Novel applications for serum procalcitonin testing in clinical practice

Choi, Justin; McCarthy, Matthew W

doi:10.1080/14737159.2018.1407244

Cited by 53 publications

(40 citation statements)

References 109 publications

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“…PCT determination may also be helpful in detecting meningitis, bacteremia, and sepsis in children with fever without an apparent source, 35 but PCT, like other biomarker cytokines, also holds promise to identify diverse medical conditions beyond those associated with acute bacterial infection. 36 …”

Section: Discussionmentioning

confidence: 99%

The diagnostic utility of procalcitonin, interleukin-6 and interleukin-8, and hyaluronic acid in the Norwegian consensus definition for early-onset neonatal sepsis (EONS)

Nakstad

2018

IDR

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IntroductionA key challenge in identifying serious bacterial infection in new born infants is the nonspecific clinical presentation of early-onset neonatal sepsis (EONS). Routinely used C-reactive protein, white blood cell count, and platelets are nonspecific. We assessed the diagnostic utility of single biomarkers or combinations of procalcitonin (PCT), interleukin (IL)-6, IL-8, and hyaluronic acid (HA) in newborn infant with EONS, and in human umbilical cord blood (HUCB) from deliveries with chorioamnionitis.Materials and methodsBlood was collected from term infants with strictly defined EONS (group 1, n=15), healthy term infants (group 2, n=15), and the umbilical vein from pregnancies with suspected chorioamnionitis (group 3, n=8), and from healthy pregnancies with no signs of infection (group 4, n=15).ResultsNeonatal plasma PCT and IL-8 showed good predictive value (90% and 83%) for EONS, and the combination of IL-6 or HA with PCT increased the predictability to 87% and 90%, respectively. PCT, IL-6, IL-8, and HA were 8.4-, 4.5-, 3.6-, and 1.9-fold higher when compared with plasma levels in noninfected neonates. PCT, IL-6, and IL-8 in HUCB predicted chorioamnionitis and fever in the delivering mother (89%, 83%, and 72%, respectively). HA was a poor predictor (59%), but its predictability increased in combination with PCT, IL-8, or IL-6. In HUCB from chorioamnionitic deliveries, IL-6, IL-8, and PCT were 23-, 14-, and 2.4-fold higher, respectively, when compared with HUCB from healthy deliveries. There was no correlation between C-reactive protein, white blood cell, and platelet count with PCT, IL-6, IL-8, or HA.ConclusionIn neonates that fulfilled the Norwegian consensus definition of neonatal sepsis, PCT, IL-6, and IL-8, but not HA, have the potential to improve our management of neonates at risk. Except for PCT and IL-8, both with a predictability of >80% in neonatal plasma, combinations of biomarkers increased the predictability for EONS and chorioamnionitis.

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Section: Discussionmentioning

confidence: 99%

The diagnostic utility of procalcitonin, interleukin-6 and interleukin-8, and hyaluronic acid in the Norwegian consensus definition for early-onset neonatal sepsis (EONS)

Nakstad

2018

IDR

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“…Previous studies also showed that elderly influenza patients, were more vulnerable to secondary infections [ 28 ]. Elevated leukocyte counts in influenza pneumonia patients is usually associated with bacterial or fungal coinfection; while, serum PCT is a relatively specific biomarker of bacterial infection [ 29 ]. In our study, more than 90% of IPA patients had a serum PCT of < 0.1 ng/ml, indicating that the coinfection with bacteria was not common.…”

Section: Discussionmentioning

confidence: 99%

Invasive pulmonary aspergillosis in immunocompetent patients hospitalised with influenza A-related pneumonia: a multicenter retrospective study

