Serial and panel analyses of biomarkers do not improve the prediction of bacteremia compared to one procalcitonin measurement

Tromp, Mirjam; Lansdorp, Benno; Bleeker‐Rovers, Chantal P.; Gunnewiek, J.M. Klein; Kullberg, Bart‐Jan; Pickkers, Peter

doi:10.1016/j.jinf.2012.06.004

Cited by 44 publications

(33 citation statements)

References 46 publications

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“…In line with previous studies [16], [17], [26], also this study shows that PCT is a good biomarker to predict bacteremia, as detected by blood culture. In a study on 79 patients, PCT levels observed in patients with a positive SF assay were higher than those observed in patients with a negative one, but the difference was not statistically significant [27].…”

Section: Discussionsupporting

confidence: 92%

“…Procalcitonin is considered a good biomarker of sepsis that correlates with the extent and severity of infection [14] and a reliable test to rule out or predict bacteremia in patients with acute fever [16], [17] and pneumonia [26]. In line with previous studies [16], [17], [26], also this study shows that PCT is a good biomarker to predict bacteremia, as detected by blood culture.…”

Section: Discussionsupporting

confidence: 87%

“…Among early diagnostic markers of sepsis, PCT seems to have a good diagnostic accuracy in predicting bacteremia [16], [17].…”

Section: Introductionmentioning

confidence: 99%

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Procalcitonin Predicts Real-Time PCR Results in Blood Samples from Patients with Suspected Sepsis

et al. 2012

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BackgroundEarly diagnosis and rapid bacterial identification are of primary importance for outcome of septic patients. SeptiFast® (SF) real-time PCR assay is of potential utility in the etiological diagnosis of sepsis, but it cannot replace blood culture (BC) for routine use in clinical laboratory. Procalcitonin (PCT) is a marker of sepsis and can predict bacteremia in septic patients. The aim of the present study was to investigate whether PCT serum levels could predict SF results, and could help screening febrile patients in which a SF assay can improve the etiological diagnosis of sepsis.MethodsFrom 1009 febrile patients with suspected sepsis, 1009 samples for BC, SF real-time PCR, and PCT determination were obtained simultaneously, and results were compared and statistically analysed. Receiver operating characteristic (ROC) curves were generated to determine the area under the curve and to identify which cut-off of PCT value produced the best sensitivity to detect SF results.ResultsMean PCT values of sera drawn simultaneously with samples SF positive (35.42±61.03 ng/ml) or BC positive (23.14±51.56 ng/ml) for a pathogen were statistically higher than those drawn simultaneously with SF negative (0.84±1.67 ng/ml) or BC negative (2.79±16.64 ng/ml) samples (p<0.0001). For SF, ROC analysis showed an area under the curve of 0.927 (95% confidence interval: 0.899–0.955, p<0.0001). The PCT cut-off value of 0.37 ng/ml showed a negative predictive value of 99%, reducing the number of SF assays of 53.9%, still identifying the 96.4% of the pathogens.ConclusionPCT can be used in febrile patients with suspected sepsis to predict SF positive or negative results. A cut-off value of 0.37 ng/ml can be considered for optimal sensitivity, so that, in the routine laboratory activity, SF assay should not be used for diagnosis of sepsis in an unselected patient population with a PCT value <0.37 ng/ml.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 87%

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Procalcitonin Predicts Real-Time PCR Results in Blood Samples from Patients with Suspected Sepsis

et al. 2012

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“…Indeed, this strategy has been shown to improve the diagnostic value of single markers in some 22,33,34 _ENRE-F_22_ENREF_1, although not all studies. 30,92 Most biomarkers examined are stimulated both by bacterial and viral pathogens, but reach higher concentrations during bacterial infection. Therefore, moderately increased levels of these biomarkers can be found during both bacterial and viral infections, limiting the sensitivity.…”

Section: Combination Of Biomarkersmentioning

confidence: 99%

Utility of immune response-derived biomarkers in the differential diagnosis of inflammatory disorders

Oever

Netea

Kullberg

2016

Journal of Infection

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“…32 di penderita yang kritis di ICU, dengan nilai cut off 2 ng/mL didapatkan kepekaan 96%; kekhasan 86%; nilai duga positif 81% dan nilai duga negatif 97%. Hasil telitian ini juga sama dengan hasil telitian sebelumnya oleh Tromp et al 29 yang juga membandingkan PCT dengan IL-6 dan tolok ukur sepsis lainnya seperti: lipopolysaccharidebinding protein (LBP) dan C-reactive protein (CRP). Di hasil telitian tersebut ditemukan PCT memiliki nilai diagnostik yang lebih tinggi dibandingkan IL-6.…”

Section: Diagnosis Sepsisunclassified

Procalcitonin Dan Interleukin-6 Pada Sepsis Dengan Gejala Systemic Inflammatory Response Syndrome (Sirs)

Ks¹,

Dm²,

Emma³

2018

Indonesian J. Clin. Pathol. Med. Lab.

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Sepsis is the cause of patient’s death in the intensive care unit. Sepsis is an inflammatory response to infections. Infection whencontinued can cause systemic inflammatory response syndrome (SIRS). Clinical signs and pathology of SIRS are similar to sepsis, thusclinical as well as laboratory examination is needed to distinguish these. Culture result usually can be seen at least 24 hours aftersampling. In this case a test is needed to diagnose sepsis quickly so that the patient does not experience more severe conditions. Theindicator used in the diagnostic procedure is to know the diagnostic value of procalcitonin (PCT) levels as well as of interleukin-6 (IL-6)for the diagnosis of sepsis. Thirty-two blood samples of patients treated in the Department of SIRS. Dr. Kariadi Semarang were takenconsecutively from November 2011 up to January 2012. PCT levels are determined by ELFA, levels of IL-6 were determined by ELISAmethod. To determine the sensitivity, specificity, positive predictive value and negative predictive value, 2 × 2 table was used. The ROCcurve (receiver operating characteristic) showed an area under the curve of PCT of 0.83 (95% CI = 0.66 to 0.99), cut-off 5.1 ng/mL wasused as an indicator of sepsis. PCT diagnostic test results showed 88.9% sensitivity, 73.9% specificity, 57.1% positive predictive value andnegative predictive value of 94.4%. The area under the curve for IL-6 was 0.67 (95% CI = 0.47 to 0.86), cut off 47.2 pg/mL as an indicatorof sepsis. Diagnostic tests results showed 77.8% sensitivity, 60.9% specificity, 43.7% positive predictive value and negative predictive valueof 87.5%. It can be concluded that the examination of serum PCT levels can be used as a diagnostic test (screening test) for sepsis.

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Serial and panel analyses of biomarkers do not improve the prediction of bacteremia compared to one procalcitonin measurement

Cited by 44 publications

References 46 publications

Procalcitonin Predicts Real-Time PCR Results in Blood Samples from Patients with Suspected Sepsis

Procalcitonin Predicts Real-Time PCR Results in Blood Samples from Patients with Suspected Sepsis

Utility of immune response-derived biomarkers in the differential diagnosis of inflammatory disorders

Procalcitonin Dan Interleukin-6 Pada Sepsis Dengan Gejala Systemic Inflammatory Response Syndrome (Sirs)

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