Comparison between procalcitonin and C-reactive protein to predict blood culture results in ICU patients

Bassetti, Matteo; Russo, Alessandro; Righi, Elda; Dolso, Elisabetta; Merelli, Maria; Cannarsa, Nicola; D’Aurizio, Federica; Sartor, Assunta; Curcio, Francesco

doi:10.1186/s13054-018-2183-x

“…The median PCT levels in the adult population with GNB infection has been reported in 26.1 ng/ml, 25.1 ng/ml, and 7.47 ng/ml, comparable to our results with an 18.2 mcg/Lvalue (18)(19)(20). A previous report in the adult population of Shuhua et al (20), regarding sensitivity and speci city, with an optimal cut-off value of 3.11 ng/mL, led to 63.9% and 93.3% values, respectively.…”

Section: Discussionsupporting

confidence: 92%

Procalcitonin levels in children with bloodstream infections caused by different species: a cohort study

Bejarano

¹

,

Ranero

²

,

Tamez-Rivera

³

et al. 2020

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Abstract Background: Timely diagnosis and accurate identification of the causative microorganism in sepsis is crucial in order to offer directed treatment and increase survival rates. Previous studies have aimed to identify biomarkers that could potentially predict blood culture positivity in patients with bacteremia; however, most of the research has been performed in adult populations. The aim of this study were to analyze procalcitonin levels in confirmed bloodstream infections by species in children and assess its utility in immunocompromised patients. Methods: We included children who met the diagnostic criteria for sepsis, with PCT levels collected within a 72-hour period prior to obtaining a blood culture. Kruskal-Wallis test was used to compare differences among groups. Receiver-operating characteristic curves were used to evaluate PCT cut-offs. Results: 120 patients were included, mean age of 55 months. Subjects with immunodeficiency mean PCT was 26.68 mcg/L, compared to 8.78 in immunocompetent hosts. Subjects with Gram-negative bacilli (GNB) had the highest mean PCT levels (18.2 ± 34.2). The difference among microorganisms was significant. Sensitivity and specificity were 78% and 53% for Gram-positive cocci, 60.9% and 33.3% for GNB, and 75% with 25% for yeasts. Subgroup analysis showed 87.5% sensitivity and 16.7% specificity of PCT for predicting GNB blood culture in immunodeficiency children. Conclusions: PCT could be considered as a surrogate biomarker in immunocompromised children and a viable tool to differentiate etiology by species. Key words: Procalcitonin; Sepsis; Bacterial sepsis

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“…In our study we found a 75% sensitivity and 53% specificity of PCT as a predictor of GNB infection, using a PCT cut-off value of 0.5 mcg/L. (19). Median PCT levels of 0.6 ng/ml, 0.5 ng/ml, 1 ng/ml and 0.5 ng/ml were reported by Shuhua et al (20), Miglietta et al (26), Oussalah et al (27) and Leli et al (29), respectively.…”

Section: Discussionsupporting

confidence: 47%

“…The AUC in the ROC analysis was 0.69 (0.67-0.72) for differentiating GNB from GPC or candidemia, and 0.73 ( 0.71-0.74) for the prediction of GNB compared to all other blood culture results. Bassetti M et al(19), reported similar findings with a median PCT concentration of 25.1 ng/ml in GNB bacteremia compared to 8.9 ng/ml in GPC. The AUC was 0.7 (0.62-0.77) among GNB and 0.46 (0.39-0.53) among GPB.…”

mentioning

confidence: 54%

Procalcitonin levels in children with bloodstream infections caused by different species: a cohort study

