Use of Plasma Procalcitonin Levels as an Adjunct to Clinical Microbiology

Gilbert, David N.

doi:10.1128/jcm.00655-10

Cited by 136 publications

(101 citation statements)

References 39 publications

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“…The peptide precursor is released by parenchymal cells including liver, kidney and muscles cells as well as adipocytes in response to bacterial toxins. After exposition to those toxins, serum levels of PCT increase within 2 to 4 h [20] and a peak of PCT in serum can be detected after approximately 14 h [21,22] . PCT is seen as a specific biomarker for bacterial infection [23] , although elevations of PCT in serum can also be observed under non-infectious conditions, such as trauma [24] , major surgical procedures, pancreatitis and renal impairment [25][26][27][28] .…”

Section: Crp and Pctmentioning

confidence: 99%

Are there new approaches for diagnosis, therapy guidance and outcome prediction of sepsis?

Kojic

Siegler

Uhle

et al. 2015

WJEM

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Beside many efforts to improve outcome, sepsis is still one of the most frequent causes of death in critically ill patients. It is the most common condition with high mortality in intensive care units. The complexity of the septic syndrome comprises immunological aspects -i.e. , sepsis induced immunosuppression -but is not restricted to this fact in modern concepts. So far, exact mechanisms and variables determining outcome and mortality stay unclear. Since there is no typical risk profile, early diagnosis and risk stratification remain difficult, which hinders rapid and effective treatment initiation. Due to the heterogeneous nature of sepsis, potential therapy options should be adapted to the individual. Biomarkers like C-reactive protein and procalcitonin are routinely used as complementary tools in clinical decision-making. Beyond the acute phase proteins, a wide bunch of promising substances and non-laboratory tools with potential diagnostic and prognostic value is under intensive investigation. So far, clinical decision just based on biomarker assessment is not yet feasible. However, biomarkers should be considered as a complementary approach. Core tip: Sepsis is a complex continuum of disturbed systems. Despite the presence of clinical consensus criteria, the early diagnosis especially in the perioperative setting is challenging. A magnitude of potential new biomarkers is tested for this purpose, but evidence is mounting that due to the complex nature of the syndrome, biomarkers are rather complementary tools for clinical decision making than "magic bullets". Moreover, biomarkers are also evaluated for therapy guidance, linking diagnostic results to an individual therapeutic regime. This review summarizes the developments in the biomarker field, aiming to provide an overview about current targets and their limitations.

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Section: Crp and Pctmentioning

confidence: 99%

Are there new approaches for diagnosis, therapy guidance and outcome prediction of sepsis?

Kojic

Siegler

Uhle

et al. 2015

WJEM

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“…34 ' 36 In addition, further research into the use of biomarkers (such as procalcitonin) that can help to distinguish bacterial from viral disease would be useful in optimizing the use of antibacterial agents, including determining the appropriate duration of therapy. 37 Finally, it is imperative that the appropriate federal agencies, such as CDC, AHRQ, FDA, and NIH, receive adequate appropriations to fund these research efforts.…”

Section: Research On Antimicrobial Stewardship Is Neededmentioning

confidence: 99%

Policy Statement on Antimicrobial Stewardship by the Society for Healthcare Epidemiology of America (SHEA), the Infectious Diseases Society of America (IDSA), and the Pediatric Infectious Diseases Society (PIDS)

Fishman¹

2012

Infect. Control Hosp. Epidemiol.

578

249

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Antimicrobial resistance has emerged as a significant healthcare quality and patient safety issue in the twenty-first century that, combined with a rapidly dwindling antimicrobial armamentarium, has resulted in a critical threat to the public health of the United States. Antimicrobial stewardship programs optimize antimicrobial use to achieve the best clinical outcomes while minimizing adverse events and limiting selective pressures that drive the emergence of resistance and may also reduce excessive costs attributable to suboptimal antimicrobial use. Therefore, antimicrobial stewardship must be a fiduciary responsibility for all healthcare institutions across the continuum of care. This position statement of the Society for Healthcare Epidemiology of America, the Infectious Diseases Society of America, and the Pediatric Infectious Diseases Society of America outlines recommendations for the mandatory implementation of antimicrobial stewardship throughout health care, suggests process and outcome measures to monitor these interventions, and addresses deficiencies in education and research in this field as well as the lack of accurate data on antimicrobial use in the United States.

