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Sample records for abnormal procalcitonin levels

  1. Procalcitonin levels in salmonella infection

    Vikas Mishra

    2015-01-01

    Full Text Available Aim: Procalcitonin (PCT as a diagnostic marker for bacteremia and sepsis has been extensively studied. We aimed to study PCT levels in Salmonella infections whether they would serve as marker for early diagnosis in endemic areas to start empiric treatment while awaiting blood culture report. Materials and Methods: BACTEC blood culture was used to isolate Salmonella in suspected enteric fever patients. Serum PCT levels were estimated before starting treatment. Results: In 60 proven enteric fever patients, median value of serum PCT levels was 0.22 ng/ml, values ranging between 0.05 and 4 ng/ml. 95% of patients had near normal or mild increase (<0.5 ng/ml, only 5% of patients showed elevated levels. Notably, high PCT levels were found only in severe sepsis. Conclusion: PCT levels in Salmonella infections are near normal or minimally increased which differentiates it from other systemic Gram-negative infections. PCT cannot be used as a specific diagnostic marker of typhoid.

  2. PELOD score, serum procalcitonin, and lactate levels in pediatric sepsis

    Jufitriani Ismy

    2015-11-01

    Full Text Available Background Sepsis remains a major cause of morbidity and mortality among critically ill children in the pediatric intensive care unit (PICU. Procalcitonin and lactate have been used as biomarkers of sepsis, as they have been correlated with disease severity, organ failure and death. The Pediatric Logistic Organ Dysfunction (PELOD score is a tool to assess the severity of organ dysfunction in critically ill children. Objective To investigate the correlation between PELOD score and procalcitonin and lactate levels in pediatric sepsis. Methods A cross-sectional study was conducted in children with sepsis who were admitted to the PICU from April to July 2012. Sepsis was defined as systemic inflammatory response syndrome (SIRS, as a result of suspected or proven infection. Proven infection was defined as positive culture findings (blood, urine ot other specimens and/or serum procalcitonin >2 ng/mL. Spearman’s test was used to assess for correlations between PELOD scores and procalcitonin as well as lactate levels. Results Thirty-two patients were analyzed, consisting of 18 males and 14 females with an age range of 1-432 months (median 21 months. There was no statistically significant correlation between procalcitonin level and PELOD score (r=- 0.186, 95%CI -0.502 to 0.174, P=0.308 nor between lactate level(r=-0.069, 95%CI-0.408 to 0.287, P=0.709 and PELOD score. Conclusion Serum procalcitonin and lactate levels are not correlated with PELOD scores in children with sepsis.

  3. PELOD score, serum procalcitonin, and lactate levels in pediatric sepsis

    Jufitriani Ismy

    2016-11-01

    Full Text Available Background Sepsis remains a major cause of morbidity andmortality among critically ill children in the pediatric intensivecare unit (PICU. Procalcitonin and lactate have been used asbiomarkers of sepsis, as they have been correlated with diseaseseverity, organ failure and death. The Pediatric Logistic OrganDysfunction (PELOD score is a tool to assess the severity oforgan dysfunction in critically ill children.Objective To investigate the correlation between PELOD scoreand procalcitonin and lactate levels in pediatric sepsis.Methods A cross-sectional study was conducted in childrenwith sepsis who were admitted to the PICU from April to July2012. Sepsis was defined as systemic inflammatory responsesyndrome (SIRS, as a result of suspected or proven infection.Proven infection was defined as positive culture findings (blood, mL. Spearman’s test was used to assess for correlations betweenPELOD scores and procalcitonin as well as lactate levels.Results Thirty-two patients were analyzed, consisting of 18 malesand 14 females with an age range of 1-432 months (median 21months. There was no statistically significant correlation betweenprocalcitonin level and PELOD score (r=- 0.186, 95%CI -0.502to 0.174, P=0.308 nor between lactate level(r=-0.069, 95%CI-0.408 to 0.287, P=0.709 and PELOD score.Conclusion Serum procalcitonin and lactate levels are notcorrelated with PELOD scores in children with sepsis.

  4. The Procalcitonin And Survival Study (PASS – A Randomised multi-center investigator-initiated trial to investigate whether daily measurements biomarker Procalcitonin and pro-active diagnostic and therapeutic responses to abnormal Procalcitonin levels, can improve survival in intensive care unit patients. Calculated sample size (target population: 1000 patients

    Fjeldborg Paul

    2008-07-01

    Full Text Available Abstract Background Sepsis and complications to sepsis are major causes of mortality in critically ill patients. Rapid treatment of sepsis is of crucial importance for survival of patients. The infectious status of the critically ill patient is often difficult to assess because symptoms cannot be expressed and signs may present atypically. The established biological markers of inflammation (leucocytes, C-reactive protein may often be influenced by other parameters than infection, and may be unacceptably slowly released after progression of an infection. At the same time, lack of a relevant antimicrobial therapy in an early course of infection may be fatal for the patient. Specific and rapid markers of bacterial infection have been sought for use in these patients. Methods Multi-centre randomized controlled interventional trial. Powered for superiority and non-inferiority on all measured end points. Complies with, "Good Clinical Practice" (ICH-GCP Guideline (CPMP/ICH/135/95, Directive 2001/20/EC. Inclusion: 1 Age ≥ 18 years of age, 2 Admitted to the participating intensive care units, 3 Signed written informed consent. Exclusion: 1 Known hyper-bilirubinaemia. or hypertriglyceridaemia, 2 Likely that safety is compromised by blood sampling, 3 Pregnant or breast feeding. Computerized Randomisation: Two arms (1:1, n = 500 per arm: Arm 1: standard of care. Arm 2: standard of care and Procalcitonin guided diagnostics and treatment of infection. Primary Trial Objective: To address whether daily Procalcitonin measurements and immediate diagnostic and therapeutic response on day-to-day changes in procalcitonin can reduce the mortality of critically ill patients. Discussion For the first time ever, a mortality-endpoint, large scale randomized controlled trial with a biomarker-guided strategy compared to the best standard of care, is conducted in an Intensive care setting. Results will, with a high statistical power answer the question: Can the survival

  5. Procalcitonin Levels in Patients with Complete and Incomplete Kawasaki Disease

    Hwa Jin Cho

    2013-01-01

    Full Text Available Incomplete Kawasaki disease (iKD is considered to be a less complete form of Kawasaki disease (cKD, and several differences in the laboratory presentations of iKD and cKD have been noted. We investigated serum procalcitonin levels in patients with iKD, cKD, and other febrile diseases (a control group. Seventy-seven patients with cKD, 24 with iKD, and 41 controls admitted to our hospital from November 2009 to November 2011 were enrolled in the present study. We obtained four measurements of serum procalcitonin levels and those of other inflammatory markers from each patient. Samples were taken for analysis on the day of diagnosis (thus before treatment commenced; D0 and 2 (D2, 14 (D14, and 56 days (D56 after intravenous immunoglobulin infusion. We obtained control group data at D0. The mean D0 serum procalcitonin levels of cKD patients (0.71±1.36 ng/mL and controls (0.67±1.06 ng/mL were significantly higher than those of iKD patients (0.26±0.26 ng/mL (P=0.014 and P=0.041, resp.. No significant difference in mean procalcitonin level was evident among groups at any subsequent time. In conclusion, the serum procalcitonin level of patients with acute-stage cKD was significantly higher than that of iKD patients.

  6. Increased serum procalcitonin levels in pregnant patients with asymptomatic bacteriuria

    Bilir, Filiz; Akdemir, Nermin; Ozden, Selcuk; Cevrioglu, A Serhan; Bilir, Cemil

    2013-01-01

    Background Among the pregnancy urinary tract infections, asymptomatic bacteriuria (ASB) is the most common one. Untreated ASB can progress to pyelonephritis in 30-50% of the patients and can also result in prematurity in 27% of the pregnancy so it needs immediate diagnosis and treatment. In this study, we wanted to evaluate procalcitonin levels, compared to other inflammatory in pregnant women with ASB. Methods The study was designed between the period of January 2012 and February 2013 at Sak...

  7. Usefulness of Measuring Serum Procalcitonin Levels in Patients with Inflammatory Bowel Disease

    Chung, Sook Hee; Lee, Hye Won; Kim, Seung Won; Park, Soo Jung; Hong, Sung Pil; Kim, Tae Il; Kim, Won Ho; Cheon, Jae Hee

    2016-01-01

    Background/Aims The relationships between serum procalcitonin, inflammatory bowel disease (IBD) and intestinal Behçet’s disease (BD) have not been completely determined. We aimed to evaluate the usefulness of measuring serum procalcitonin levels to assess disease activity and infection stage in patients with IBD and intestinal BD. Methods We retrospectively analyzed clinical data from 129 patients with IBD and intestinal BD for whom serum procalcitonin and C-reactive protein (CRP) levels were...

  8. Serum Procalcitonine Levels as an Early Diagnostic Indicator of Sepsis

    Beqja-Lika, Anila; Bulo-Kasneci, Anyla; Refatllari, Etleva; Heta-Alliu, Nevila; Rucaj-Barbullushi, Alma; Mone, Iris; Mitre, Anila

    2013-01-01

    Introduction: Prompt and accurate diagnosis of sepsis is of high importance for clinicians. Procalcitonine (PCT) and C-reactive protein (CRP) have been proposed as markers for this purpose. Our aim was to evaluate the levels of PCT and CRP in early sepsis and its correlation with severity of sepsis. Methods: Levels of PCT and CRP were taken from 60 patients with sepsis criteria and 39 patients with SIRS symptoms from the University Hospital Center “Mother Teresa” in Tirana, Albania during 201...

  9. Serum procalcitonin and cerebrospinal fluid cytokines level in children with meningitis

    Erdal Taskın

    2004-01-01

    Full Text Available Aims: To determine the level of serum procalcitonin and cerebrospinal fluid cytokines in children with bacterial or viral meningitis and to document the use of these parameters in differential diagnosis.

  10. Early Serum Procalcitonin Level after Primary Total Hip Replacement

    Samy Bouaicha

    2013-01-01

    Full Text Available Background. Procalcitonin (PCT is a useful surrogate marker for the differentiation of postoperative infection and unspecific inflammatory reaction after surgery. It is known that postoperative course of the PCT serum level varies with type of surgery. No data exists about the postoperative course of serum PCT levels after primary total hip replacement (THR. Purpose. To characterize early postoperative serum PCT levels in uneventful primary THR compared to postoperative levels of different frequently used inflammatory blood parameters. Method. We prospectively investigated 31 patients. Blood samples were taken preoperatively and for 5 days postoperatively. PCT levels were compared with C-reactive protein (CRP, interleukin-6 (IL-6, and blood leucocyte counts (WBC. Results. In uneventful THR PCT levels showed a uniform low-level course with a peak at the second postoperative day. At the fifth day values returned to almost preoperative levels. On contrary, CRP levels remained high during the entire observational period. Only IL-6 levels showed a peak at postoperative day one with a quick and uniform return to preoperative levels. Conclusion. Similar to observations in cardiothoracic, intestinal, and neural surgeries, postoperative course of PCT after primary THR showed a uniform low-level course with a peak at the second postoperative day but below expected levels in systemic infections.

