Utility of Procalcitonin as a Biomarker for Sepsis in Children

Abstract

Sepsis is a complex process defined as life-threatening organ dysfunction caused by a dysregulated host response to infection. It is associated with significant morbidity and mortality rates in both adults and children, and emphasis has been placed on its early recognition and prompt provision of antimicrobials. Owing to limitations of current diagnostic tests (i.e., poor sensitivity and delayed results), significant research has been conducted to identify sepsis biomarkers. Ideally, a biomarker could reliably and rapidly distinguish bacterial infection from other, noninfectious causes of systemic inflammatory illness. In doing so, a sepsis biomarker could be used for earlier identification of sepsis, risk stratification/prognostication, and/or guidance of antibiotic decision-making. In this minireview, we review one of the most common clinically used sepsis biomarkers, procalcitonin, and its roles in sepsis management in these three areas. We highlight key findings in the adult literature but focus the bulk of this review on pediatric sepsis. The challenges and limitations of procalcitonin measurement in sepsis are also discussed.

Role of C reactive protein and procalcitonin in the diagnosis of lower respiratory tract infection in children in the outpatient setting

“…Although both biomarkers have a good negative predictive value to rule out serious bacterial infections, PCT is increasingly used to identify severe bacterial infections in children such as urinary tract infection and meningitis and to determine the risk of serious bacterial infection in infants with fever of unknown source and oncology patients with neutropenic fever, since it shows a more specific increase in response to bacterial infection, becomes elevated faster, and decreases earlier in response to appropriate antibiotic therapy than CRP (table 1). 578 PCT testing is mostly performed in emergency care settings in middle-high income settings because of its higher cost and longer turnaround time than CRP testing; CRP is widely used in primary care, including in some low income countries, because of its affordability and fast turnaround time (table 1). 5678…”

“…578 PCT testing is mostly performed in emergency care settings in middle-high income settings because of its higher cost and longer turnaround time than CRP testing; CRP is widely used in primary care, including in some low income countries, because of its affordability and fast turnaround time (table 1). 5678…”

Diagnostic Value of sIL-2R, TNF-α and PCT for Sepsis Infection in Patients with Closed Abdominal Injury Complicated with Severe Multiple Abdominal Injuries

“…Blood culture is considered as the "golden criteria" for diagnosing septic infection [9], because blood culture can isolate pathogenic bacteria, which is conducive to further antimicrobial susceptibility test and reasonable selection of antimicrobial agents. However, it has been reported [10] that only half of the patients suspected of sepsis were found to be infected by pathogenic bacteria, and there were also problems such as contamination of normal skin bacteria and long culture time leading to inability to obtain results in time [11]. Therefore, the early diagnosis of sepsis and targeted treatment within a few hours of the rst diagnosis are extremely important [12].…”

The associations of long non-coding RNA taurine upregulated gene 1 and microRNA-223 with general disease severity and mortality risk in sepsis patients

“…Sepsis is characterized by dysregulated inflammatory response to infectious pathogens, and leads to life-threatening organ dysfunctions. [ 1 , 2 ] According to a Chinese statistical report, the occurrence of sepsis is estimated to be 461 cases per 100,000 populations per year. [ 3 ] Despite the understanding of the pathophysiology and the improved protocolized care, the in-hospital deaths related to sepsis is continually increased, moreover, the survivors of sepsis may suffer impaired physical functions, cognitive defects, and even high readmission rates or long-term mortality.…”