Procalcitonin; a feasible biomarker for severe bacterial infections in Obstetrics and Gynecology?

Tujula, Benita; Kokki, Hannu; Räsänen, Juha; Kokki, Merja

doi:10.1111/aogs.13346

Cited by 22 publications

(27 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…WCC and CRP are nonspecific for inflammation versus infection, but PCT appears to be more specific for bacterial infection. 36,[39][40][41] A number of PCT assays are available, but a meta-analysis conducted by NICE was unable to provide sufficient evidence to recommend routine use to guide acute treatment during suspected bacterial infection. 42 The updated Surviving Sepsis Campaign (SSC) guidelines admit that there is low quality of evidence to support recommendation for the use of PCT to guide management, 40 and caution should be exercised in the extrapolation of this to the pregnant population, particularly in the absence of a normal range.…”

Section: C-reactive Protein and Procalcitoninmentioning

confidence: 99%

Maternal sepsis update: current management and controversies

Greer

Shah

Johnson

2019

The Obstetric & Gynaecologis

View full text Add to dashboard Cite

Sepsis is a leading cause of maternal morbidity and mortality, globally and in the UK. In pregnancy and the puerperium, women may be more susceptible to rapid deterioration of illness following an infection. Sepsis has a complex pathophysiology and the immunological and cardiovascular adaptations of normal pregnancy may have an adverse impact on the maternal response to infection. Furthermore, physiological changes of pregnancy, which mimic those of sepsis, often delay recognition and optimal management. 'Bedside' identification of pathogens and their antibiotic resistance patterns may help to improve clinical outcomes. Recent updates in sepsis management, areas of controversy and the importance of translational research and clinical trials for pregnancy and the puerperium are discussed. Learning objectivesTo highlight the difficulties of diagnosing sepsis in pregnancy. To highlight recent updates, new definitions and controversies of current sepsis management. To highlight the potential for research to develop novel biomarkers and therapeutic agents specific to the pregnant woman. Ethical issuesSepsis research involving new technologies differentially benefits high-income countries compared with low-/middle-income countries despite the greatest burden of maternal sepsis being in the latter. With the current rapid evolution of omic technology platforms, greater affordability will provide greater accessibility.

show abstract

Section: C-reactive Protein and Procalcitoninmentioning

confidence: 99%

Maternal sepsis update: current management and controversies

Greer

Shah

Johnson

2019

The Obstetric & Gynaecologis

View full text Add to dashboard Cite

show abstract

“…Mycoplasma) or in local infections with no systemic response [30]. Optimizing antibiotic therapy is important at an individual patient-level but can also minimize emergence of antibiotic resistance [31]. PCT can also be used in the guidance of antibiotic therapy.…”

Section: Review Series: Immunology Of Pregnancymentioning

confidence: 99%

“…Several studies have indicated that pregnant serum PCT is not relevant to predict spontaneous preterm birth [50] or for maternal bacterial infection in pregnancy [31]; for instance, during chorioamnionitis PCT is more likely to be released by the fetus rather than by placental tissue [51], indicating that it cannot be a good marker for maternal infection. All these investigations concur to validate the observations that gravid condition (pregnancy hormones and immunity state) can render the main PCT producers resistant to LPS activation.…”

Section: Pct As a Marker Of Sepsis During Pregnancymentioning

confidence: 99%

“…PCT can also be used in the guidance of antibiotic therapy. Optimizing antibiotic therapy is important at an individual patient-level but can also minimize emergence of antibiotic resistance [31].…”

Section: Review Series: Immunology Of Pregnancymentioning

confidence: 99%

“…As we have already described, PCT seems to be a useful biomarker for severe bacterial infections, and this could also be the case in the obstetrics and gynecology field, but the use of PCT as a marker of sepsis during pregnancy is controversial, as the general reference values for PCT in pregnancy have not been currently established. More data are needed to also support the use of PCT in obstetrics and gynecology [31], because reference intervals (RIs) for this prohormone, which are essential for clinical decision-making, are lacking. The existing RIs for PCT are mainly based on general adults, not involving pregnant women.…”