  11. Procalcitonin levels associate with severity of Clostridium difficile infection.

    Krishna Rao

    Full Text Available OBJECTIVE: Clostridium difficile infection (CDI is a major cause of morbidity and biomarkers that predict severity of illness are needed. Procalcitonin (PCT, a serum biomarker with specificity for bacterial infections, has been little studied in CDI. We hypothesized that PCT associated with CDI severity. DESIGN: Serum PCT levels were measured for 69 cases of CDI. Chart review was performed to evaluate the presence of severity markers and concurrent acute bacterial infection (CABI. We defined the binary variables clinical score as having fever (T >38°C, acute organ dysfunction (AOD, and/or WBC >15,000 cells/mm(3 and expanded score, which included the clinical score plus the following: ICU admission, no response to therapy, colectomy, and/or death. RESULTS: In univariate analysis log10 PCT associated with clinical score (OR 3.13, 95% CI 1.69-5.81, P0.2 ng/mL was 81% sensitive/73% specific for a positive clinical score and had a negative predictive value of 90%. CONCLUSION: An elevated PCT level associated with the presence of CDI severity markers and CDI was unlikely to be severe with a serum PCT level below 0.2 ng/mL. The extent to which PCT changes during CDI therapy or predicts recurrent CDI remains to be quantified.

  12. Plasma procalcitonin level as a predictor of treatment response in ICU patients with bacterial sepsis

    Mobaien AR

    2010-05-01

    Full Text Available "nBackground: Sepsis is one of the most important causes of mortality in severely ill ICU patients. At least, a part of high mortality rate in sepsis patients is due to less specific clinical symptoms for prompt diagnosis. Recently some studies report that serum levels of procalcitonin will increase in these patients but changes of serum levels following treatments is not known. This study was designed to determin procalcitonin levels in patients with bacterial infectious disease in ICU, initially and during therapy and compare the levels during response to treatment. "n"nMethods: This prospective cross-sectional study was conducted on ICU patients with infectious diseases, blood specimen collected on day 1 and then in days 3 and 7 of ICU admission. The semi-quantitative PCT-Q test was performed. "n"nResults: Thirty five patients, 22(62.9 % men and 13(37.1% women, were enrolled in this study. 18(51.4% patients died. Procalcitonin level in most patients in admission day was more than 10 ng/ml [16 (45.7%] but in patients that react to treatment, decline to lower than 0.5 ng/ml [14(77.8%]. Mean rank of procalcitonin level from 1.14 ng/ml in first day reached to 2.72 ng/ml in seventh day (p<0.0001. "n"nConclusions: This study showed that serum procalcitonin levels in ICU patients with bacterial sepsis significantly decrease following response to treatment. The measurement of serum procalcitonin in ICU patients with bacterial infectious diseases at first arrival day and following treatment is recommended.

  13. Role of serum procalcitonin level in early diagnosis of bacterial pneumonia in children, a hospital based study

    Sheikh Mohd Saleem; S. M. Salim Khan; Shah Sumaya Jan

    2016-01-01

    Background: Procalcitonin (PCT) is a precursor of hormone calcitonin. It is composed of 116 amino acids and is produced by para follicular C cells of the thyroid and by neuroendocrine cells of lungs and intestine. The level of Procalcitonin in healthy individuals is below the limit of detection (0.01 and micro;g/L).These levels may rise from extra thyroid tissues especially in response to inflammatory stimulus of bacterial origin. PCT has the greatest sensitivity and Specificity for different...

  14. Procalcitonin Levels Predict Clinical Course and Progression-Free Survival in Patients With Medullary Thyroid Cancer

    Walter, Martin A.; Meier, Christian; Radimerski, Tanja; Iten, Fabienne; Kraenzlin, Marius; Mueller-Brand, Jan; de Groot, Jan Willem B.; Kema, Ido P.; Links, Thera P.; Mueller, Beat

    2010-01-01

    BACKGROUND: Procalcitonin has been well established as an important marker of sepsis and systemic infection. The authors evaluated the diagnostic and predictive value of calcitonin and its prohormone procalcitonin in medullary thyroid cancer. METHODS: The authors systematically explored the ability

  15. Levels of procalcitonin, C-reactive protein and neopterin in patients with advanced HIV-1 infection

    P Bipath

    2012-06-01

    Full Text Available Objectives. To compare the value of procalcitonin, C-reactive protein (CRP and neopterin as indicators of immune deficiency, co-infection, efficacy of treatment, and disease progression, in patients with advanced HIV-1 infection. Design. Cross-sectional, investigating baseline blood measurements and clinical observations in 82 HIV-positive patients divided into an antiretroviral treatment (ART group and an ART-naïve group. Setting. Secondary general hospital in Pretoria. Results. Procalcitonin and CRP levels showed no significant differences between the ART and ART-naïve groups, and no correlations with CD4 counts or viral loads. CRP levels were significantly higher with TB co-infection (p<0.05. Neopterin levels were raised above normal in 92% of the ART-naïve group and in 75% of the ART group. The levels were significantly higher (p<0.05 in the ART- naïve group. Negative correlations were found between neopterin and CD4 counts for the total patient group (r=-0.482; p<0.001. Neopterin was significantly (p<0.05 higher in the HIV/TB co-infection group than in those without TB. Higher neopterin levels at baseline were associated with a decline in CD4 counts over the ensuing 6-month period, and patients with higher baseline neopterin levels developed more complications over the 6-month period. Conclusions. Compared with procalcitonin and CRP, neopterin appears to be associated with the degree of immunodeficiency and of co-infection with TB. Neopterin levels may be investigated further as a measure of disease progression or treatment response. S Afr J HIV Med 2012;13(2:78-82.

  16. Serum procalcitonin level in infectious and non- infectious systemic inflammatory response syndrome: a three- year study

    Ahmadinejad Z

    2010-01-01

    Full Text Available "n Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:Arial; mso-bidi-theme-font:minor-bidi;} Background: Sepsis is the leading cause of hospital admission and mortality. One marker for differentiation between infectious and non-infectious diseases is serum procalcitonin (PCT level. The goal of this study was evaluation of serum procalcitonin level for differentiation among infectious & non infectious systemic inflammatory response syndrome (SIRS."n"nMethods: In a cross sectional study 263 patients with probable symptoms of sepsis that admitted to emergency department of Imam Khomeini Hospital Complex in Tehran, Iran, between 2006 and 2008, were evaluated for serum procalcitonin level by semi quantitative method. The clinical findings, demographic and laboratory data were identified by reviewing the medical notes."n"nResults: A total of 263 patients enrolled in the study. Mean age in study patients was 46.9 year (±20.7 and most of the patients were male (65.8%. In 104 patients (39.5% serum procalcitonin level was less than 0.5 (ng/ml, in 49 patients (18.6% was between 0.5 and 2 (ng/ml, in 74 patients (28.1% was between 2 and 10 (ng/ml and in 36 patients (13.8% was more than 10 (ng/ml. Sixty three patients (60.6% with PCT<0.5ng/ml, had non-infectious SIRS, while all patients with PCT≥10ng/ml, had infectious

  17. Changes of serum procalcitonin (PCT) and IL-6 levels in patients with sepsis

    Objective: To investigate the importance of determination of changes of serum procalcitonin (PCT) and IL-6 levels in patients with sepsis. Methods: Serum PCT (with double-sandwich immunofluorescence assay) and IL-6 (with ELISA) levels were measured repeatedly in 130 patients with sepsis on d1, d3, d5, d7 after admission. Values in 130 healthy individuals were also measured as control. Results: The serum levels of PCT and IL-6 in the patients with sepsis of admission were significantly higher than those in controls. The levels dropped markedly in the survivors by d7. Among the septic patients, the levels in the succumbed patients were significantly higher those in the survivors (P<0.05). Conclusion: Serum PCT and IL-6 values appeared to be of prognostic value in patients with sepsis. (authors)

  18. Serum Neopterin and Procalcitonin Levels in Relationship with Pediatric Burn Wound Infections.

    Pilanci, Ozgur; Ergin, Sevgi; Sirekbasan, Serhat; Ersin, Idris; Habip, Zafer; Yuksel, Pelin; Kuvat, Nuray; Aslan, Mustafa; Dinc, Oyku; Saribas, Suat; Kocazeybek, Bekir

    2016-03-01

    Infection and septic complications in burn patients can be monitored by procalcitonin (PCT) and neopterin plasma values. The aim of the study was to investigate serum neopterin and PCT levels with WBC (white blood cell) and CRP (C-reactive protein) levels in patient group (PG) and healthy control group (HCG) and to investigate the relationship of these markers with burn wound infections (BWI). As the PG, 23 patients between 0-12 ages and up to 30% Total Body Surface Area (TBSA) burned and 15 HCG were included. PCT, neopterin, WBC, and CRP results on the first, the seventh, the fourteenth and the 21st day have been compared. During the follow-up period, 11 patients with BWI and 12 patients without BWI were classified as infected and non-infected patients, respectively. PCT and neopterin levels were detected higher in patients with BWI but no significant difference were present. Also, PCT and neopterin levels within the first 24 hours following the burn were detected higher in PG than HCG. CRP and WBC levels were detected high due to burn trauma. PCT and neopterin levels were increased in patients with BWI. PCT levels were increased during the pre-infectious period, while neopterin levels increased during the post-infectious period. PMID:27020868

  19. An Evaluation of Serum Procalcitonin and C-Reactive Protein Levels as Diagnostic and Prognostic Biomarkers of Severe Sepsis

    Szederjesi Janos

    2015-10-01

    Full Text Available Background: Recommendations have been made, following the multicenter Surviving Sepsis Campaign study, to standardize the definition of severe sepsis with reference to several parameters such as haemodynamic stability, acid-base balance, bilirubin, creatinine, International Normalized Ratio (INR, urine output and pulmonary functional value of the ratio between arterial oxigen partial pressure and inspiratory oxigen concentration. Procalcitonin (PCT is considered to be a gold standard biomarker for the inflammatory response, and recent studies have shown that it may help to discover whether a seriously ill person is developing sepsis. C-reactive protein (CRP is also used as a marker of inflammation in the body, as its blood levels increase if there is any inflammation in the body. The aim of this study was to evaluate serum procalcitonin and C-reactive protein levels as diagnostic and prognostic biomarkers of severe sepsis.

  20. Comparative Study of Plasma Endotoxin with Procalcitonin Levels in Diagnosis of Bacteremia in Intensive Care Unit Patients

    Tao Wang; Yun-Liang Cui; Zhao-Fen Lin; De-Chang Chen

    2016-01-01

    Background: Both procalcitonin (PCT) and plasma endotoxin levels cannot be solely used for a definite diagnosis of bacteremia or sepsis, and there has been few study comparing the values of the two biomarkers for the diagnosis of bacteremia. The aim of this study was to identify bacteria causing bacteremia and evaluate the role of the two biomarkers in the diagnosis of bacteremia in Intensive Care Unit (ICU). Methods: The medical records of 420 patients in ICU were retrospectively reviewed...

  1. Comparative Study of Plasma Endotoxin with Procalcitonin Levels in Diagnosis of Bacteremia in Intensive Care Unit Patients

    WANG, Tao; Cui, Yun-Liang; Lin, Zhao-fen; Chen, De-Chang

    2016-01-01

    Background: Both procalcitonin (PCT) and plasma endotoxin levels cannot be solely used for a definite diagnosis of bacteremia or sepsis, and there has been few study comparing the values of the two biomarkers for the diagnosis of bacteremia. The aim of this study was to identify bacteria causing bacteremia and evaluate the role of the two biomarkers in the diagnosis of bacteremia in Intensive Care Unit (ICU). Methods: The medical records of 420 patients in ICU were retrospectively reviewed. P...