Bejarano

¹

,

Ranero

²

,

Tamez-Rivera

³

et al. 2020

Preprint

0

View full text Add to dashboard Cite

Background: Timely diagnosis and accurate identification of the causative microorganism in sepsis is crucial in order to offer targeted treatment and increase survival rates. Previous studies have aimed to identify biomarkers that could potentially predict blood culture positivity in patients with bacteremia; however, most of the research has been performed in adult populations. The aims of this study were to analyze procalcitonin (PCT) levels in confirmed bloodstream infections by species in children and assess their utility in immunocompromised patients.Methods: Medical records of children younger than 18 years admitted from 2011 to 2018 were reviewed. Subjects who met the diagnostic criteria for sepsis, with PCT levels collected within a 72-hour period prior to obtaining a blood culture were included. Kruskal-Wallis test was used to compare differences among groups. Receiver-operating characteristic curves were used to evaluate PCT cut-offs. Results: A total of 120 patients were included. Mean age was 55 months. Mean PCT levels in immunosuppressed patients was 26.68 mcg/L, compared to 8.78 in the immunocompetent group. Subjects with bacteremia by Gram-negative bacilli (GNB) had the highest mean PCT levels (18.2 ± 34.2) (p < 0.001). Sensitivity and specificity were 78% and 53% for Gram-positive cocci (GPC), 60.9% and 33.3% for GNB, and 75% and 25% for yeasts, respectively. Subgroup analysis showed 87.5% sensitivity and 16.7% specificity of PCT for predicting documented GNB bacteremia in immunodeficient children. Conclusions: PCT may be considered as a surrogate biomarker in immunocompromised children, and a viable tool to differentiate etiology by species.

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“…The AUC in the ROC analysis was 0.69 (0.67-0.72) for differentiating GNB from GPC or candidemia, and 0.73 ( 0.71-0.74) for the prediction of GNB compared to all other blood culture results. Bassetti M et al (19), reported similar ndings with a median PCT concentration of 25.1 ng/ml in GNB bacteremia compared to 8.9 ng/ml in GPC. The AUC was 0.7 (0.62-0.77) among GNB and 0.46 (0.39-0.53) among GPB.…”

Section: Discussionmentioning

confidence: 63%

“…Identi cation of Candida species was not performed in our study; however, previous authors have not found any difference regarding PCT levels in infections by different Candida species. Thomas-Rüddel et al (18) reported a median PCT level of 4.7 ng/ml, compared to 2.1 ng/ml by Bassetti et al (19).…”

Section: Discussionmentioning

confidence: 88%

Procalcitonin levels in children with bloodstream infections caused by different species: a cohort study

Bejarano¹,

Ranero²,

Tamez-Rivera³

et al. 2020

Preprint

0

View full text Add to dashboard Cite

Background: Timely diagnosis and accurate identification of the causative microorganism in sepsis is crucial in order to offer targeted treatment and increase survival rates. Previous studies have aimed to identify biomarkers that could potentially predict blood culture positivity in patients with bacteremia; however, most of the research has been performed in adult populations. The aims of this study were to analyze procalcitonin (PCT) levels in confirmed bloodstream infections by species in children and assess their utility in immunocompromised patients.Methods: Medical records of children younger than 18 years admitted from 2011 to 2018 were reviewed. Subjects who met the diagnostic criteria for sepsis, with PCT levels collected within a 72-hour period prior to obtaining a blood culture were included. Kruskal-Wallis test was used to compare differences among groups. Receiver-operating characteristic curves were used to evaluate PCT cut-offs. Results: A total of 120 patients were included. Mean age was 55 months. Mean PCT levels in immunosuppressed patients was 26.68 mcg/L, compared to 8.78 in the immunocompetent group. Subjects with bacteremia by Gram-negative bacilli (GNB) had the highest mean PCT levels (18.2 ± 34.2) (p < 0.001). Sensitivity and specificity were 78% and 53% for Gram-positive cocci (GPC), 60.9% and 33.3% for GNB, and 75% and 25% for yeasts, respectively. Subgroup analysis showed 87.5% sensitivity and 16.7% specificity of PCT for predicting documented GNB bacteremia in immunodeficient children. Conclusions: PCT may be considered as a surrogate biomarker in immunocompromised children, and a viable tool to differentiate etiology by species.

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Comparison between procalcitonin and C-reactive protein to predict blood culture results in ICU patients

Cited by 23 publications

References 5 publications

Procalcitonin levels in children with bloodstream infections caused by different species: a cohort study

Procalcitonin levels in children with bloodstream infections caused by different species: a cohort study

Procalcitonin levels in children with bloodstream infections caused by different species: a cohort study

Procalcitonin levels in children with bloodstream infections caused by different species: a cohort study

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