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“…Prokalsitonin, kalsitoninin ön-hormonu olup, ciddi bakteriyel enfeksiyonları belirlemede, CRP ve lökosit sayısına göre daha duyarlıdır (10)(11)(12). Bakteriyel ve aseptik menenjit ayrımında serum prokalsitonin düzeyinin ≥ 0,5 ng/mL, > 2 ng/mL, > 4,8 ng/mL, ≥ 5 pg/mL düzeylerindeki kesim noktalarındaki duyarlılığı %100-89 ve özgüllüğü %93,5-66 arasında değiştiği rapor edilmiştir (13)(14)(15)(16)(17).…”

Section: Discussionunclassified

THE EFFECTIVENESS OF LABORATORY TESTS FOR THE PREDICTION OF ACUTE BACTERIAL MENINGITIS IN THE PEDİATRİC EMERGENCY DEPARTMENT The Effectiveness of Laboratory Tests for the Prediction of Acute Bacterial Menengitis in the Pediatric Emergency Department

Gökalp¹,

Bal²,

Bıcılıoğlu³

et al. 2015

Turk J Ped Em Int Care Med

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ÖZET Amaç:Çocuk acil servisinde akut bakteriyel menenjit ön tanısıyla lomber ponksiyon yapılan çocuklarda laboratuvar tetkiklerinin tanıdaki yerinin araştırılması. Yöntemler: 01.01.2008 -31.12.2013 yılları arasında İzmir Tepecik Eğitim ve Araştırma Hastanesi Çocuk Acil Servisi'nde akut bakteriyel menenjit ön tanısıyla lomber ponksiyon yapılan çocukların tıbbi kayıtları geriye dönük olarak incelenmiştir. Başvuru öncesi antibiyotik kullanan olgular çalışma dışı bırakılmıştır. Olgular 3 grup altında toplanmıştır: Normal beyin omurilik sıvısı (BOS), aseptik menenjit ve akut bakteriyel menenjit. Bu üç grubun laboratuvar tetkikleri karşılaştırılmıştır. Bulgular: Toplam 632 olgu (ortalama yaş: 42,2 ± 0,8 ay; minimum: 1 ay; maksimum: 210 ay; 387 erkek) çalışmaya dahil edildi. Toplam 205 olguda (%32,4) normal BOS bulguları, 401 olguda (%63,4) aseptik menenjit ve 29 olguda (%4,6) akut bakteriyel menenjit saptandı. Akut bakteriyel menenjit grubunda serum prokalsitonin düzeyi yüksek ve BOS glikoz düzeyi düşük saptandı (p < 0,05). Serum prokalsitoninin (< 24 ng/mL) ve BOS glikozunun (< 49 mg/dL) duyarlılık-ları %95 ve %51,8; özgüllükleri %92 ve %70,6 olarak saptandı. Periferik kandaki lökosit ve nötro l sayıları, serum Creaktif protein düzeyi, BOS lökosit sayısı ve protein düzeyleri açısından gruplar arasında fark saptanmadı (p > 0,05). Sonuç: Acil serviste lomber ponksiyon yapılan çocuk olguların çok az bir kısmında akut bakteriyel menenjit saptanmıştır. Serum prokalsitonin ölçümü çocuk acil servisinde akut bakteriyel menenjiti ayırt etmede etkin bir laboratuvar testi olarak öne çıkmıştır. CAYD 2015;2(1):19-24. Anah tar Ke li me ler: Menenjit, prokalsitonin, BOS glikoz, Çocuk AcilTo evaluate the accuracy of laboratory tests in identifying children who had lumbar puncture for suspected bacterial meningitis in the ED. Methods: Retrospective review of the medical records of children with preliminary diagnosis of acute bacterial meningitis and had a lumbar puncture between January 1st, 2008 and December 31st, 2013. All patients presenting to the emergency department (ED) of Izmir Training and Research hospital during the study period. Children who received antibiotics prior to admission to the ED were excluded. The patient population was strati ed into three group based on the results of cerebrospinal analysis and culture (CSF); normal, aseptic meningitis, and bacterial meningitis. The results of all laboratory tests were compared between the groups. Results: We enrolled 632 patients. The mean age was 42.2 ± 0.8 month (range 1-210 months) and 387 were males. Normal CSF was noted in 205 patients (32.4%), aseptic meningitis 401 patients (63.4%), and 29 (4.6%) had bacterial meningitis. Children with acute bacterial meningitis had a higher level of procalcitonin and lower levels of CSF glucose

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Use of Plasma Procalcitonin Levels as an Adjunct to Clinical Microbiology

Cited by 136 publications

References 39 publications

Are there new approaches for diagnosis, therapy guidance and outcome prediction of sepsis?

Are there new approaches for diagnosis, therapy guidance and outcome prediction of sepsis?

Policy Statement on Antimicrobial Stewardship by the Society for Healthcare Epidemiology of America (SHEA), the Infectious Diseases Society of America (IDSA), and the Pediatric Infectious Diseases Society (PIDS)

THE EFFECTIVENESS OF LABORATORY TESTS FOR THE PREDICTION OF ACUTE BACTERIAL MENINGITIS IN THE PEDİATRİC EMERGENCY DEPARTMENT The Effectiveness of Laboratory Tests for the Prediction of Acute Bacterial Menengitis in the Pediatric Emergency Department

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