  2. Comparison on Serum Levels of Procalcitonin of Children with Viral and Bacterial Infection

    2013-01-01

    Objective To compare and analyze serum levels of procalcitonin (PCT) of children with viral and bacterial infection and probe into the importance of determining the level of serum PCT in the diagnosis of bacterial infection in order to provide evidences of the clinical use of antibiotics. Methods A total of 85 cases of children with an average age of 8.9 years (10 months-12 years) were enrolled in this study, 53 cases were with viral infection and 32 cases with bacterial infection. We determined serum levels of PCT by semi-quantitative solid phase immunoassay, and the serum levels of PCT were divided into four grades as Results The serum level of PCT of the group with bacterial infection were signiifcantly higher than that of the group with viral infection (P Conclusions Serum PCT is a bacterial sensitive marker of bacterial infection in children, and the determination of the level of serum PCT is helpful for the diagnosis of bacterial infection, which can also be a basis for the use of antibiotics.

  3. Procalcitonin levels in acute exacerbation of COPD admitted in ICU: a prospective cohort study

    Daubin, Cédric; Parienti, Jean-Jacques; Vabret, Astrid; Ramakers, Michel; Fradin, Sabine; Terzi, Nicolas; Freymuth, François; Charbonneau, Pierre; du Cheyron, Damien

    2008-01-01

    Background Antibiotics are recommended for severe acute exacerbation of chronic obstructive pulmonary disease (AECOPD) admitted to intensive care units (ICU). Serum procalcitonin (PCT) could be a useful tool for selecting patients with a lower probability of developing bacterial infection, but its measurement has not been investigated in this population. Methods We conducted a single center prospective cohort study in consecutive COPD patients admitted to the ICU for AECOPD between September 2005 and September 2006. Sputum samples or tracheal aspirates were tested for the presence of bacteria and viruses. PCT levels were measured at the time of admittance, six hours, and 24 hours using a sensitive immunoassay. Results Thirty nine AECOPD patients were included, 31 of which (79%) required a ventilator support at admission. The median [25%–75% interquartile range] PCT level, assessed in 35/39 patients, was: 0.096 μg/L [IQR, 0.065 to 0.178] at the time of admission, 0.113 μg/L [IQR, 0.074 to 0.548] at six hours, and 0.137 μg/L [IQR, 0.088 to 0.252] at 24 hours. The highest PCT (PCTmax) levels were less than 0.1 μg/L in 14/35 (40%) patients and more than 0.25 μg/L in 10/35 (29%) patients, suggesting low and high probability of bacterial infection, respectively. Five species of bacteria and nine species of viruses were detected in 12/39 (31%) patients. Among the four patients positive for Pseudomonas aeruginosa, one had a PCTmax less than 0.25 μg/L and three had a PCTmax less than 0.1 μg/L. The one patient positive for Haemophilus influenzae had a PCTmax more than 0.25 μg/L. The presence or absence of viruses did not influence PCT at time of admission (0.068 vs 0.098 μg/L respectively, P = 0.80). Conclusion The likelihood of bacterial infection is low among COPD patients admitted to ICU for AECOPD (40% with PCT procalcitonin-based therapeutic strategy in critically ill COPD patients. PMID:18947382

  4. Procalcitonin in liver transplantation: are high levels due to donors or recipients?

    Eyraud, Daniel; Ben Ayed, Saïd; Tanguy, Marie Laure; Vézinet, Corinne; Siksik, Jean Michel; Bernard, Maguy; Fratéa, Sylvia; Movschin, Marie; Vaillant, Jean-Christophe; Coriat, Pierre; Hannoun, Laurent

    2008-01-01

    Introduction To date, a specific marker to evaluate and predict the clinical course or complication of the liver-transplanted patient is not available in clinical practice. Increased procalcitonin (PCT) levels have been found in infectious inflammation; poor organ perfusion and high PCT levels in the cardiac donor appeared to predict early graft failure. We evaluated PCT as a predictor of early graft dysfunction and postoperative complications. Methods PCT serum concentrations were measured in samples collected before organ retrieval from 67 consecutive brain-dead donors and in corresponding recipients from day 0, before liver transplantation, up to day 7 after liver transplantation. The following parameters were recorded in donors: amount of vasopressive drug doses, cardiac arrest history 24 hours before retrieval, number of days in the intensive care unit, age of donor, and infection in donor, and the following parameters were recorded in recipients: cold and warm ischemia time, veno-venous bypass, transfusion amount during orthotopic liver transplantation (OLT), and occurrence of postoperative complication or hepatic dysfunction. Results In the donor, the preoperative level of PCT was associated with cardiac arrest and high doses of catecholamines before organ retrieval. In the recipient, elevated PCT levels were observed early after OLT, with a peak at day 1 or 2 after OLT, then a decrease until day 7. A postoperative peak of PCT levels was associated neither with preoperative PCT levels in the donor or the recipients nor with hepatic post-OLT dysfunction or other postoperative complications, but with two donor parameters: infection and cardiac arrest. Conclusion PCT level in the donor and early PCT peak in the recipient are not predictive of post-OLT hepatic dysfunction or other complications. Cardiac arrest and infection in the donor, but not PCT level in the donor, are associated with high post-OLT PCT levels in the recipient. PMID:18601732

  5. Serum procalcitonin and CRP levels in non-alcoholic fatty liver disease: a case control study

    Ersoz Galip

    2009-02-01

    Full Text Available Abstract Background Both C reactive protein (CRP and procalcitonin (PCT are well known acute phase reactant proteins. CRP was reported to increase in metabolic syndrome and type-2 diabetes. Similarly altered level of serum PCT was found in chronic liver diseases and cirrhosis. The liver is considered the main source of CRP and a source of PCT, however, the serum PCT and CRP levels in non-alcoholic fatty liver disease (NAFLD were not compared previously. Therefore we aimed to study the diagnostic and discriminative role of serum PCT and CRP in NAFLD. Methods Fifty NAFLD cases and 50 healthy controls were included to the study. Liver function tests were measured, body mass index was calculated, and insulin resistance was determined by using a homeostasis model assessment (HOMA-IR. Ultrasound evaluation was performed for each subject. Serum CRP was measured with nephalometric method. Serum PCT was measured with Kryptor based system. Results Serum PCT levels were similar in steatohepatitis (n 20 and simple steatosis (n 27 patients, and were not different than the control group (0.06 ± 0.01, 0.04 ± 0.01 versus 0.06 ± 0.01 ng/ml respectively. Serum CRP levels were significantly higher in simple steatosis, and steatohepatitis groups compared to healthy controls (7.5 ± 1.6 and 5.2 ± 2.5 versus 2.9 ± 0.5 mg/dl respectively p Conclusion Serum PCT was within normal ranges in patients with simple steatosis or steatohepatitis and has no diagnostic value. Serum CRP level was increased in NAFLD compared to controls. CRP can be used as an additional marker for diagnosis of NAFLD but it has no value in discrimination of steatohepatitis from simple steatosis.

  6. Diagnostic and prognostic value of procalcitonin levels in patients with Bell's palsy.

    Kilicaslan, Saffet; Uluyol, Sinan; Gur, Mehmet Hafit; Arslan, Ilker Burak; Yagiz, Ozlem

    2016-06-01

    Inflammation is thought to play an important role in the pathogenesis of Bell's palsy (BP). Procalcitonin (PCT) is currently among the most frequently used proinflammatory biomarkers in clinical practice. In this study, we assessed the serum PCT levels for predicting the severity and prognosis of BP. In total, 32 patients with House-Brackmann (HB) grade II and III BP (low-grade group), 22 patients with HB grade IV and V (high-grade group) and 35 healthy individuals (control group) were included in this prospective study. PCT levels were compared among these three groups at the time of diagnosis. All patients received standard prednisolone and acyclovir treatment. The correlation between PCT levels and recovery was analyzed 3 months after treatment. The PCT levels for control, low-grade and high-grade BP groups were 0.01 ± 0.001, 0.35 ± 0.05, and 0.98 ± 0.41 ng/mL, respectively. The PCT level in low-grade group was significantly higher than that in control group (p < 0.001), and the PCT level in high-grade BP group was significantly higher than that in low-grade group (p = 0.01, p < 0.05). The complete recovery rate was 93.7 % in low-grade and 54.5 % in high-grade BP group (p = 0.015, p < 0.05). There was a strong negative correlation between PCT levels and recovery rates (r = -0.896, p < 0.001). PCT levels were significantly associated with the severity of BP and higher PCT levels were related with poor clinical outcome in terms of recovery. These results support the diagnostic and prognostic significance of PCT in patients with early BP. PMID:26894418

  7. HIGH BLOOD LEVELS PROCALCITONIN AS SYSTEMIC IMFLAMATORY RESPONSE SYNDROME PREDICTOR IN SEVERE AND MODERATE HEAD INJURY

    B. Sinaga

    2014-01-01

    Full Text Available BackgroundNumerous studies have shown that procalcitonin (PCT was not related to degree of trauma. High PCT serum levels have been found in patients with bacterial or fungal infection and also in acute phase of trauma. Currently, there has been no research discussed about changes in serum levels of PCT in particular head injuries and severe head injuries. Moderate and severe head injuries were common trauma cases in Emergency Room (ER and had high mortality rate. Based on Glasgow Coma Scale (GCS, moderate and severe head injuries were scored between 3 and 13. This research aim to determine whether high blood levels PCT can be used as a predictor of the occurrence of SIRS. Method: A cohort prospective study was applied in this research to determine high blood levels of PCT as a predictor for SIRS in moderate and severe head injury. This study was conducted from June 2013 - August 2013 at Sanglah General Hospital with 40 research subjects. Data was presented in tables and analyzed with Chi Square test at 95% CI and p <0.05% was considered significant. Results: From the 40 samples, there were 34 males (85% and 6 females (15%, 18 samples (45% had moderate head injury and 22 samples (65% had severe head injury. One sample (2.5 % was 0-10 years old, 15 samples (37.5% were 10-20 years old, 13 samples (32.5% were 20-40 years old, 7 samples (17.5% were 40-60 years old and 4 samples (10% were>60 years old. PCT levels in the blood obtained on day first were normal in 6 samples (15% and elevated in 34 samples (85%, SIRS (+ were found in 35 samples (87.5% and 5 samples (12.5% were SIRS (-. Using bivariate analysis between PCT levels and SIRS showed p = 0.000 (p < 0.05, and multivariate analysis of the control variables showed no significant correlation between variables with PCT levels. Conclusion: From 40 samples moderate head injury and severe head injury, there were 34 samples (85% with elevated PCT level on the first day, while 35 samples (87.5% had SIRS

  8. Procalcitonin levels predict acute kidney injury and prognosis in acute pancreatitis: a prospective study.

    Hua-Lan Huang

    Full Text Available BACKGROUND: Acute kidney injury (AKI has been proposed as a leading cause of mortality for acute pancreatitis (AP patients admitted to the intensive care unit (ICU. This study investigated the predictive value of procalcitonin (PCT for AKI development and relevant prognosis in patients with AP, and compared PCT's predictive power with that of other inflammation-related variables. METHODS: Between January 2011 and March 2013, we enrolled 305 cases with acute pancreatitis admitted to ICU. Serum levels of PCT, serum amyloid A (SAA, interleukin-6 (IL-6, and C reactive protein (CRP were determined on admission. Serum PCT was tested in patients who developed AKI on the day of AKI occurrence and on either day 28 after occurrence (for survivors or on the day of death (for those who died within 28 days. RESULTS: Serum PCT levels were 100-fold higher in the AKI group than in the non-AKI group on the day of ICU admission (p<0.05. The area under the receiver-operating characteristic (ROC curve of PCT for predicting AKI was 0.986, which was superior to SAA, CRP, and IL-6 (p<0.05. ROC analysis revealed all variables tested had lower predictive performance for AKI prognosis. The average serum PCT level on day 28 (2.67 (0.89, 7.99 ng/ml was significantly (p<0.0001 lower than on the day of AKI occurrence (43.71 (19.24,65.69 ng/ml in survivors, but the serum PCT level on death (63.73 (34.22,94.30 ng/ml was higher than on the day of AKI occurrence (37.55 (18.70,74.12 ng/ml in non-survivors, although there was no significant difference between the two days in the latter group (p = 0.1365. CONCLUSION: Serum PCT is superior to CRP, IL-6, and SAA for predicting the development of AKI in patients with AP, and also can be used for dynamic evaluation of AKI prognosis.

