The role of procalcitonin in reducing antibiotics across the surgical pathway

Sartelli, Massimo; Ansaloni, Luca; Bartoletti, Michele; Catena, Fausto; Cardi, Maurizio; Cortese, Francesco; Marzo, Francesco Di; Pea, Federico; Plebani, Mario; Rossolini, Gian María; Sganga, Gabriele; Viaggi, Bruno; Viale, Pierluigi

doi:10.1186/s13017-021-00357-0

Cited by 10 publications

(22 citation statements)

References 69 publications

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“…Procalcitonin is a protein consisting of 116 amino acids and is the peptide precursor of calcitonin ( 15 ). In normal physiological conditions, PCT is synthesized mainly in thyroid C cells and to a lesser extent by neuroendocrine tissues in other organs such as the lung and gastrointestinal tract ( 16 ). In response to stimulation induced by glucocorticoids, calcitonin gene-related peptides, glucagon, gastrin or β-adrenergic signals, PCT is converted to calcitonin before entering the circulatory system and therefore exhibits very low serum PCT levels (< 0.02 ng/mL) under normal physiological conditions ( 17 ).…”

Section: Procalcitoninmentioning

confidence: 99%

Progress in the study of biomarkers for early prediction of systemic inflammatory response syndrome after percutaneous nephrolithotomy

Zhang

Jin

et al. 2023

Front. Immunol.

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Urolithiasis is a common and frequent disease in urology. Percutaneous nephrolithotomy (PCNL) is preferred for the treatment of upper urinary tract stones and complicated renal stones >2 cm in diameter, but it has a higher rate of postoperative complications, especially infection, compared with other minimally invasive treatments for urinary stones. Complications associated with infection after percutaneous nephrolithotomy include transient fever, systemic inflammatory response syndrome (SIRS), and sepsis, which is considered one of the most common causes of perioperative death after percutaneous nephrolithotomy. In contrast, SIRS serves as a sentinel for sepsis, so early intervention of SIRS by biomarker identification can reduce the incidence of postoperative sepsis, which in turn reduces the length of stay and hospital costs for patients. In this paper, we summarize traditional inflammatory indicators, novel inflammatory indicators, composite inflammatory indicators and other biomarkers for early identification of systemic inflammatory response syndrome after percutaneous nephrolithotomy.

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Section: Procalcitoninmentioning

confidence: 99%

Progress in the study of biomarkers for early prediction of systemic inflammatory response syndrome after percutaneous nephrolithotomy

Zhang

Jin

et al. 2023

Front. Immunol.

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“…Furthermore, several randomized controlled trials evaluated the use of procalcitonin to guide antimicrobial duration in septic patients [ 81 , 82 , 83 , 84 ]. According to a multidisciplinary task force of experts, procalcitonin may be considered as an excellent parameter for guiding treatment and duration of antibiotic therapy in general and emergency surgery [ 85 ]. Further, the use of an early warning score, namely quick SOFA (qSOFA) [ 41 , 79 , 86 , 87 , 88 ], SIRS [ 89 , 90 , 91 ], Modified Early Warning Score (MEWS), and National Early Warning Score (NEWS) [ 92 ], can facilitate the stratification of risk in patients with suspected infection.…”

Section: Inflammatory Response and Infections In Acute Care Surgery: ...mentioning

confidence: 99%

Antimicrobial Challenge in Acute Care Surgery

Schena¹,

de’Angelis

Carra

et al. 2022

Antibiotics

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The burden of infections in acute care surgery (ACS) is huge. Surgical emergencies alone account for three million admissions per year in the United States (US) with estimated financial costs of USD 28 billion per year. Acute care facilities and ACS patients represent boost sanctuaries for the emergence, development and transmission of infections and multi-resistant organisms. According to the World Health Organization, healthcare-associated infections affected around 4 million cases in Europe and 1.7 million in the US alone in 2011 with 39,000 and 99,000 directly attributable deaths, respectively. In this scenario, antimicrobial resistance arose as a public-health emergency that worsens patients’ morbidity and mortality and increases healthcare costs. The optimal patient care requires the application of comprehensive evidence-based policies and strategies aiming at minimizing the impact of healthcare associated infections and antimicrobial resistance, while optimizing the treatment of intra-abdominal infections. The present review provides a snapshot of two hot topics, such as antimicrobial resistance and systemic inflammatory response, and three milestones of infection management, such as source control, infection prevention, and control and antimicrobial stewardship.

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“…11 Procalcitonin (PCT) in normal condition is present in C-cells of the thyroid gland 12 but in bacterial infection procalcitonin levels are raised in blood and it is one of the sensitive marker of bacterial infection. 13 PCT is involved in apoptosis and facilitate cell damage. It is expensive and not available in all health related facilities.…”

Section: Introductionmentioning

confidence: 99%

Role of neutrophils to lymphocytes ratio in identification of bacterial infection in adult population

Ghouri¹,

Khurshid²,

Tariq³

et al. 2023

J Fatima Jinnah Med Univ

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Background: Bacterial infection are difficult to distinguish from viral infection. Neutrophils are the first cells mobilize to infectious site caused by bacteria and also apoptosis of lymphocytes in response to cell mediated immunity hence raised in neutrophils and decrease in lymphocyte count. The goal of this study is to determine the neutrophil to lymphocyte ratio in patient with positive blood culture for bacteria in patients admitted in hospital. Patients and methods: This cross-sectional study was conducted at Department of Pathology, Hamdard University Karachi, Pakistan from 1st January to 31st June 2022. Total 123 adult patients with positive blood cultures admitted in ward or ICU were enrolled in the study. CBC Samples were collected from patients admitted in ward or ICU and blood culture were already sent due to clinical condition, the organism isolated in blood culture were recorded As blood culture is a gold standard investigation to detect bacterial infection .In this study we will record neutrophil to lymphocyte ratio in patients admitted with positive blood culture for bacteria. Age less than 15 years, pregnant female, OPD patients, negative blood cultures and patients on antibiotic therapy were excluded. Complete blood count (CBC) was performed in Beckman coulter model DxH 520 made by Germany. Age and ward of patient, organism isolated from blood culture, CRP. Results: A total of 123 patients with positive blood culture were enrolled in the study. Out of 123 patients 61.8% (n=76) were male and 38.2% (n=47) were female. Mean NLR was 5.9± 13.1. Total 45.5% patients presented with high NLR. Mean CRP was 58.5± 68.7. Conclusion: High NLR was seen in 45.5% which shows NLR is an important indicator of bacterial infection. More studies are needed to define true significance of NLR in all ages and negative blood cultures.

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The role of procalcitonin in reducing antibiotics across the surgical pathway

Cited by 10 publications

References 69 publications

Progress in the study of biomarkers for early prediction of systemic inflammatory response syndrome after percutaneous nephrolithotomy

Progress in the study of biomarkers for early prediction of systemic inflammatory response syndrome after percutaneous nephrolithotomy

Antimicrobial Challenge in Acute Care Surgery

Role of neutrophils to lymphocytes ratio in identification of bacterial infection in adult population

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