Liang

Han

et al. 2020

BMC Pulm Med

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Background Increasing cases of pulmonary aspergillosis (IPA) in immunocompetent patients with severe influenza have been reported. Howevere, the risk factors for occurence and death are largely unknown. Methods Data of hospitalised patients with influenza A-related pneumonia (FluA-p) obtained from five teaching hospitals from 2031 to 2018, were reviewed. Univariate and multivariate logistical regression analyses were performed to determine the risk factors involved in the acquisition and 60-day mortality in IPA patients. Results Of the 693 FluA-p patients included in the study, 3.0% (21/693) were IPA patients with a 60-day mortality of 42.9% (9/21). Adjusted for confounders, a Cox proportional hazard model showed that IPA was associated with increased risk for 60-day mortality [hazard ratio (HR) 4.336, 95% confidence interval (CI) 1.191–15.784, p = 0.026] in FluA-p patients. A multivariate logistic regression model confirmed that age (odd ratio (OR) 1.147, 95% CI 1.048–1.225, p = 0.003), systemic corticosteroids use before IPA diagnosis (OR 33.773, 95% CI 5.681–76.764, p < 0.001), leukocytes > 10 × 109/L (OR 1.988, 95% CI 1.028–6.454, p = 0.029) and lymphocytes < 0.8 × 109/L on admission (OR 34.813, 95% CI 1.676–73.006, p = 0.022), were related with the acquisition of IPA. Early neuraminidase inhibitor use (OR 0.290, 95% CI 0.002–0.584, p = 0.021) was associated with a decreased risk for a 60-day mortality in IPA patients. Conclusions Our results showed that IPA worsen the clinical outcomes of FluA-p patients. The risk factors for the acquisition and death were helpful for the clinicians in preventing and treating IPA.

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“…while, serum PCT is a relatively specific biomarker of bacterial infection [29]. In our study, more than 90% of IPA patients had a serum PCT of < 0.1 ng/ml, indicating that the coinfection with bacteria was not common.…”

Section: Discussionmentioning

confidence: 49%

Invasive pulmonary aspergillosis in immunocompetent patients hospitalised with influenza A-related pneumonia: a multicenter retrospective study

Chen

Han

et al. 2020

Preprint

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Background Increasing cases of pulmonary aspergillosis (IPA) in immunocompetent patients with severe influenza have been reported. Howevere, the risk factors for occurence and death are largely unknown.Methods Data of hospitalised patients with influenza A-related pneumonia (FluA-p) obtained from five teaching hospitals from 2031 to 2018, were reviewed. Univariate and multivariate logistical regression analyses were performed to determine the risk factors involved in the acquisition and 60-day mortality in IPA patients. Results Of the 693 FluA-p patients included in the study, 3.0% (21/693) were IPA patients with a 60-day mortality of 42.9% (9/21). Adjusted for confounders, a Cox proportional hazard model showed that IPA was associated with increased risk for 60-day mortality [hazard ratio ( HR) 4.336, 95% confidence interval (CI) 1.191-15.784, p = 0.026] in FluA-p patients. A multivariate logistic regression model confirmed that age (odd ratio ( OR) 1.147, 95% CI 1.048-1.225, p = 0.003), systemic corticosteroids use before IPA diagnosis ( OR 33.773, 95% CI 5.681-76.764, p < 0.001), leukocytes > 10×10 9 /L ( OR 1.988, 95% CI 1.028-6.454, p = 0.029) and lymphocytes < 0.8×10 9 /L on admission ( OR 34.813, 95% CI 1.676-73.006, p = 0.022), were related with the acquisition of IPA. Early neuraminidase inhibitor use ( OR 0.290, 95% CI 0.002-0.584, p = 0.021) was associated with a decreased risk for a 60-day mortality in IPA patients. Conclusions Our results showed that IPA worsen the clinical outcomes of FluA-p patients. The risk factors for the acquisition and death were helpful for the clinicians in preventing and treating IPA.

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Novel applications for serum procalcitonin testing in clinical practice

Cited by 53 publications

References 109 publications

The diagnostic utility of procalcitonin, interleukin-6 and interleukin-8, and hyaluronic acid in the Norwegian consensus definition for early-onset neonatal sepsis (EONS)

The diagnostic utility of procalcitonin, interleukin-6 and interleukin-8, and hyaluronic acid in the Norwegian consensus definition for early-onset neonatal sepsis (EONS)

Invasive pulmonary aspergillosis in immunocompetent patients hospitalised with influenza A-related pneumonia: a multicenter retrospective study

Invasive pulmonary aspergillosis in immunocompetent patients hospitalised with influenza A-related pneumonia: a multicenter retrospective study

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