  9. Evaluation of procalcitonin and neopterin level in serum of patients with acute bacterial infection

    Babak Pourakbari; Setareh Mamishi; Javid Zafari; Hanieh Khairkhah; Mohammad H Ashtiani; Masomeh Abedini; Shahla Afsharpaiman; Soroush Seifi Rad

    2010-01-01

    BACKGROUND: Fever as a common presenting complaint in pediatric patients can be due to various causes. Differentiating bacterial infection from other causes is important because the prompt use of antibiotics is critical in bacterial infection. Traditional markers of infection such as BT and WBC count may be unspecific and culture may be late or absent. CRP and Procalcitonin (PCT) have been considered to evaluate the evolution of infections and sepsis in patients presenting with SIRS. Neopteri...

  10. Procalcitonin levels in acute exacerbation of COPD admitted in ICU: a prospective cohort study

    Freymuth François

    2008-10-01

    Full Text Available Abstract Background Antibiotics are recommended for severe acute exacerbation of chronic obstructive pulmonary disease (AECOPD admitted to intensive care units (ICU. Serum procalcitonin (PCT could be a useful tool for selecting patients with a lower probability of developing bacterial infection, but its measurement has not been investigated in this population. Methods We conducted a single center prospective cohort study in consecutive COPD patients admitted to the ICU for AECOPD between September 2005 and September 2006. Sputum samples or tracheal aspirates were tested for the presence of bacteria and viruses. PCT levels were measured at the time of admittance, six hours, and 24 hours using a sensitive immunoassay. Results Thirty nine AECOPD patients were included, 31 of which (79% required a ventilator support at admission. The median [25%–75% interquartile range] PCT level, assessed in 35/39 patients, was: 0.096 μg/L [IQR, 0.065 to 0.178] at the time of admission, 0.113 μg/L [IQR, 0.074 to 0.548] at six hours, and 0.137 μg/L [IQR, 0.088 to 0.252] at 24 hours. The highest PCT (PCTmax levels were less than 0.1 μg/L in 14/35 (40% patients and more than 0.25 μg/L in 10/35 (29% patients, suggesting low and high probability of bacterial infection, respectively. Five species of bacteria and nine species of viruses were detected in 12/39 (31% patients. Among the four patients positive for Pseudomonas aeruginosa, one had a PCTmax less than 0.25 μg/L and three had a PCTmax less than 0.1 μg/L. The one patient positive for Haemophilus influenzae had a PCTmax more than 0.25 μg/L. The presence or absence of viruses did not influence PCT at time of admission (0.068 vs 0.098 μg/L respectively, P = 0.80. Conclusion The likelihood of bacterial infection is low among COPD patients admitted to ICU for AECOPD (40% with PCT

  11. Medical Costs of Abnormal Serum Sodium Levels

    Shea, Alisa M.; Hammill, Bradley G.; Curtis, Lesley H.; Szczech, Lynda A.; Schulman, Kevin A

    2008-01-01

    An abnormal serum sodium level is the most common electrolyte disorder in the United States and can have a significant impact on morbidity and mortality. The direct medical costs of abnormal serum sodium levels are not well understood. The impact of hyponatremia and hypernatremia on 6-mo and 1-yr direct medical costs was examined by analyzing data from the Integrated HealthCare Information Services National Managed Care Benchmark Database. During the period analyzed, there were 1274 patients ...

  12. Procalcitonin as an indicator of urosepsis

    Sugimoto K

    2013-03-01

    Full Text Available Koichi Sugimoto, Shogo Adomi, Hiroyuki Koike, Atsunobu Esa Department of Urology, NTT West Osaka Hospital, Osaka, Japan Background: Procalcitonin has been advocated as a marker of bacterial infection, so this study was carried out to determine the usefulness of serum procalcitonin in the early diagnosis of urosepsis. Methods: The subjects were 37 febrile patients with urinary tract infection in whom we examined the serum procalcitonin concentration at the start of treatment. Results: Thirty patients had acute pyelonephritis (16 simple, 14 complex, one had emphysematous pyelonephritis, five had acute prostatitis, and one had acute epididymitis. The procalcitonin level was <0.5 ng/mL in 18 patients, ≥0.5 ng/mL in one patient, ≥2 ng/mL in seven patients, and ≥10 ng/mL in 11 patients. Five of the 11 patients with procalcitonin levels ≥ 10 ng/mL had disseminated intravascular coagulation. All patients with urinary tract obstruction and disseminated intravascular coagulation had procalcitonin levels ≥ 10 ng/mL. Conclusion: Although this retrospective study comprised a small number of patients, we found that procalcitonin was a useful marker for urinary tract infection. Keywords: procalcitonin, urosepsis, urinary tract infection, urology

  13. The potential of molecular diagnostics and serum procalcitonin levels to change the antibiotic management of community-acquired pneumonia.

    Gilbert, David; Gelfer, Gita; Wang, Lian; Myers, Jillian; Bajema, Kristina; Johnston, Michael; Leggett, James

    2016-09-01

    Two diagnostic bundles were compared in 127 evaluable patients admitted with community-acquired pneumonia (CAP). Diagnostic modalities in all patients included cultures of sputum (if obtainable) and blood, urine for detection of the antigens of Streptococcus pneumoniae and Legionella pneumophila, and nasal swabs for PCR probes for S. pneumoniae and Staphylococcus aureus. At least one procalcitonin level was measured in all patients. For virus detection, patients were randomized to either a 5-virus, lab-generated PCR panel or the broader and faster FilmArray PCR panel. Overall, an etiologic diagnosis was established in 71% of the patients. A respiratory virus was detected in 39%. The potential for improved antibiotic stewardship was evident in 25 patients with only detectable respiratory virus and normal levels of PCT. PMID:27377675

  14. PROCALCITONIN AS A MARKER FOR EARLY DIAGNOSIS OF SEPSIS

    Rahim Raoofi

    2014-01-01

    Full Text Available Sepsis is a critical condition often caused by bacterial infection and associated with death and mortality. The prognosis of this disease depends on early diagnosis and proper treatment. Definite diagnosis of sepsis is positive blood culture and this test needs a long time to perform, so other biochemical parameters such as procalcitonin serum level has been introduced. To determine sensitivity, specificity, positive and negative predictive value of procalcitonin serum level at first time and 72 h after admission and to compare it with blood culture test for diagnosis of sepsis. Blood sample for blood culture, prepheral blood smear at first time and procalcitonin serum level measuring by semi quantitative method at first and 72 h after admission were sampled. Nine patients had positive blood cultures. Peripheral blood smear was positive in 38 patients, (29 patients: gram stain positive, 6 patients: gram stain negative and 3 patients: both gram positive and gram negative. At first time 76.8% had positive procalcitonin (>0.5 ng mL-1 and after 72 h 65% of patients had positive procalcitonin. Sensitivity, specificity, positive and negative predictive value of procalcitonin at the first time were 100, 16,16 and 100% and for procalcitonin after 72 h respectively were 75, 35, 15 and 90%. This study showed that sensitivity of procalcitonin serum level can be used for diagnosis of sepsis. Procalcitonin increased as severity of sepsis and this study suggests high serum level of procalcitonin after 72 h might indicate poor outcome.

  15. Determination of Procalcitonin Levels in Patients with Nephropathia Epidemica - A Useful Tool or an Unnecessary Diagnostic Procedure?

    Joerg Latus

    2015-01-01

    Full Text Available Background/Aims: Puumala virus causes nephropathia epidemica (NE, a milder form of hemorrhagic fever with renal syndrome that occurs in Central and Northern Europe. Several studies have sought to identify risk factors for severe NE. However, elevated procalcitonin (PCT levels have not previously been investigated as a predictive marker for a severe course of NE. Methods: A cross-sectional prospective survey of 456 adults with serologically confirmed NE was performed. Results: PCT levels at the time of diagnosis were available for 43 out of 456 patients, and in 24 of these patients (56% PCT levels were elevated (“PCT positive”. C-reactive protein (CRP levels at admission to hospital and peak CRP levels during the acute course of the disease were higher in the PCT-positive compared with the PCT-negative group (pConclusions: Elevated PCT levels are common in patients with acute NE. There was no association between PCT levels and severity of disease, including AKI or thrombocytopenia. It is important to distinguish Puumala virus infection from other causes of AKI with thrombocytopenia. However, PCT might not be useful in differentiating hantavirus infection from bacterial infection.

  16. Comparative Study of Plasma Endotoxin with Procalcitonin Levels in Diagnosis of Bacteremia in Intensive Care Unit Patients

    Tao Wang; Yun-Liang Cui; Zhao-Fen Lin; De-Chang Chen

    2016-01-01

    Background: Both procalcitonin (PCT) and plasma endotoxin levels cannot be solely used for a definite diagnosis ofbacteremia or sepsis, and there has been few study comparing the values of the two biomarkers for the diagnosis of bacteremia.The aim of this study was to identify bacteria causing bacteremia and evaluate the role of the two biomarkers in the diagnosis ofbacteremia in Intensive Care Unit (ICU).Methods: The medical records of 420 patients in ICU were retrospectively reviewed.Patients (n =241) who met the inclusion criteria were subjected to blood culture (BC) for the analysis of the endotoxin or PCT levels.The exclusion criteria included the presence of infection with human immunodeficiency virus and/or AIDS, neutropenia without sepsis, pregnancy, treatment with immunosuppressive therapies, or blood diseases such as hematological tumors.Patients' BC episodes were divided into BC negative, Gram-negative (GN) bacteria, Gram-positive bacteria, and fungi groups.The PCT and plasma endotoxin levels were compared in the different groups.Results: A total of 241 patients with 505 episodes of BC were analyzed.The GN bacteria group showed higher levels of PCT and endotoxin than the BC negative, Gram-positive bacteria, and fungi groups.GN bacteremia was more prevalent than Gram-positive bacteremia.The GN bacteremia caused by non-Enterobacteriaceae infection presented higher endotoxin level than that by Enterobacteriaceae, but no significant difference in PCT levels was observed between the two groups.The plasma endotoxin significantly differed among different groups and was bacterial species dependent.Conclusions: Plasma endotoxin was more related to GN than to Gram-positive bacteremia, and that endotoxin level was species dependent, but PCT level remained relatively more stable within the GN bacteria caused bacteremia.Both GN and positive bacteria caused bacteremia in the ICU patients in different regions of China.And PCT is a more valuable biomarker than endotoxin

  17. Comparative Study of Plasma Endotoxin with Procalcitonin Levels in Diagnosis of Bacteremia in Intensive Care Unit Patients

