Procalcitonin in daily clinical practice: an evergreen tool also during a pandemic

Russo, Alessandro; Venditti, Mario; Ceccarelli, Giancarlo; Mastroianni, Claudio Maria; d’Ettorre, Gabriella

doi:10.1007/s11739-021-02659-2

Cited by 7 publications

(7 citation statements)

References 22 publications

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“…Our data highlight the impact of BSI on outcome, the role of Acinetobacter baumannii colonization and the use of steroids on the risk to develop MDR-AB infections also during COVID-19. Antimicrobial stewardship programs are mandatory in this population [ 32 , 33 ].…”

Section: Discussionmentioning

confidence: 99%

Multidrug-resistant Acinetobacter baumannii infections in COVID-19 patients hospitalized in intensive care unit

et al. 2021

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Objectives Superinfections in patients hospitalized in intensive care unit (ICU) are an important and challenging complication, also in COVID-19. However, no definitive data are available about the role of multidrug-resistant Acinetobacter baumannii (MDR-AB) in COVID-19. Methods This was a single-center, cross-sectional study including patients with MDR-AB infections admitted to ICU with or without COVID-19, between January 2019 and January 2021. The primary objective of the study was to evaluate risk factor for MDR-AB infections in ICU patients hospitalized for COVID-19 or other etiology. The secondary endpoints were 30-days mortality in all study population and risk factors associated with development of bloodstream infection (BSI). Results During the study period 32 adults with COVID-19 were enrolled and compared with 115 patients admitted in the same ICU for other reasons. We observed a total of 114 deaths, with a survival rate of 29.3%: 18.8% in COVID-19 and 32.2% in control group. Relative risk for MDR-AB infection in COVID-19 showed that serum lactate levels mmol/l > 2, Acinetobacter baumannii colonization, BSI and steroid therapy were observed more frequently in COVID-19 patients. Cox regression analysis showed that serum lactate levels > 2 mmol/l, Acinetobacter baumannii colonization, BSI, and steroid therapy were associated with 30-days mortality. Finally, patients with COVID-19, white blood cells count > 11,000 mm3, serum lactate levels > 2 mmol/l, infections at time of ICU admission, Acinetobacter baumannii colonization, and steroid therapy were independently associated with development of BSI. Conclusions Our data highlight the impact of BSI on outcome, the role of Acinetobacter baumannii colonization and the use of steroids on the risk to develop MDR-AB infections also during COVID-19.

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Section: Discussionmentioning

confidence: 99%

Multidrug-resistant Acinetobacter baumannii infections in COVID-19 patients hospitalized in intensive care unit

et al. 2021

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“…A universal marker or combination of markers that could identify specific pathogens would be highly valuable. Clinically available markers, especially the most widely used CRP, WBC, and differential counts, can provide some indication of whether acute fever is due to a bacterial or viral infection but they remain relatively unspecific [67][68][69][70][71]. Recent studies, however, indicate that other host-derived plasma proteins could provide improved bacterial versus viral disease stratification [23,72].…”

Section: Discussionmentioning

confidence: 99%

Disease‐specific plasma protein profiles in patients with fever after traveling to tropical areas

Sundling,

Yman,

Mousavian

et al. 2024

Eur J Immunol

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Fever is common among individuals seeking healthcare after traveling to tropical regions. Despite the association with potentially severe disease, the etiology is often not determined. Plasma protein patterns can be informative to understand the host response to infection and can potentially indicate the pathogen causing the disease. In this study, we measured 49 proteins in the plasma of 124 patients with fever after travel to tropical or subtropical regions. The patients had confirmed diagnoses of either malaria, dengue fever, influenza, bacterial respiratory tract infection, or bacterial gastroenteritis, representing the most common etiologies. We used multivariate and machine learning methods to identify combinations of proteins that contributed to distinguishing infected patients from healthy controls, and each other. Malaria displayed the most unique protein signature, indicating a strong immunoregulatory response with high levels of IL10, sTNFRI and II, and sCD25 but low levels of sCD40L. In contrast, bacterial gastroenteritis had high levels of sCD40L, APRIL, and IFN‐γ, while dengue was the only infection with elevated IFN‐α2. These results suggest that characterization of the inflammatory profile of individuals with fever can help to identify disease‐specific host responses, which in turn can be used to guide future research on diagnostic strategies and therapeutic interventions.

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“…Both have a longer halflife than the cytokines that induce them enabling the detection of immune activation or infection for a longer period of time 62 . However, increased IL6 and IL1β production, and consequently CRP and PCT levels, are also seen in different viral infections 63,64 and non-infectious inflammatory diseases [65][66][67] , making it difficult for CRP and PCT to reach recommended target product profiles with >90% sensitivity and >80% specificity 68,69 . Apart from the risk of missing severe or treatable bacterial infections, the threat from overuse of antibiotics leading to antimicrobial resistance is urgent as well 7 .…”

Section: Discussionmentioning

confidence: 99%

“…A universal marker or combination of markers that could identify specific pathogens would be highly valuable. Clinically available markers, especially the most widely used CRP, WBC, and differential count, can provide some indication of whether acute fever is due to a bacterial or viral infection but they remain relatively unspecific (66–70). In this study, based on 49 markers, we did not observe signatures that were unique to viral or bacterial infections as a group.…”

Section: Discussionmentioning

confidence: 99%

Disease-specific plasma protein profiles in patients with fever after traveling to tropical areas

Sondén

Yman

Mousavian

et al. 2023

Preprint

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Objectives Fever is common among individuals seeking healthcare after traveling to tropical regions. Despite the association with potentially severe disease, the etiology is often not determined. Cytokines are soluble mediators dynamically regulated in the response to infection. Measuring cytokines in the blood can therefore be informative to understanding the host-response to infection and can potentially indicate the type of pathogen that causes the disease. Method In this study, we measured 49 host-response proteins in the plasma of 124 patients with fever after travel to tropical or subtropical regions. The patients had confirmed diagnosis of either P. falciparum malaria, dengue virus, influenza virus, bacterial respiratory tract infection, or culture-confirmed bacterial gastroenteritis, representing the most common disease etiologies. We used multivariate and machine learning methods to assess host-response protein profiles between the different disease groups and healthy control subjects with the aim to identify disease-specific protein signatures. Results The host-response varied between disease groups and combinations of cytokines and other proteins could accurately distinguish infected patients from healthy controls, and from each other. Malaria displayed the most unique protein signature, indicating a strong immunoregulatory response with high levels of IL10, sTNFRI and II, and sCD25 but low levels of sCD40L. In contrast, bacterial gastroenteritis had high levels of sCD40L, APRIL, and IFN-g, while dengue was the only infection with elevated IFNa2. Conclusions These results suggest that characterization of the inflammatory profile of individuals with fever can help to identify disease-specific host-responses, which in turn can be used to guide further diagnostic strategies.

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Procalcitonin in daily clinical practice: an evergreen tool also during a pandemic

Cited by 7 publications

References 22 publications

Multidrug-resistant Acinetobacter baumannii infections in COVID-19 patients hospitalized in intensive care unit

Multidrug-resistant Acinetobacter baumannii infections in COVID-19 patients hospitalized in intensive care unit

Disease‐specific plasma protein profiles in patients with fever after traveling to tropical areas

Disease-specific plasma protein profiles in patients with fever after traveling to tropical areas

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