Procalcitonin levels in bloodstream infections caused by different sources and species of bacteria

Shi, Yan; Sun, Li; Jia, Hong Bing; Gao, Wen; Yang, Jian; Zhang, Guo Qiang

doi:10.1016/j.ajem.2016.12.017

Cited by 89 publications

(90 citation statements)

References 33 publications

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“…Disease Markers results failed to identify a significant difference between East Asian and European population [22,23]. In our subgroup analysis, we failed to get exact age and sex information from some of the studies, which hindered the analytical process going further [21,26,31,33,36,37,40,41,54]. Our results assessing the performance of different PCT assays were in line with previous studies which demonstrated equivalence among 3 different PCT assays (Kryptor, Vidas, or Elecsys/-Cobas), as the threshold and accuracy were suggested consistent across these three tests in our study [55,56].…”

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confidence: 83%

Diagnostic Accuracy of Procalcitonin Compared to C-Reactive Protein and Interleukin 6 in Recognizing Gram-Negative Bloodstream Infection: A Meta-Analytic Study

Lai

Wang

et al. 2020

Disease Markers

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Objective. Gram-negative bloodstream infections (GNBSIs), especially those caused by antibiotic-resistant species, have become a public health challenge. Procalcitonin (PCT) showed promising potential in early diagnosis of GNBSI; however, little was known about its performance under different clinical settings. We here systematically assessed the diagnostic accuracy of PCT in recognizing GNBSI and made direct comparisons with C-reactive protein (CRP) and interleukin 6 (IL-6). Methods. PubMed, Embase, ISI Web of Knowledge, and Scopus were searched from inception to March 15th, 2019. Area under the summary receiver operating characteristic curve (AUC), pooled sensitivity, specificity, and diagnostic odds ratio (DOR) were calculated. Hierarchical summary receiver operating characteristic (HSROC) model was used for the investigation of heterogeneity and for comparisons between markers. Results. 25 studies incorporating 50933 suspected BSI episodes were included. Pooled sensitivity and specificity for PCT were 0.71 and 0.76, respectively. The overall AUC was 0.80. The lowest AUCs were found in patients with febrile neutropenia (0.69) and hematological malignancy (0.69). The highest AUC was found in groups using electrochemiluminescence immunoassay (0.87). In direct comparisons, PCT showed better overall performance than CRP with the AUC being 0.85 (95% CI 0.81–0.87) for PCT and 0.78 (95% CI 0.74–0.81) for CRP, but the relative DORs varied with thresholds between PCT and CRP (p<0.001). No significant difference was found either in threshold (p=0.654) or in accuracy (p=0.480) between PCT and IL-6 in diagnosing GNBSI. Conclusions. PCT was helpful in recognizing GNBSI, but the test results should be interpreted carefully with knowledge of patients’ medical condition and should not serve as the only criterion for GNBSI. Further prospective studies are warranted for comparisons between different clinical settings.

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confidence: 83%

Diagnostic Accuracy of Procalcitonin Compared to C-Reactive Protein and Interleukin 6 in Recognizing Gram-Negative Bloodstream Infection: A Meta-Analytic Study

Lai

Wang

et al. 2020

Disease Markers

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“…Further analysis could elucidate more specific applications of PCT, such as a study that attempted to use the value of PCT to differentiate Gram-positive from Gram-negative infections [14]. Moreover, there could be more analysis conducted on the degree of change of PCT as an infection progresses or improves with appropriate antibiotic treatment.…”

Section: Discussionmentioning

confidence: 99%

Serum Procalcitonin Level Is Associated with Positive Blood Cultures, In-hospital Mortality, and Septic Shock in Emergency Department Sepsis Patients

Webb

Kramer

Stead

et al. 2020

Cureus

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This study examines the accuracy of initial and subsequent serum procalcitonin (PCT) levels in predicting positive blood cultures, in-hospital mortality, and development of septic shock in emergency department (ED) patients with severe sepsis. This study includes all patients who presented to our ED with an admission diagnosis of severe sepsis over a period of nine months. The median initial PCT was 0.58 ng/mL, interquartile range (IQR) 0.16-5.39. The median subsequent serum PCT was 2.1 ng/mL, with an IQR of 0.3-11.1. The PCT trend over the initial three hours increased in 67% of the study population. Blood cultures were positive in 38% of the cohort. The median maximum PCT in those with a negative blood culture was 1.06 ng/mL compared to 4.19 ng/mL in those with a positive blood culture (p=0.0116). Serum PCT levels >2.0 ng/mL display significant correlation with positive blood cultures, in-hospital mortality, and development of septic shock and as such may serve as a biomarker for more serious infections.

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“…Sepsis is a leading cause of morbidity and mortality worldwide (1). Timely and accurate identi cation of the causative microorganism is crucial in order to increase survival rates by offering targeted treatment.…”

Section: Introductionmentioning

confidence: 99%

Procalcitonin levels in children with bloodstream infections caused by different species: a cohort study

Bejarano

Ranero

Tamez-Rivera

et al. 2020

Preprint

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Abstract Background: Timely diagnosis and accurate identification of the causative microorganism in sepsis is crucial in order to offer directed treatment and increase survival rates. Previous studies have aimed to identify biomarkers that could potentially predict blood culture positivity in patients with bacteremia; however, most of the research has been performed in adult populations. The aim of this study were to analyze procalcitonin levels in confirmed bloodstream infections by species in children and assess its utility in immunocompromised patients. Methods: We included children who met the diagnostic criteria for sepsis, with PCT levels collected within a 72-hour period prior to obtaining a blood culture. Kruskal-Wallis test was used to compare differences among groups. Receiver-operating characteristic curves were used to evaluate PCT cut-offs. Results: 120 patients were included, mean age of 55 months. Subjects with immunodeficiency mean PCT was 26.68 mcg/L, compared to 8.78 in immunocompetent hosts. Subjects with Gram-negative bacilli (GNB) had the highest mean PCT levels (18.2 ± 34.2). The difference among microorganisms was significant. Sensitivity and specificity were 78% and 53% for Gram-positive cocci, 60.9% and 33.3% for GNB, and 75% with 25% for yeasts. Subgroup analysis showed 87.5% sensitivity and 16.7% specificity of PCT for predicting GNB blood culture in immunodeficiency children. Conclusions: PCT could be considered as a surrogate biomarker in immunocompromised children and a viable tool to differentiate etiology by species. Key words: Procalcitonin; Sepsis; Bacterial sepsis

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Procalcitonin levels in bloodstream infections caused by different sources and species of bacteria

Abstract: PCT can distinguish between GNB and GPB infection, as well as between different bacterial species and infection sites.

Cited by 89 publications

References 33 publications

Diagnostic Accuracy of Procalcitonin Compared to C-Reactive Protein and Interleukin 6 in Recognizing Gram-Negative Bloodstream Infection: A Meta-Analytic Study

Diagnostic Accuracy of Procalcitonin Compared to C-Reactive Protein and Interleukin 6 in Recognizing Gram-Negative Bloodstream Infection: A Meta-Analytic Study

Serum Procalcitonin Level Is Associated with Positive Blood Cultures, In-hospital Mortality, and Septic Shock in Emergency Department Sepsis Patients

Procalcitonin levels in children with bloodstream infections caused by different species: a cohort study

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