    Wang, Tao; Cui, Yun-Liang; Lin, Zhao-Fen; Chen, De-Chang

    2016-01-01

    Background: Both procalcitonin (PCT) and plasma endotoxin levels cannot be solely used for a definite diagnosis of bacteremia or sepsis, and there has been few study comparing the values of the two biomarkers for the diagnosis of bacteremia. The aim of this study was to identify bacteria causing bacteremia and evaluate the role of the two biomarkers in the diagnosis of bacteremia in Intensive Care Unit (ICU). Methods: The medical records of 420 patients in ICU were retrospectively reviewed. Patients (n = 241) who met the inclusion criteria were subjected to blood culture (BC) for the analysis of the endotoxin or PCT levels. The exclusion criteria included the presence of infection with human immunodeficiency virus and/or AIDS, neutropenia without sepsis, pregnancy, treatment with immunosuppressive therapies, or blood diseases such as hematological tumors. Patients’ BC episodes were divided into BC negative, Gram-negative (GN) bacteria, Gram-positive bacteria, and fungi groups. The PCT and plasma endotoxin levels were compared in the different groups. Results: A total of 241 patients with 505 episodes of BC were analyzed. The GN bacteria group showed higher levels of PCT and endotoxin than the BC negative, Gram-positive bacteria, and fungi groups. GN bacteremia was more prevalent than Gram-positive bacteremia. The GN bacteremia caused by non-Enterobacteriaceae infection presented higher endotoxin level than that by Enterobacteriaceae, but no significant difference in PCT levels was observed between the two groups. The plasma endotoxin significantly differed among different groups and was bacterial species dependent. Conclusions: Plasma endotoxin was more related to GN than to Gram-positive bacteremia, and that endotoxin level was species dependent, but PCT level remained relatively more stable within the GN bacteria caused bacteremia. Both GN and positive bacteria caused bacteremia in the ICU patients in different regions of China. And PCT is a more valuable

  18. Evolution of procalcitonin, C-reactive protein and fibrinogen levels in neutropenic leukaemia patients with invasive pulmonary aspergillosis or mucormycosis.

    Roques, Marjorie; Chretien, Marie Lorraine; Favennec, Camille; Lafon, Ingrid; Ferrant, Emmanuelle; Legouge, Caroline; Plocque, Alexia; Golfier, Camille; Duvillard, Laurence; Amoureux, Lucie; Bastie, Jean Noel; Maurin-Bernier, Lory; Dalle, Frederic; Caillot, Denis

    2016-06-01

    Unlike bacterial infections, the value of procalcitonin (PCT) in detecting fungal infections in leukaemia patients is not clear. To determine whether the monitoring of PCT coupled with C-reactive protein (CRP) and fibrinogen (Fib) could be helpful in the management of pulmonary aspergillosis (IPA) or mucormycosis (PM), we retrospectively analysed the evolution of PCT, CRP and Fib levels in 94 leukaemia patients with proven/probable IPA (n = 77) or PM (n = 17) from D-12 to D12 relative to IFI onset defined as D0. Overall, 2140 assays were performed. From D-12 to D0, 12%, 5% and 1.4% of patients had PCT >0.5, 1 and 1.5 μg l(-1) , respectively, while CRP was >50, 75 and 100 mg l(-1) in 84%, 70% and 57% and Fib was >4, 5 and 6 g l(-1) in 96%, 80% and 61% of cases respectively (P 1.5 μg l(-1) , while CRP >100 mg l(-1) and Fib >6 g l(-1) were observed in 80% and 75% of cases respectively (P < 10(-7) ). In leukaemia patients, IPA or PM was accompanied by a significant increase in CRP and Fib while PCT remained low. PMID:26931315

  19. Differential kinetics of plasma procalcitonin levels in cerebral malaria in urban Senegalese patients according to disease outcome

    Babacar Mbengue

    2011-11-01

    Full Text Available P. falciparum malaria continues as the serial killer of over a million lives yearly, mainly for children in sub-Saharan Africa. For severe malaria, we are still on the quest for a prognostic marker of fatal outcome. We analysed the association between serum levels of Procalcitonin (PCT, a marker of septic inflammation, and clinical outcome in Senegalese patients admitted with confirmed cerebral malaria in the intensive care facility of Hopital Principal. A total of 98 patients living in the hypoendemic urban area of Dakar, Senegal, were enrolled during transmission seasons. Levels of PCT were compared between surviving vs the 26.5 % fatal cases in blood samples of the 3 days following hospitalisation. Mean PCT levels were elevated in patients with active infection, with a large range of values (0.1 to 280 nanog per mL, significantly higher on day 0 in fatal cases than in surviving (53.6 vs 27.3; P=0.01. No exact individual threshold level could indicate occurrence of fatality, however mortality could be most accurately predicted by PCT level above 69 nanog per ML and there was a very clear different profile of evolution of PCT levels on the 3 days of observation decreasing early from day 1 in surviving patients (P<10–3, contrary to fatal cases. These results indicate that PCT kinetic rather than intrinsic level could be of use to predict a reduced risk of fatality in patient with cerebral malaria and could serve as potential predicting marker for severe malaria.

  20. Procalcitonin as a marker of neonatal sepsis

    Nazeer Ahmad Jeergal; Rizwan-u-zama; Naushad Ali .N. Malagi; Faisal Farooqui; Sadashiva .B. Ukkali; Ravindra Naganoor; A.N. Thobbi

    2016-01-01

    Introduction: Neonatal sepsis is one of the commonest causes of neonatal mortality in the developing world. Procalcitonin (PCT) has emerged as the most studied and promising sepsis biomarker. Objective: To assess the role of procalcitonin (PCT) as a marker in the early diagnosis, treatment and follow-up of neonatal sepsis. Methods: Twenty five neonates with clinical (n=5), suspected (n=13) and proven sepsis (n=7) were evaluated. The PCT levels were measured by immunoluminoassay before and on ...

  1. Procalcitonin in liver transplant patients--yet another stone turned

    Jensen, Jens-Ulrik; Lundgren, Jens D

    2008-01-01

    Liver transplantation has been reported to initiate increases in procalcitonin levels, in the absence of bacterial infection. The results of a study investigating the course of procalcitonin levels over several days after liver transplantation in noninfected patients were recently reported in...... undergoing liver transplantation with and without bacterial infection are needed....

  2. Diagnostic value of serum procalcitonin levels in children with meningitis: a comparison with blood leukocyte count and C-reactive protein

    Objectives: To determine the level of serum procalcitonin, blood leukocyte count (TLC) and C-reactive protein (CRP) in children with bacterial and non bacterial meningitis and document their efficacy in differential diagnosis. Also described are procalcitonin levels variation during treatment. Methods: From March 2005 to February 2008, we evaluated 38 clinically suspected meningitis patients in the paediatric departments, Al-Jedaany Hospital, Jeddah, KSA, for Serum procalcitonin, CRP, TLC and Lumbar punctures and CSF analysis. Patients were classified into bacterial meningitis group I (18) and non bacterial meningitis group II (20). Results: Serum PCT levels were significantly higher in bacterial meningitis (BM) 9 mean 4.8 +- 3.85 ng/ml (2.9-11.6)) compared with non bacterial meningitis (NBM) (mean 0.38 +- 0.25 ng/ml(0.31-0.61)) P< 0.001). Mean of all CSF parameters, TLC (15,000 +- 2,900 cell/ml(BM) and 9,500 +-1,105 cell/ml(NBM))and CRP (20 +- 6.8 mg/l (BM) and 12.5 +-12.0 mg/l(NBM))showed a zone of overlapping between the two groups. There is a positive correlation between serum PCT, TLC and CRP in bacterial and non bacterial meningitis cases but this relation becomes highly significant with bacterial meningitis positive group. Day 3 and day 6 treatment serum PCT was less than on admission levels (P<0.001). Conclusion: PCT can be used in the early diagnosis of bacterial meningitis and may be a useful adjunct in differentiating bacterial and non bacterial meningitis than CRP or TLC and diminishing the value of lumbar puncture performed 48-72 hours after admission to assess treatment efficacy. (author)

  3. Serum procalcitonin and interleukin-6 levels may help to differentiate systemic inflammatory response of infectious and non-infectious origin

    杜斌; 潘家绮; 陈德昌; 李毅

    2003-01-01

    Objective To evaluate the efficacy of using procalcitonin (PCT) and interleukin-6 (IL-6) to differentiate sepsis from non-infectious systemic inflammatory response syndrome (SIRS). Methods We made a prospective study in a general intensive care unit at Peking Union Medical College Hospital. Twenty patients with sepsis and 31 patients with non-infectious SIRS were enrolled in this study. Serum concentrations of PCT, IL-6 and C-reactive protein (CRP) were determined within 24 h after clinical onset of sepsis or non-infectious SIRS. Leukocyte count, percentage of neutrophils, and absolute neutrophil count, as well as maximal body temperature were also recorded.Results Serum concentrations of PCT, IL-6, and CRP, as well as maximal body temperature, were significantly higher in septic patients [3.6 (1.8, 27.5) μg/L, 810±516 ng/L, 180±108 g/L, 38.6±1.2℃] than non-infectious SIRS patients [0.5 (0.2, 1.8) μg/L, 235±177 ng/L, 109±70 g/L, 37.9±0.9℃]. IL-6 and PCT exhibited the best discriminative power between sepsis and non-infectious SIRS, with sensitivity above 80% and specificity above 70%. A sepsis score with combination of IL-6 and PCT showed the best discriminative power with the area under the receiver operating characteristic curve of 0.923.Conclusions Assessing IL-6 and PCT levels are more reliable ways to differentiate sepsis from non-infectious SIRS, compared with conventional inflammatory parameters.

  4. [Proper usage of procalcitonin].

    Green, Y; Petignat, P-A; Perrier, A

    2007-10-17

    In the last fifteen years, procalcitonin measurement has been evaluated as a rapid diagnostic aid for suspected infection. Procalcitonin is now widely used in any febrile patient despite the lack of evidence supporting that practice. Indeed, procalcitonine has proven effective in the intensive care setting, as a diagnostic aid for septic shock, as a prognostic instrument and to tailor the duration of antibiotic treatment. Studies in non intensive care settings are more recent and scarce. Procalcitonin has been assessed in the emergency department in patients with lower respiratory tract infections and in patients admitted for an acute febrile illness. Results are encouraging but preliminary, therefore procalcitonine measurement should be restricted to patients with criteria of severe infection for the time being. PMID:18018823

  5. PROCALCITONIN AS A MARKER FOR EARLY DIAGNOSIS OF SEPSIS

    Rahim Raoofi; Zahra Salmani; Fatemh Moradi; Abdolrerza Sotoodeh; Saeed Sobhanian

    2014-01-01

    Sepsis is a critical condition often caused by bacterial infection and associated with death and mortality. The prognosis of this disease depends on early diagnosis and proper treatment. Definite diagnosis of sepsis is positive blood culture and this test needs a long time to perform, so other biochemical parameters such as procalcitonin serum level has been introduced. To determine sensitivity, specificity, positive and negative predictive value of procalcitonin serum level at first time and...

  6. Diagnostic value of procalcitonin for acute complicated appendicitis

    Yamashita, Hiromasa; YUASA, NORIHIRO; TAKEUCHI, EIJI; Goto, Yasutomo; Miyake, Hideo; Miyata, Kanji; Kato, Hideki; Ito, Masafumi

    2016-01-01

    ABSTRACT A rapid and reliable test for detection of complicated appendicitis would be useful when deciding whether emergency surgery is required. We investigated the clinical usefulness of procalcitonin for identifying acute complicated appendicitis. We retrospectively analyzed 63 patients aged ≥15 years who underwent appendectomy without receiving antibiotics before admission and had preoperative data on the plasma procalcitonin level (PCT), body temperature (BT), white blood cell count (WBC...