Section: Pct As a Marker Of Sepsis During Pregnancymentioning

confidence: 99%

See 2 more Smart Citations

Overview of procalcitonin in pregnancy and in pre-eclampsia

Mangogna

Agostinis

Ricci

et al. 2019

Clinical and Experimental Immunology

View full text Add to dashboard Cite

Procalcitonin (PCT), a precursor for calcitonin, is a prohormone involved in the inflammatory processes, which has been poorly studied in the context of pregnancy. During severe inflammation, PCT derives from almost all cell types, including monocytes and parenchymal tissues, making it a good predictive and diagnostic marker of an inflammatory state with rapidly increased serum levels in inflammation or sepsis. In normal pregnancy, PCT is basally expressed at very low level by decidual cells, even if decidual macrophages, which in normal pregnancy are skewed to M2 macrophages, are resistant to lipopolysaccharide (LPS)-induced production of PCT. As PCT increase is associated with an inflammatory state, several research groups investigated whether PCT can be considered a marker of pre-eclampsia, a pregnancy disease characterized by systemic inflammation. The first aim of this review is to summarize what is already known about the tissues synthesizing PCT, about the stimuli that cause the increase of circulating PCT levels and how PCT acts as a proinflammatory stimulus by itself. Secondly, we will describe the role of this prohormone in normal pregnancy and in pregnancies complicated by pre-eclampsia, highlighting the involvement of the decidual macrophages and the proinflammatory cytokine tumor necrosis factor-α in the modulation of PCT expression in the decidual microenvironment.

show abstract

Serum procalcitonin to differentiate acute antepartum pyelonephritis from asymptomatic bacteriuria and acute cystitis during pregnancy: A multicenter prospective observational study

Hsiao

Zhang

Kang

et al. 2021

Intl J Gynecology & Obste

View full text Add to dashboard Cite

Objective: To examine whether serum procalcitonin (PCT) is useful for differentiating acute pyelonephritis (APN) from asymptomatic bacteriuria and acute cystitis during pregnancy. Methods:A multicenter prospective observational study was conducted to compare serum white blood cell (WBC) counts, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) level, and PCT level among pregnant women with asymptomatic bacteriuria, acute cystitis, and APN and healthy pregnant women (controls).Utility of WBC count, ESR, CRP, and PCT biomarkers for the prediction of APN during pregnancy were measured.Results: Area under the curve (AUC) values of PCT, CRP, ESR, and WBC count for predicting asymptomatic bacteriuria were 0.576, 0.628, 0.542, and 0.532, respectively; those for predicting acute cystitis were 0.766, 0.735, 0.681, and 0.597, respectively; and those for predicting acute pyelonephritis 0.859, 0.763, 0.711, and 0.732, respectively. Compared with the other inflammatory markers used to predict APN, PCT exhibited the highest AUC (0.859 [95% confidence interval (CI) 0.711-0.935]). A cutoff value of >0.25 ng/ml had a sensitivity of 87% and a specificity of 79%. Conclusion:Serum PCT can be a valuable addition to existing methods of differentiating asymptomatic bacteriuria, acute cystitis, and APN during pregnancy and can facilitate the early identification of APN during pregnancy.

show abstract

Procalcitonin; a feasible biomarker for severe bacterial infections in Obstetrics and Gynecology?

Cited by 22 publications

References 13 publications

Maternal sepsis update: current management and controversies

Maternal sepsis update: current management and controversies

Overview of procalcitonin in pregnancy and in pre-eclampsia

Serum procalcitonin to differentiate acute antepartum pyelonephritis from asymptomatic bacteriuria and acute cystitis during pregnancy: A multicenter prospective observational study

Contact Info

Product

Resources

About