Direct comparison of the diagnostic accuracy between blood and cerebrospinal fluid procalcitonin levels in patients with meningitis

Shen, Huiqin; Gao, Wei; Cheng, Juan-Juan; Zhao, Sihai; Sun, Yi; Han, Ze‐Guang; Hua, Jun

doi:10.1016/j.clinbiochem.2015.06.017

Cited by 17 publications

(17 citation statements)

References 23 publications

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“…Furthermore, we found that the area under the ROC curve for CSF PCT was 0.92, which was substantially different from the area under the ROC curve for serum PCT (by 0.56). These findings suggest that increases in CSF PCT levels can be used for the diagnosis of intracranial infection, which is similar to the conclusions of many other studies [13,14,18]. However, in this study, serum PCT did not show good diagnostic value for intracranial infection, which is consistent with the results of Choi et al's study [19].…”

Section: Discussionsupporting

confidence: 91%

“…Recent studies have also shown that elevated PCT levels in the serum and CSF may be used for the diagnosis of intracranial infection. Other studies have shown that CSF PCT has better sensitivity and specificity than serum PCT [12][13][14][15]. Additionally, studies have suggested that increased CSF PCT is a non-specific finding, even though the brain tissue itself does not produce synthetic secretions [16,17].…”

Section: Discussionmentioning

confidence: 99%

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Higher Procalcitonin Level in Cerebrospinal Fluid than in Serum Is a Feasible Indicator for Diagnosis of Intracranial Infection

Wang

2020

Surgical Infections

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Objective: To explore the value of the difference in procalcitonin (PCT) levels in serum and cerebrospinal fluid (CSF) for diagnosing intracranial infection in post-neurosurgical patients. Methods: Patients who were treated at our hospital after craniotomy from January 2015 to January 2019 were enrolled in this study. Twenty patients eventually diagnosed with intracranial infection were included in a study group and 22 patients with no intracranial infection were included in a control group. A t-test was used to compare the differences between serum and CSF PCT levels of PCT, and the diagnostic value of PCT was evaluated by receiver operating characteristic (ROC) curve analysis. Results: The serum PCT levels in the study and control groups were 0. 10-0. 03 ng/mL and 0. 09-0. 03 ng/ mL, respectively, and they were not substantially different between the groups. The CSF PCT level in the study group was substantially higher than that in the control group, with values of 0. 13-0. 03 ng/mL and 0. 07-0. 02 ng/mL, respectively. The CSF/serum PCT ratio in the study group was substantially higher than that in the control group, with values of 1. 31-0. 19 and 0. 79-0. 23, respectively. The areas under the ROC curve for serum PCT, CSF PCT and the CSF/serum PCT ratio were 0. 56, 0. 92, and 0. 95, respectively, resulting in a substantial difference among the three groups. Conclusion: CSF PCT may be a valuable marker for diagnosing intracranial infection in patients after neurosurgery; in particular, the specificity of CSF PCT is higher if the CSF PCT level is higher than the serum PCT level.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Higher Procalcitonin Level in Cerebrospinal Fluid than in Serum Is a Feasible Indicator for Diagnosis of Intracranial Infection

Wang

2020

Surgical Infections

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“…Twenty-two studies were included in this systematic review and meta-analysis. 13 – 34 A flowchart of the eligible studies is shown in Supplementary Figure 1, and the characteristics of the studies included in this report are summarized in Table 1 . Nine of the included studies were conducted in Asia 21 – 23 , 26 – 28 , 32 – 34 and 11 were conducted in Europe.…”

Section: Resultsmentioning

confidence: 99%

“… 13 – 34 A flowchart of the eligible studies is shown in Supplementary Figure 1, and the characteristics of the studies included in this report are summarized in Table 1 . Nine of the included studies were conducted in Asia 21 – 23 , 26 – 28 , 32 – 34 and 11 were conducted in Europe. 13 – 20 , 25 , 29 , 30 The sample sizes in each study ranged from 30 to 254, with a total combined sample size of 2058.…”

Section: Resultsmentioning

confidence: 99%

Diagnostic Accuracy of Procalcitonin in Bacterial Meningitis Versus Nonbacterial Meningitis