  7. The role of procalcitonin in adult patients with community-acquired pneumonia--a systematic review

    Berg, Peter; Lindhardt, Bjarne Ørskov

    2012-01-01

    Promising results in relation to severity assessment and treatment of patients with community-acquired pneumonia (CAP) have recently been presented from the study of procalcitonin (PCT) levels in these patients.......Promising results in relation to severity assessment and treatment of patients with community-acquired pneumonia (CAP) have recently been presented from the study of procalcitonin (PCT) levels in these patients....

  8. Procalcitonin increase in early identification of critically ill patients at high risk of mortality

    Jensen, Jens Ulrik; Heslet, Lars; Jensen, Tom Hartvig;

    2006-01-01

    To investigate day-by-day changes in procalcitonin and maximum obtained levels as predictors of mortality in critically ill patients.......To investigate day-by-day changes in procalcitonin and maximum obtained levels as predictors of mortality in critically ill patients....

  9. 血清降钙素原在胆道感染中的诊断价值%Clinical application of serum procalcitonin level in diagnosing biliary tract infection

    李惠; 高堃; 翟仁友; 戴定可; 黄强; 王剑锋

    2013-01-01

    Objective To discuss the clinical value of serum procalcitonin level in diagnosing biliary tract infection. Methods A total of 53 patients with obstructive jaundice were enrolled in this study. The serum procalcitonin level was determined in all patients by immunolofluoreseence sandwich method. Percutanous biliary drainage was performed in all patients. Based on the bile culture result and the clinical manifestations, the patients were divided into the bacterial infection group (n = 33) and the non-bacterial infection group (n = 20). The serum procalcitonin level, white blood cell (WBC) count and the percentage of neutrophilic granulocyte were determined, and the results were compared between the two groups. Results Taking 0.25 ng/ml as the positive threshold of serum procalcitonin level, the sensitivity and the specificity for the diagnosis of biliary tract bacterial infection were 91.9% and 87.5% respectively. When WBC of 8.89 × 109/L was taken as the positive threshold, the sensitivity and the specificity for the diagnosis of biliary tract bacterial infection were 54.8% and 83.3% respectively. If neutrophilic granulocyte of 74.25% was regarded as the positive threshold, the sensitivity and the specificity for the diagnosis of biliary tract bacterial infection were 66.1% and 70.8% respectively. The serum procalcitonin level in the bacterial infection group was significantly higher than that in the non-bacterial infection group (P < 0.05). Conclusion Determination of serum procalcitonin level is very helpful for the diagnosis of biliary tract bacterial infection with much higher sensitivity and specificity. Therefore, serum procalcitonin level can be used as an effective index for biliary tract bacterial infection.%目的 探讨血清降钙素原(PCT)浓度在胆道感染中的诊断价值.方法 采用荧光免疫夹心法检测53例梗阻性黄疸患者血清PCT浓度,所有患者均行经皮经肝穿刺胆管引流术,根据胆汁培养结果及临床症状

  10. Procalcitonin for detecting community-acquired bacterial pneumonia

    Devi Gusmaiyanto

    2015-03-01

    Full Text Available Background Pneumonia is a major cause of morbidity and mortality in children under five years of age. Pneumonia can be of bacterial or viral origin. It is difficult to distinguish between these two agents based on clinical manifestations, as well as radiological and laboratory examinations. Furthermore, bacterial cultures take time to incubate and positive results may only be found in 10-30% of bacterial pneumonia cases. Procalcitonin has been used as a marker to distinguish etiologies, as bacterial infections tend to increase serum procalcitonin levels. Objective To determine the sensitivity, specificity, positive predictive value and negative predictive value of procalcitonin in community-acquired bacterial pneumonia. Method This cross-sectional study was conducted in the Pediatric Health Department of Dr. M. Djamil Hospital, Padang. Subjects were selected by consecutive sampling. Procalcitonin measurements and PCR screening were performed on blood specimens from 32 pneumonia patients and compared. Results Of the 32 subjects, most were boys (56.25%, under 5 years of age (99%, and had poor nutritional status (68.75%. Using a cut-off point of 0.25 ng/mL, procalcitonin level had a sensitivity of 92%, specificity 50%, positive predictive value 88%, and negative predictive value 60% for diagnosing bacterial pneumonia. Using a cut-off point of 0.5 ng/mL, procalcitonin level had a specificity of 46%, specificity 83%, positive predictive value 91%, and negative predictive value 25%. Conclusion A cut-off point of 0.25 ng/mL of procalcitonin level may be more useful to screen for bacterial pneumonia than a cut-off point of 0.5 ng / mL. However, if the 0.25 ng/mL cut-off point is used, careful monitoring will be required for negative results, as up to 40% may actually have bacterial pneumonia. [Paediatr Indones. 2015;55:65-9.].

  11. Plasma Procalcitonin Is Associated with Obesity, Insulin Resistance, and the Metabolic Syndrome

    Abbasi, Ali; Corpeleijn, Eva; Postmus, Douwe; Gansevoort, Ron T.; de Jong, Paul E.; Gans, Rijk O. B.; Struck, Joachim; Hillege, Hans L.; Stolk, Ronald P.; Navis, Gerjan; Bakker, Stephan J. L.

    2010-01-01

    Context: Procalcitonin, a well-known biomarker of sepsis and bacterial infections, is produced by adipose tissue and has potential as a marker for chronic low-grade inflammation. Objectives: The objective of this study was to investigate whether plasma procalcitonin levels in the normal range are as

  12. Prognostic value of serum procalcitonin and C-reactive protein levels in critically ill patients who developed ventilator-associated pneumonia

    Hakan Tanriverdi

    2015-01-01

    Full Text Available INTRODUCTION: Ventilator-associated pneumonia (VAP is an important cause of mortality and morbidity in critically ill patients. We sought to determine the prognostic value of procalcitonin (PCT and C-reactive protein (CRP kinetics in critically ill patients who developed VAP. METHODS: Patients who were admitted to the intensive care unit (ICU and developed VAP were eligible. Patients were followed for 28 days after the pneumonia diagnosis and blood samples for PCT and CRP were collected on the day of the pneumonia diagnosis (D0, and days 3 (D3 and 7 (D7 after the diagnosis. Patients were grouped as survivors and non-survivors, and the mean PCT and CRP values and their kinetics were assessed. RESULTS: In total, 45 patients were enrolled. Of them, 22 (48.8% died before day 28 after the pneumonia diagnosis. There was no significant difference between the survivor and non-survivor groups in terms of PCT on the day of pneumonia diagnosis or CRP levels at any point. However, the PCT levels days 3 and 7 were significantly higher in the non-survivor group than the survivor group. Whereas PCT levels decreased significantly from D0 to D7 in the survivor group, CRP did not. A PCT level above 1 ng/mL on day 3 was the strongest predictor of mortality, with an odds ratio of 22.6. CONCLUSION: Serum PCT was found to be a superior prognostic marker compared to CRP in terms of predicting mortality in critically ill patients who developed VAP. The PCT level on D3 was the strongest predictor of mortality in VAP.

  13. Correlation between abdominal infections and change of serum procalcitonin level%腹腔感染与血清降钙素原水平变化的相关性分析

    吴新军; 王雷; 秦玉刚; 王煜霞; 金建云; 闫争强

    2013-01-01

    目的 分析腹腔感染与血清降钙素原(PCT)水平变化的关系,为腹腔感染的治疗及预后判断提供参考.方法 选取医院收治的66例腹腔感染患者为观察组,根据感染程度不同分为一般感染组40例,重症感染组26例,另选取32名健康志愿者为对照组,应用双抗夹心免疫发光法测定观察组和对照组患者PCT水平.结果 重症感染组患者PCT水平为(67.47±12.83)μg/L,一般感染组为(17.19±5.45)μg/L,对照组为(0.33±0.07)μg/L,3组数据比较差异有统计学意义(P<0.05),进一步经Newmen-Keuls法检验,重症感染组高于一般感染组和对照组(P<0.05),一般感染组高于对照组(P<0.05);APACHE-Ⅱ评分重症感染组为(23.18±5.28)分,一般感染组为(3.23±1.87)分,比较差异有统计学意义(P<0.05);观察组不同程度感染组患者PCT水平与APACHE-Ⅱ评分呈正相关(P<0.05);观察组治疗前PCT水平为(40.19±8.78) μg/L、治疗后PCT水平为(6.29±2.10)μg/L,对照组PCT水平为(0.33±0.07)μg/L,3组数据比较差异有统计学意义(P<0.05),进一步经Newmen-Keuls法检验,观察组治疗前高于治疗后和对照组(P<0.05),治疗后与对照组比较差异无统计学意义.结论 血清降钙素原可反映腹腔感染的严重程度,并对治疗效果和预后的判断有重要意义.%OBJECTIVE To analyze the correlation between the abdominal infections and the change of level of serum procalcitonin so as to provide basis for the treatment of abdominal infections and the judgment of prognosis.METHODS A total of 66 cases of patients with abdominal infections were selected as the research objects and were divided into the general infection group with 40 cases and the severe infection group with 26 cases according to the severity of the infections,and 32 cases of healthy volunteers were selected as the control group,the levels of the serum procalcitonin of the two groups were determined by using double anti-sandwich immune

  14. Hubungan Kadar Procalcitonin dengan beratnya Pneumonia Komunitas

    Manullang, Doharjo

    2016-01-01

    Background The assessment of level severity in patient with Community Acquired Pneumonia (CAP) is very important determine the next management of disease. Procalcitonin (PCT) is known as one of biomarker sepsis and infection. The application of PCT is known to be used in diagnosis, to help clinician to decide antibiotic treatment and to make prognosis. It is still controversy whether the PCT early admission is related in clinical scoring system or prognostic score. Objective To...

