Value of measuring serum procalcitonin, C-reactive protein, and mannan antigens to distinguish fungal from bacterial infections

Petrikkos, George; Christofilopoulou, Sofia; Tentolouris, Nikolaοs; Charvalos, Ekatherina; Kosmidis, Chris; Daikos, Georgios

doi:10.1007/s10096-005-1312-z

Cited by 47 publications

(30 citation statements)

References 15 publications

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“…For example, Peltola and coworkers [22] have shown that two consecutive C-reactive protein ≤20 mg/L can largely exclude the possibility of invasive bacterial infection both in immunocompetent and immunocompromised hosts. Another prospective study of hospitalized patients, found that C-reactive protein levels were lower in those with fungal infections than in those with bacterial infections [23]. Our data confirmed these previous findings that a lower C-reactive protein response is associated with IFI than with M. tuberculosis or other bacterial infections in SLE patients.…”

Section: Discussionsupporting

confidence: 94%

Invasive fungal infection in Chinese patients with systemic lupus erythematosus

Chen

Zhu

et al. 2012

Clin Rheumatol

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Invasive fungal infection (IFI) can be a lethal complication in systemic lupus erythematosus (SLE). The aim of this study was to determine the characteristics of hospitalized SLE patients with IFI, and identify the risk factors compared to SLE with other major infections or those with active disease alone. Data from 18 SLE in-patients with IFI at Shanghai Renji Hospital between January 2007 and January 2011 were collected by chart review. SLE patients with either active Mycobacterium tuberculosis (n = 19) or other bacterial infections (n = 17), or active SLE (n = 54) in the same period acted as controls. SLE in-patients with IFI (n = 11) from January 2002 to December 2006 was considered as a historical control group. The most frequent pathogens of SLE-IFI was Cryptococcus neoformans (n = 9, 50.0 %), followed by Aspergillus and Candida (both n = 3, 16.7 %). The infection sites included lung (n = 8, 44.4 %), central nervous system (n = 8, 44.4 %), and disseminated IFI (n = 2, 11.1 %). Three patients (16.7 %) died from IFI. Compared with other major infections, IFI patients were younger, with shorter SLE disease duration, lower C-reactive protein response, higher corticosteroids, and antibiotics exposure. Compared with active SLE, IFI patients had elevated alanine transaminase level, higher corticosteroids and antibiotics exposure. In multivariate analysis, the only significant risk factors for IFI were maximum prednisolone exposure ≥45 mg/day prior to infection or flare within 3 months (OR = 10.284, 95 %CI (2.877, 36.836)). Compared with the historical SLE-IFI patients, the short-term survival improved over time (63.6 % versus 83.3 %). SLE-IFI is a unique entity that characterized by certain aforementioned parameters compared with other major infections or disease flare in SLE. Familiar with the disease pattern along with appropriate antifungal treatment may lead to a better outcome in SLE-IFI patients.

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Section: Discussionsupporting

confidence: 94%

Invasive fungal infection in Chinese patients with systemic lupus erythematosus

Chen

Zhu

et al. 2012

Clin Rheumatol

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“…10e15,17 Several other studies have reported lower PCT levels in patients with fungal than in those with bacterial infections. 18,19,21 Distefano et al compared PCT and CRP levels in low birthweight infants 21 ; PCT levels were significantly lower in babies with fungal than in those with bacterial infections. Petrikkos and co-workers first evaluated serum PCT levels in fungal infections 18 and then the power of PCT and mannan antigen to distinguish fungal from bacterial infection.…”

Section: Discussionmentioning

confidence: 96%

Procalcitonin levels in surgical patients at risk of candidemia

Martini

Gottin

Menestrina

et al. 2010

Journal of Infection

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“…Several investigators [32,34] have reported normal PCT levels at the onset of fungal infections with subsequent increases in patients with higher severity of illness. Petrikkos et al [51] measured serum PCT, CRP, and mannan antigens in 91 neutropenic, human immunodeficiency virus (HIV) infected, critically ill patients with fungal and bacterial infection. CRP and PCT levels were higher in patients with bacterial infection than in those with fungal infection on the first and the third day after the onset of infection.…”

Section: Value Of Pct According To the Infecting Micro-organismmentioning

confidence: 99%