Markers for the Diagnosis of Spontaneous Bacterial Peritonitis

Impact of Serum and Ascitic Fluid Procalcitonin on Diagnosis and Outcome of Patients with Spontaneous Bacterial Peritonitis

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