  15. Impact of Low Procalcitonin Results on Antibiotic Administration in Hospitalized Patients at a Tertiary Care Center.

    Brennan, Meghan B; Osterby, Kurt; Schulz, Lucas; Lepak, Alexander J

    2016-06-01

    Procalcitonin is a sensitive and specific marker of bacterial infection; low results allow clinicians to safely de-escalate antibiotics. This retrospective cohort study aimed to determine the effect of low procalcitonin results on withholding, discontinuing, or de-escalating antibiotics in hospitalized patients at a tertiary care center. Antibiotics were initiated or continued without de-escalation in 55% of patients with low procalcitonin results. Among patients with low procalcitonin results, the primary service, but not measures of patient complexity, disease severity, or underlying disease process (lower respiratory tract infection evaluation versus systemic inflammatory response syndrome/possible sepsis) was associated with initiation or continued broad-spectrum antibiotic use. Provider-level factors may be an important variable in the initiation or continued use of broad-spectrum antibiotics for patients with low procalcitonin levels. PMID:27251126

  16. 老年脓毒症患者血浆D-二聚体和降钙素原水平变化∗%The Changes of Plasma Levels of D-dimer and Procalcitonin in Elderly Patients with Sepsis

    杨勇文; 李从荣#

    2015-01-01

    目的::回顾性分析 D-二聚体和降钙素原水平在老年脓毒症患者中的变化。方法:将172例老年脓毒症患者按预后分为生存组(n=115)和死亡组(n=57);采用免疫比浊法和电化学发光法分别检测两组患者入院时血浆 D-二聚体和降钙素原水平,比较血浆 D-二聚体、降钙素原水平和急性生理与慢性健康状况评分(APACHEⅡ评分)的组间差异及其相关性。结果:生存组血浆 D-二聚体和降钙素原水平和 APACHEⅡ评分均低于死亡组(P<0.01);老年脓毒症患者血浆 D-二聚体和降钙素原水平与 APACHEⅡ评分存在明显正相关性(r 分别为0.352、0.234,P <0.05)。结论:不同预后的老年脓毒症患者血浆 D-二聚体和降钙素原水平存在差异,监测这两个生物学指标对老年脓毒症患者的预后具有一定的参考价值。%Objective:To analysis the changes of D-dimer,procalcitonin levels in elderly patients with sepsis. Method:1 72 cases of elderly patients with sepsis were divided into survival group (n=1 1 5)and death group (n=57).When patients admitted to hospital,immune turbidimetric method and electrochemical luminescence method were used respectively to detect the plasma D-dimer and procalcitonin levels.The plasma D-dimer,procalcitonin lev-els and acute physiology and chronic health evaluation (APACHE Ⅱ score)differences between groups and their correlation were analyzed.Results:Survival group of plasma D-dimer and procalcitonin levels and APACHE Ⅱscores were lower than the death group with statistical significance (P <0.01 ).Plasma D-dimer and procalcitonin levels and APACHE Ⅱ scores were significantly positive correlations (r = 0.352,0.234,P < 0.05 ).Conclusion:There were differences in plasma of D-dimer and procalcitonin levels of in the elderly sepsis patients with different prognosis.The two biological indicators had certain reference value for the prognosis of elderly patients with sepsis.

  17. Serum procalcitonin level and SOFA score at discharge from the intensive care unit predict post-intensive care unit mortality: a prospective study.

    Yosuke Matsumura

    Full Text Available PURPOSE: The final decision for discharge from the intensive care unit (ICU is uncertain because it is made according to various patient parameters; however, it should be made on an objective evaluation. Previous reports have been inconsistent and unreliable in predicting post-ICU mortality. To identify predictive factors associated with post-ICU mortality, we analyzed physiological and laboratory data at ICU discharge. METHODS: Patients admitted to our ICU between September 2012 and August 2013 and staying for critical care>2 days were included. Sequential Organ Failure Assessment (SOFA score; systemic inflammatory response syndrome score; white blood cell count; and serum C reactive protein, procalcitonin (PCT, interleukin-6 (IL-6, lactate, albumin, and hemoglobin levels were recorded. The primary end point was 90-day mortality after ICU discharge. Two hundred eighteen patients were enrolled (195 survivors, 23 non-survivors. RESULTS: Non-survivors presented a higher SOFA score and serum PCT, and IL-6 levels, as well as lower serum albumin and hemoglobin levels. Serum PCT, albumin, and SOFA score were associated with 90-day mortality in multiple logistic regression analysis. Hosmer-Lemeshow test showed chi-square value of 6.96, and P value of 0.54. The area under the curve (95% confidence interval was 0.830 (0.771-0.890 for PCT, 0.688 (0.566-0.810 for albumin, 0.861 (0.796-0.927 for SOFA score, and increased to 0.913 (0.858-0.969 when these were combined. Serum PCT level at 0.57 ng/mL, serum albumin at 2.5 g/dL and SOFA score at 5.5 predict 90-day mortality, and high PCT, low albumin and high SOFA groups had significantly higher mortality. Serum PCT and SOFA score were significantly associated with survival days after ICU discharge in Cox regression analysis. CONCLUSIONS: Serum PCT level and SOFA score at ICU discharge predict post-ICU mortality and survival days after ICU discharge. The combination of these two and albumin level might enable

  18. CHANGES OF SEURM PROCALCITONIN LEVELS IN MIGRAINE PATIENTS%偏头痛患者血清降钙素原水平的变化

    陈东平; 侯淑红; 张志坚; 陈衍贵; 陈明生

    2011-01-01

    Objective: To investigate the changes of serum procalcitonin (PCT) levels in patients with migraine and the underlying mechanism of migraine. Method: 163 adult patients with migraine were divided into two main groups: migraine during headache attack period (n = 80) and migraine during headache free period (n = 83). These patients were further divided into four subgroups according to with or without aura. The serum levels of PCT in all patients were measured. Result: PCT levels in patients with migraine during headache attack period were significantly higher than those during headache free period (P < 0.01). PCT levels in patients with migraine with aura and in patients with migraine without aura during headache attack period were also significantly higher than those during headache free period (P < 0.01). Conclusion: PCT may be an inflammatory marker for migraine attacks, and was response for one of the underlying mechanisms of migraine attacks.%目的:观察偏头痛患者血清降钙素原(PCT)水平的变化,探讨偏头痛可能的发病机制.方法:将163例偏头痛患者分成偏头痛发作期组(n=80)和偏头痛发作间期组(n=83).根据患者有无先兆症状进一步分成四个亚组:无先兆偏头痛的发作期组(n=68)、先兆偏头痛的发作期组(n=12)、无先兆偏头痛的发作间期组(n=70)、先兆偏头痛的发作间期组(n=13).测定每组患者血清PCT水平.结果:所有偏头痛患者中,偏头痛发作期PCT水平明显高于发作间期(P<0.01).在无先兆偏头痛或先兆偏头痛患者中,偏头痛发作期PCT水平也分别明显高于发作间期(P<0.01).结论:PCT可能是偏头痛发作的一个炎症标志,是偏头痛发作的潜在机制之一.

  19. 血清降钙素原检测在新生儿细菌性肺炎中的临床意义%The Clinical Signiifcance of Serum Level of Procalcitonin in Diagnosis of Neonatal Bacterial Pneumonia

    谭长英; 崔亚利

    2016-01-01

    目的探究血清降钙素原(Procalcitonin,PCT)检测在新生儿细菌性肺炎早期诊断中的临床应用。方法回顾性分析2015年5~7月,华西第二医院新生儿科确诊的新生儿肺炎细菌感染组49例,非细菌感染38例,检测血清降钙素原,观察阳性率及其在新生儿细菌性肺炎早期诊断中的应用价值。结果新生儿肺炎细菌感染组及非细菌感染组降钙素原阳性率差异具有统计学意义(P<0.05),在新生儿细菌性肺炎早期诊断中具有临床应用价值。结论降钙素原检测能鉴别细菌性炎症与非细菌性炎症反应,在新生儿细菌性肺炎早期诊断中具有指导意义,能够判断细菌感染的严重程度及预后,以便指导临床抗生的合理应用。%Objective To explore the clinical signiifcance of serum level of procalcitonin in the diagnosis of neonatal bacterial pneumonia. Methods Select 49 cases as newborn pneumonia bacterial infection group, and 38 cases as non-bacterial infection group, which used as control group, all the serum procalcitonin data were got from department of laboratory medicine, west china second university hospital, sichuan university, from May to July in 2015. Results Neonatal pneumonia bacteria infection and the non-bacterial infection group procalcitonin original positive rate were signiifcant (P<0.05). Conclusion Procalcitonin can be used to identify bacterial inlfammation and non-bacterial inlfammatory reaction, and to determine the severity and prognosis of bacterial infection in order to guide the rational use of antibiotics.

  20. Elevated procalcitonin is associated with increased mortality in patients with scrub typhus infection needing intensive care admission

    John Victor Peter

    2013-01-01

    Full Text Available Context: Procalcitonin is a biomarker of bacterial sepsis. It is unclear if scrub typhus, a rickettsial illness, is associated with elevated procalcitonin levels. Aim: To assess if scrub typhus infection is associated with high procalcitonin levels and whether high levels portend a poorer prognosis. Setting and Design: Retrospective study of patients with severe scrub typhus infection, admitted to the medical intensive care unit of a tertiary care university affiliated teaching hospital. Materials and Methods: Eighty-four patients with severe scrub typhus infection that also had procalcitonin levels were assessed. Statistical Analysis: Relationship between procalcitonin and mortality explored using univariate and multivariate analyses. Results: The mean (±standard deviation age was 40.0 ± 15.5 years. Patients were symptomatic for 8.3 ± 4.3 days prior to presentation. The median admission procalcitonin level was 4.0 (interquartile range 1.8 to 8.5 ng/ml; 59 (70.2% patients had levels >2 ng/ml. Invasive mechanical ventilation was required in 65 patients; 20 patients died. On univariate analysis, admission procalcitonin was associated with increased odds of death [odds ratio (OR 1.09, 95% confidence interval (CI 1.03 to 1.18]. On multivariate logistic regression analysis including procalcitonin and APACHE-II score, the APACHE-II score was significantly associated with mortality (OR 1.16, 95% CI 1.06 to 1.30, P = 0.004 while a trend was observed with procalcitonin (OR 1.05, 95%CI 1.01 to 1.13, P = 0.09. The area under the receiver operating characteristic (ROC curve, AUC, for mortality was 0.77 for procalcitonin and 0.78 for APACHE-II. Conclusions: Procalcitonin is elevated in severe scrub typhus infection and may be associated with higher mortality.

  1. Sensitivity and specificity of serum procalcitonin level compared to leucocyte count for diagnosis of surgical site infection on patients undergoing major surgery

    Muhammad Sayuti; Supomo; Umi Sholekah Intansari

    2016-01-01

    Surgical site infection (SSI) is one of the most serious complications on sugical procedure. However, its diagnosis is still based on the clinical and laboratory examination that take more time and less sensitive and specific. Therefore, early diagnosis that is more accurate and precise is needed. Some biomarker such as serum procalcitonin (PCT) is promoted for diagnosis SSI. The aim of the study was to evaluate the sensitivity and specificity of serum PCT compared with leucocy...

  2. Difference in procalcitonin level of patients with fungal infections and its relationship with prognosis%不同真菌感染对降钙素原的差异与疾病预后的关系

    魏万昆; 万程彬; 张毅

    2015-01-01

    目的:观察不同真菌感染降钙素原的差异性,并对其与疾病预后的相关性进行分析。方法选取2012年6月-2013年6月于IC U就诊的危重病患者54例,根据危险评分分组,非危重组24例、危重组25例、极危重组5例;研究不同感染部位血清降钙素原水平、不同菌株感染血清降钙素原水平以及降钙素原与疾病预后的相关性。结果54例真菌感染患者中肺部感染26例占48.15%、消化道感染12例占22.21%、泌尿道感染9例占16.67%、血流感染9例占12.96%;不同感染部位血清降钙素原水平具有一定差异性,其中血清降钙素原水平较其他部位明显偏高,差异有统计学意义( P<0.05);共培养出病原菌86株,其中白色假丝酵母菌占55.81%,热带假丝酵母菌占37.21%,克柔假丝酵母菌占6.98%,降钙素原水平差异无统计学意义;随着危重程度的不断升高,降钙素原水平逐渐增高,组间差异有统计学意义(P<0.05),PCT与危重评分呈正相关(P<0.05)。结论降钙素原对真菌感染的诊断有重大意义,但不同菌株间差异无显著性,其水平与疾病危重程度密切相关。%OBJECTIVE To observe the difference in the procalcitonin level of the patients with different fungal in‐fections and explore its relationship with the prognosis of disease .METHODS A total of 54 critically ill patients who were treated in the ICU from Jun 2012 to Jun 2013 were enrolled in the study and divided into the non‐critical‐ly ill group with 24 cases ,the critically ill group with 25 cases ,and the extremely critically ill group with 5 cases according to the score of risk .The levels of procalcitonin of the patients with different sites of infections ,the levels of procalcitonin of the patients with infections due to different species of pathogens ,and the relationship between the level of procalcitonin and the prognosis of

  3. Comparative Study of Plasma Endotoxin with Procalcitonin Levels in Diagnosis of Bacteremia in Intensive Care Unit Patients

    Tao Wang

    2016-01-01

    Conclusions: Plasma endotoxin was more related to GN than to Gram-positive bacteremia, and that endotoxin level was species dependent, but PCT level remained relatively more stable within the GN bacteria caused bacteremia. Both GN and positive bacteria caused bacteremia in the ICU patients in different regions of China. And PCT is a more valuable biomarker than endotoxin in the diagnosis of bacteremia.

