Usefulness of procalcitonin and C-reactive protein for predicting bacteremia in urinary tract infections in the emergency department

Julián-Jiménez, Agustín; Gutiérrez-Martín, P.; Lizcano-Lizcano, A.; López-Guerrero, M.; Barroso-Manso, Á.; Heredero-Gálvez, Eva

doi:10.1016/j.acuroe.2015.07.011

Cited by 14 publications

(6 citation statements)

References 21 publications

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“…Consistent with previous reports, this study demonstrated that patients with UTI who had bacteremia fulfilled more SIRS criteria than those without bacteremia [ 6 ]. Additionally, the results of our study and several other studies have indicated that patients with bacteremia tend to have a higher white cell count and CRP level than those without bacteremia [ 4 , 24 , 25 ]. Physicians can thus use these markers to identify patients with bacteremia.…”

Section: Discussionsupporting

confidence: 72%

The Presence of Bacteremia Indicates Higher Inflammatory Response and Augments Disease Severity in Adult Patients with Urinary Tract Infections

Hsu

Lin

Chen

2022

JCM

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Background: This study investigated the association between the presence of bacteremia and increase in the requirement for intensive care in adult patients with urinary tract infection (UTI). The study also analyzed the differences in clinical features between patients with versus without bacteremia. Methods: We conducted a retrospective screening of the medical records of adult patients admitted during a 4-month period at a single medical center. We excluded patients with concomitant infections and patients whose urine and blood samples were not collected in the emergency department (ED). The included patients were allocated to two groups—bacteremia and nonbacteremia groups—according to the blood culture results for samples collected in the ED. Results: The study cohort comprised 637 patients, including 158 (24.8%) patients in the bacteremia group and 479 (75.2%) patients in the nonbacteremia group. Compared with the patients in the nonbacteremia group, those in the bacteremia group satisfied more systemic inflammatory response syndrome (SIRS) criteria; they had a higher white cell count, C-reactive protein level, and sequential organ failure assessment (SOFA) scores; and had a greater requirement for intensive care (bacteremia vs. nonbacteremia; SIRS: 79.1% vs. 49.9%, p = 0.000; leukocytosis: 68.2% vs. 57.6%, p = 0.000; elevation of CRP: 96.2% vs. 78.6%, p = 0.000; SOFA: 39.2% vs. 23.2%, p = 0.000; requirement for intensive care: 13.9% vs. 4.4%, p = 0.000, respectively). According to the results of multivariate logistic regression, bacteremia and sepsis were independent factors associated with the requirement for intensive care. Conclusions: Bacteremia increased the requirement for intensive care in patients with UTI. Physicians can identify bacteremia using inflammatory markers, the SIRS criteria, and SOFA scores.

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Section: Discussionsupporting

confidence: 72%

The Presence of Bacteremia Indicates Higher Inflammatory Response and Augments Disease Severity in Adult Patients with Urinary Tract Infections

Hsu

Lin

Chen

2022

JCM

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“…However, PCT values assume considerable significance in suspecting bacteremia, more than that of lactate, CRP, and leukocyte estimations and therefore of great value in emergency situations. 25 It is said that PCT can accurately predict the presence of bacteremia in patients with a febrile UTI. 26 However, in many studies, it is shown that PCT levels may increase in non-infectious diseases conditions also.…”

Section: Discussionmentioning

confidence: 99%

Procalcitonin levels in patients with suspected sepsis

et al. 2021

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Background: Procalcitonin (PCT) was found to be a valuable and reliable biomarker for sepsis, especially in critical care patients for whom early recognition and prompt treatment could reduce mortality. Aims and Objectives: This study was aimed at correlating the levels of PCT as diagnostic marker for sepsis in relation to the culture positivity of various samples from blood, respiratory, urine, and exudates from patients admitted in a tertiary care hospital. Materials and Methods: Results of PCT level along with bacterial culture results of blood, respiratory, urine, and exudates were analyzed from 780 patients for a period of 1 year. Results: High PCT values ranging from 0.52 to 200 ng/ml were found in 331 patients admitted with suspected sepsis. Out of 135 cases of sepsis, 85 had blood culture positivity alone and 50 had culture positivity in blood and in other sites with the same organism. Among the 85 cases of bloodstream infections, in which no localized infections were identified, the median PCT was 33 for Gram-negative bacteremia, which was significantly higher as compared with a median of 16 for Gram-positive cocci. In UTI with bacteremia, the median PCT was 45.34 and in UTI without bacteremia, it was 5. Conclusion: From this study, we concluded that PCT values may be useful to distinguish Gram-negative and Gram-positive bacteremia, and furthermore, a high PCT value for patients with UTI may be helpful in predicting bacteremia.

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“…61 The average value of serum PCT in patients with urinary tract infection complicated with bacteremia was (8.08 ± 16.37) ng/mL, and the sensitivity, specificity, positive predictive value, and negative predictive value of urinary tract infection and negative predictive value with PCT ⩾ 1.16 ng/mL as the diagnostic criteria, Bacteremia was 100%, 97%, 84%, and 100%, which were significantly better than serum Lac, CRP, and WBC levels. 62 High levels of PCT can be used as biomarkers for diagnosing urosepsis and identifying severe bacterial infections, and continuous dynamic measurement of PCT levels can effectively guide the use of antibiotics in urosepsis. 63 The high timeliness, sensitivity, and specificity of PCT can provide effective laboratory evidence for early warning and diagnosis of urosepsis in clinical work.…”

Section: Pctmentioning

confidence: 99%

Diagnostic and therapeutic value of biomarkers in urosepsis

Wang

Huang

et al. 2023

Therapeutic Advances in Urology

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Urosepsis is sepsis caused by urogenital tract infection and is one of the most common critical illnesses in urology. If urosepsis is not diagnosed early, it can rapidly progress and worsen, leading to increased mortality. In recent years, with the increase of urinary tract surgery, the incidence of urosepsis continues to rise, posing a serious threat to patients. Early diagnosis of urosepsis, timely and effective treatment can greatly reduce the mortality of patients. Biomarkers such as WBC, NLR, PCT, IL-6, CRP, lactate, and LncRNA all play specific roles in the early diagnosis or prognosis of urosepsis. In addition to the abnormal increase of WBC, we should be more alert to the rapid decline of WBC. NLR values were superior to WBC counts alone in predicting infection severity. Compared with several other biomarkers, PCT values can differentiate between bacterial and non-bacterial sepsis. IL-6 always has high sensitivity and specificity for the diagnosis of sepsis, and CRP also has high sensitivity and specificity for the diagnosis of urosepsis. Lactic acid is closely related to the prognosis of patients with urosepsis. LncRNAs may be potential biomarkers of urosepsis. This article summarizes the main biomarkers, hoping to provide a reference for the timely diagnosis and evaluation of urosepsis.

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Usefulness of procalcitonin and C-reactive protein for predicting bacteremia in urinary tract infections in the emergency department

Cited by 14 publications

References 21 publications

The Presence of Bacteremia Indicates Higher Inflammatory Response and Augments Disease Severity in Adult Patients with Urinary Tract Infections

The Presence of Bacteremia Indicates Higher Inflammatory Response and Augments Disease Severity in Adult Patients with Urinary Tract Infections

Procalcitonin levels in patients with suspected sepsis

Diagnostic and therapeutic value of biomarkers in urosepsis

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