Wei

Qin

et al. 2016

Medicine

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Several studies have investigated the diagnostic accuracy of procalcitonin (PCT) levels in blood or cerebrospinal fluid (CSF) in bacterial meningitis (BM), but the results were heterogeneous.The aim of the present study was to ascertain the diagnostic accuracy of PCT as a marker for BM detection.A systematic search of the EMBASE, Scopus, Web of Science, and PubMed databases was performed to identify studies published before December 7, 2015 investigating the diagnostic accuracy of PCT for BM. The quality of the eligible studies was assessed using the revised Quality Assessment for Studies of Diagnostic Accuracy method. The overall diagnostic accuracy of PCT detection in CSF or blood was pooled using the bivariate model.Twenty-two studies involving 2058 subjects were included in this systematic review and meta-analysis. The overall specificities and sensitivities were 0.86 and 0.80 for CSF PCT, and 0.97 and 0.95 for blood PCT, respectively. Areas under the summary receiver operating characteristic curves were 0.90 and 0.98 for CSF PCT and blood PCT, respectively.The major limitation of this systematic review and meta-analysis was the small number of studies included and the heterogeneous diagnostic thresholds adopted by eligible studies.Our meta-analysis shows that PCT is a useful biomarker for BM diagnosis.

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“…The highest diagnostic accuracy in that study for CSF PCT was 83%, with sensitivity 67% and specificity 100% when a threshold of 0.74ng/mL was selected. 13 In a study, serum procalcitonin with a cut off of 0.5ng/mL had a sensitivity and negative predictive value of 100%, specificity of 87.09% and positive predictive value of 82.60% which is indicative of the fact that serum procalcitonin is a valuable and powerful biomarker in diagnosing acute bacterial meningitis. Cerebrospinal fluid procalcitonin also with a cut off of 0.5 ng/mL had a sensitivity of 84.21%, specificity of 93.54%, positive predictive value of 88.88% and negative predictive value of 90.62% which indicates that after serum procalcitonin, it could be considered a good biomarker in differentiating acute bacterial meningitis.…”

Section: Discussionmentioning

confidence: 99%

Cerebrospinal fluid procalcitonin: a promising diagnostic tool in differentiating bacterial from aseptic meningitis

Ahmad

Ali

Iqbal

et al. 2019

Int J Contemp Pediatr

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Background: Procalcitonin in cerebrospinal fluid has been evaluated with regard to its usefulness in distinguishing between the possible causative organisms for infections. CSF PCT as a diagnostic marker has also been evaluated for differentiating bacterial from viral meningitis with conflicting results obtained so far. The current study was designed to see the role of procalcitonin as diagnostic marker and in differentiating bacterial from aseptic meningitis in pediatric age group.Methods: Children from 5 months to 15 years of age who were suspected cases of meningitis and were admitted to Pediatric Department in SKIMS Srinagar, Jammu and Kashmir were included in this case control prospective study conducted from 2014 to 2016. The total number of 200 children participated in the study among which 100 were cases and 100 controls. Serum and CSF PCT was measured by a fluorescence immunoassay using QDX Instacheck with a detection limit of 0.25-100 ng/ml. Data was analyzed by using standard statistical tests using SPSS 20.Results: The mean CSF PCT in ng/ml in our study for viral meningitis was 0.59±0.43 (range=0.00-1.90), for bacterial meningitis 4.92±1.50 (range=2.89-10.82) and for controls 0.22±0.11 (range=0.00-0.32), respectively. CSF PCT was significantly higher in viral and bacterial meningitis as compared to controls (p<0.01) and significantly higher in bacterial meningitis as compared to viral meningitis (p<0.01). An AUC of 1.000 was established using serum and CSF PCT for bacterial meningitis. The diagnostic accuracy of serum and CSF PCT was almost 100% at cut-off of 2.2 ng/ml and 2.89 ng/ml, respectively.Conclusions: Author have concluded that CSF PCT can be used as a diagnostic marker with better results in differentiation of bacterial from aseptic meningitis.

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Direct comparison of the diagnostic accuracy between blood and cerebrospinal fluid procalcitonin levels in patients with meningitis

Cited by 17 publications

References 23 publications

Higher Procalcitonin Level in Cerebrospinal Fluid than in Serum Is a Feasible Indicator for Diagnosis of Intracranial Infection

Higher Procalcitonin Level in Cerebrospinal Fluid than in Serum Is a Feasible Indicator for Diagnosis of Intracranial Infection

Diagnostic Accuracy of Procalcitonin in Bacterial Meningitis Versus Nonbacterial Meningitis

Cerebrospinal fluid procalcitonin: a promising diagnostic tool in differentiating bacterial from aseptic meningitis

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