Increased serum procalcitonin levels in pregnant patients with asymptomatic bacteriuria

Abstract

BackgroundAmong the pregnancy urinary tract infections, asymptomatic bacteriuria (ASB) is the most common one. Untreated ASB can progress to pyelonephritis in 30-50% of the patients and can also result in prematurity in 27% of the pregnancy so it needs immediate diagnosis and treatment. In this study, we wanted to evaluate procalcitonin levels, compared to other inflammatory in pregnant women with ASB.MethodsThe study was designed between the period of January 2012 and February 2013 at Sakarya University School of Medicine, Department of Gynecology and Obstetrics. The study population included 30 pregnant patients with asymptomatic bacteriuria and 39 healthy pregnant controls.ResultsMean age was 28 (SD, 5.5) of the study population; mean maternal weight was 70 (SD, 8) kilogram. There were no statically significant differences between the groups according to the routine biochemical parameters, but gestational age was significantly lower in the ASB group compared to the controls (20.4 vs 28.6, respectively; p < 0.001). Serum procalcitonin levels were negative in all of the controls. In ASB group, 9 (30%) patients had procalcitonin levels greater than >0.05 ng/ml and 21(70%) patients had negative procalcitonin levels (Chi-squrae, p < 0.001). The sensitivity and specificity of procalcitonin assay for ASB was calculated as 30% and 100%, respectively. The positive predictive value was 100% and the negative predictive value was 65%. The most frequent microorganisms in the urine culture were Escherichia coli (26 patients, 87%), Proteus mirabilis (3 patients, 10%) and Klebsiella (1 patient, 3%) in the ASB group. We experienced four (44%) recurrences among nine positive procalcitonin in ASB patients after completion of treatment of the first ASB diagnosis.DiscussionProcalcitonin levels were significantly higher in ASB group than the control group and serum procalcitonin levels were higher in pregnant women with recurrent ASB. This finding is an important result revealed that high procalcitonin level can predict the further urinary tract infection risk. Finally, serum procalcitonin levels were normal in healthy pregnant women while other inflammatory markers such as WBC, ESR and CRP levels were higher.

Outcome of Pregnancy Complicated by Asymptomatic Bacteriuria

“…The most affected maternal age range was between 25 and 29 years as observed by other authors [3,14]. ASB was rarely found among teenagers [3], as in our series.…”

“…Our prevalence of ASB (7.8%) is within the range found worldwide which varies between 2 and 11% [13,14]. This might show that the prevalence of ASB is less influenced by the country income status.…”

Oral Intake of Ginger for Chemotherapy-Induced Nausea and Vomiting Among Women With Breast Cancer

“…Ebrahimi, Maltepe, and Einarson (2010) indicated that ginger was used in the complementary treatment of hyperemesis gravidarum. Ginger has an antiemetic effect in hyperemesis gravidarum and postoperative nausea and/or vomiting (Bilir, Akdemir, Ozden, Cevrioglu, & Bilir, 2013;Hines, Steels, Chang, & Gibbons, 2012;Marcus & Snodgrass, 2005). However, these studies were rather limited in how ginger may affect CINV (Alparslan et al, 2012;Chrubasik, Pittler, & Roufogalis, 2005).…”

Nėščiųjų ir jų partnerių šlapimo takų infekcijos reikšmė nėštumo eigai

“…Ieškodami žymenų, kurie padėtų numatyti ŠTI pasikartojimo riziką, Filiz Bilir su kolegomis 2013 m. paskelbė tyrimą, kuriame pirmą kartą buvo tirtas proklacitonino panaudojimas nėščiųjų besimptomės bakteriurijos diagnostikoje [35]. Tyrime pastebėta, kad: 1. prokalcitonino koncentracija kraujo serume buvo statistiškai patikimai didesnė tarp sergančiųjų besimptome bakteriurija nei tarp sveikų nėščiųjų; 2. didelė prokalcitonino koncentracija pirmą kartą diagnozuojama besimptomės bakteriurijos metu gali įspėti apie ŠTI pasikartojimą ateityje; 3. sveikų nėščių moterų kraujo serume prokalcitonino lygis buvo normalus, tuo tarpu eritrocitų nusėdimo greičio, C reaktyvaus baltymo koncentracijos ir leukocitų skaičius buvo gerokai padidėję.…”