  4. Role of serum procalcitonin level in early diagnosis of bacterial pneumonia in children, a hospital based study

    Sheikh Mohd Saleem

    2016-05-01

    Conclusions: Serum PCT is an important biomarker for prompt diagnosis of bacterial infection and a sensitive indicator to distinguish bacterial from non-bacterial pneumonia. Evaluating serum PCT levels helps in early use of antibiotic therapy and prognosis of underlying disease. [Int J Res Med Sci 2016; 4(5.000: 1518-1521

  5. Diagnostic value of soluble CD163 serum levels in patients suspected of meningitis: comparison with CRP and procalcitonin

    Knudsen, Troels Bygum; Larsen, Klaus; Kristiansen, Thomas Birk;

    2007-01-01

    The aim of the study was to evaluate and compare the diagnostic value of sCD163 serum levels with CRP and PCT in meningitis and bacterial infection. An observational cohort study was conducted between February 2001 and February 2005. The study population comprised 55 patients suspected of meningi...

  6. Procalcitonin as a Marker of Neonatal Sepsis

    Mohmoud Hajiahmadi

    2009-04-01

    Full Text Available Objective:Early diagnosis of neonatal sepsis and appropriate treatment decreases the mortality and morbidity of these infants. The aim of this study was to assess the role of procalcitonin (PCT as a marker in the early diagnosis, treatment and follow-up of neonatal sepsis. Methods:Thirty-eight neonates with clinical (n=8, suspected (n=19 and proven sepsis (n=11 were evaluated. The PCT levels were measured by immunoluminoassay before and on day 5 of treatment. PTC levels of 0.5-2 ng/ml, 2.1-10 ng/ml and >10 ng/ml were considered as weakly positive, positive, and strongly positive, respectively. The sepsis screen tests and cultures of blood or other sterile body fluids in these three groups of infants were recorded. Findings:The levels of PCT in proven sepsis group were higher than that in other groups. Strongly positive PTC level was seen in none of 8 cases of clinical sepsis, 4 of 19 suspected and in 10 of 11 cases with proven sepsis. PCT levels were dramatically decreased in three groups on day 5 of treatment. Conclusion:The results show that the serum procalcitonin levels seem to be significantly increased in proven sepsis and decrease dramatically in all types of sepsis after appropriate treatment.

  7. Maternal Plasma Procalcitonin Concentrations in Pregnancy Complicated by Preterm Premature Rupture of Membranes

    Andrzej Torbé

    2007-01-01

    Full Text Available Objectives. Our objective is to compare maternal plasma procalcitonin concentrations in preterm premature rupture of membranes (pPROM and premature rupture of membranes (PROM at term with their levels in uncomplicated pregnancy, and to determine whether these concentrations are useful in the diagnosis of pPROM cases suspected of infection and in the prediction of pPROM-to-delivery interval. Study design. Forty eight patients with pPROM, 30 with PROM at term, 31 healthy women at preterm gestation, and 33 healthy women at term were included. In pPROM group, analysis of procalcitonin concentrations with reference to leucocytosis, serum C-reactive protein, vaginal fluid culture, neonatal infection, histological chorioamnionitis and pPROM-to-delivery interval was carried out. Results. Procalcitonin concentrations in pPROM and PROM at term cases were comparable. However, in both groups procalcitonin values were significantly higher than in healthy controls in approximate gestational age. In pPROM group, procalcitonin concentrations between the patients with and without laboratory indices of infection were comparable, as well as between patients who gave birth to newborns with and without congenital infection, and between patients with and without histological chorioamnionitis. The predictive values of procalcitonin determinations were poor. Conclusion. The value of maternal plasma procalcitonin determinations in the diagnostics of pPROM cases suspected of intraamniotic infection, as well as for the prediction of pPROM-to-delivery interval, newborn's infection or histological chorioamnionitis is unsatisfactory. However, procalcitonin concentrations are elevated, both in patients with preterm and term PROMs in comparison to healthy pregnants, and therefore further evaluations are necessary to establish the role of procalcitonin in the pathophysiology of pregnancy.

  8. Diagnostic value of soluble CD163 serum levels in patients suspected of meningitis: comparison with CRP and procalcitonin

    Knudsen, Troels Bygum; Larsen, Klaus; Kristiansen, Thomas Birk; Møller, Holger Jon; Tvede, Michael; Eugen-Olsen, Jesper; Kronborg, Gitte

    The aim of the study was to evaluate and compare the diagnostic value of sCD163 serum levels with CRP and PCT in meningitis and bacterial infection. An observational cohort study was conducted between February 2001 and February 2005. The study population comprised 55 patients suspected of...... marker for distinguishing bacterial infection from non-bacterial disease (specificity 0.91; sensitivity 0.47). However, the overall diagnostic accuracy of CRP (AUC =0.91) and PCT (AUC =0.87) were superior (p<0.02 and p<0.06) compared to that of sCD163 (AUC =0.72). For the diagnosis of systemic bacterial...... infection, the AUC of sCD163 (0.83) did not differ significantly from those of CRP or PCT. All markers had AUCs <0.75 for differentiating between purulent meningitis and other conditions. In conclusion, CRP and PCT had high diagnostic value and were superior as markers of bacterial infection compared to s...

  9. Procalcitonin for detecting community-acquired bacterial pneumonia

    Devi Gusmaiyanto

    2016-06-01

    Full Text Available Background Pneumonia is a major cause of morbidity andmortality in children under five years of age. Pneumonia can be ofbacterial or viral origin. It is difficult to distinguish between thesetwo agents based on clinical manifestations, as well as radiologicaland laboratory examinations. Furthermore, bacterial cultures taketime to incubate and positive results may only be found in 10-30%of bacterial pneumonia cases. Procalcitonin has been used as amarker to distinguish etiologies, as bacterial infections tend toincrease serum procalcitonin levels.Objective To determine the sensitivity, specificity, positivepredictive value and negative predictive value of procalcitoninin community-acquired bacterial pneumonia.Method This cross-sectional study was conducted in thePediatric Health Department of Dr. M. Djamil Hospital, Padang.Subjects were selected by consecutive sampling. Procalcitoninmeasurements and PCR screening were performed on bloodspecimens from 32 pneumonia patients and compared.Results Of the 32 subjects, most were boys (56.25%, under 5years of age (99%, and had poor nutritional status (68.75%.Using a cut-off point of 0.25 ng/mL, procalcitonin level hada sensitivity of 92%, specificity 50%, positive predictive value 88%, and negative predictive value 60% for diagnosing bacterial pneumonia. Using a cut-off point of 0.5 ng/mL, procalcitonin level had a specificity of 46%, specificity 83%, positive predictive value 91%, and negative predictive value 25%.Conclusion A cut-off point of 0.25 ng/mL of procalcitonin level may be more useful to screen for bacterial pneumonia than a cutoff point of 0.5 ng / mL. However, if the 0.25 ng/mL cut-off point is used, careful monitoring will be required for negative results, as up to 40% may actually have bacterial pneumonia. [PaediatrIndones. 2015;55:65-9.].

  10. Hubungan Procalcitonin dengan Skor Pneumonia Severity Indeks (PSI) Untuk Menilai Tingkat Keparahan Penyakit Pneumonia Komuniti di RSUP H. Adam Malik Medan

    Siregar, Ahmad Aswar

    2016-01-01

    Background: procalcitonin as a biomarker for acute bacterial infection which is commonly used recently. Objective: This study is trying to find the relationship between Procalcitonin and PSI scores to asses the severity of CAP. Methods: This study used longitudinal data collection approach without a control group. Patients with a diagnosis of Community Acquired Pneumonia were checked the Procalcitonin levels and measured the PSI scores on the first and third day of hospitalization. ...

  11. Ability of procalcitonin to discriminate infection from non-infective inflammation using two pleural disease settings.

    Fiona J McCann

    Full Text Available Procalcitonin has been shown to be useful in separating infection from non-infective disorders. However, infection is often paralleled by tissue inflammation. Most studies supporting the use of procalcitonin were confounded by more significant inflammation in the infection group. Few studies have examined the usefulness of procalcitonin when adjusted for inflammation.Pleural inflammation underlies the development of most exudative effusions including pleural infection and malignancy. Pleurodesis, often used to treat effusions, involves provocation of intense aseptic pleural inflammation. We conducted a two-part proof-of-concept study to test the specificity of procalcitonin in differentiating infection using cohorts of patients with pleural effusions of infective and non-infective etiologies, as well as subjects undergoing pleurodesis.We measured the blood procalcitonin level (i in 248 patients with pleural infection or with non-infective pleural inflammation, matched for severity of systemic inflammation by C-reactive protein (CRP, age and gender; and (ii in patients before and 24-48 hours after induction of non-infective pleural inflammation (from talc pleurodesis.1 Procalcitonin was significantly higher in patients with pleural infection compared with controls with non-infective effusions (n = 32 each group that were case-matched for systemic inflammation as measured by CRP [median (25-75%IQR: 0.58 (0.35-1.50 vs 0.34 (0.31-0.42 µg/L respectively, p = 0.003]. 2 Talc pleurodesis provoked intense systemic inflammation, and raised serum CRP by 360% over baseline. However procalcitonin remained relatively unaffected (21% rise. 3 Procalcitonin and CRP levels did not correlate. In 214 patients with pleural infection, procalcitonin levels did not predict the survival or need for surgical intervention.Using a pleural model, this proof-of-principle study confirmed that procalcitonin is a biomarker specific for infection and is not affected by non

  12. Comparison between Procalcitonin, Brain Natriuretic Peptide, and Uric Acid in Children with Cardiomyopathy and Controls

    Noor Mohammad Noori

    2015-01-01

    Full Text Available Objective. This study was performed to determine the level of procalcitonin, Brain Natriuretic Peptide (BNP, and uric acid in children with cardiomyopathy in comparison with controls and the association with echocardiographic findings. Methods. The levels of BNP, procalcitonin, and serum uric acid were measured and the amounts of biomarkers compared with echocardiographic findings. Results. In this study mean age of participants was the same (p=0.321. The majority of echocardiographic indices in left and right heart have different means in case and controls (p<0.05. Means of BNP, procalcitonin, and uric acid were 213.814 ± 309.601, 9.326 ± 3.881, and 6.846 ± 1.814 for case group and 2.76 ± 1.013, 1.851 ± 1.466, and 3.317 ± 0.924 for control (p<0.001, respectively. In the patients group there was relationship of Ross classification with BNP (χ2 = 15.845, p<0.05 and with age (χ2 = 8.946, p<0.05. For uric acid and procalcitonin no significant relationships were observed. Conclusions. procalcitonin, uric acid, and BNP had significant relationship with many echocardiographic findings in participants. For patients, procalcitonin did not show correlation. The severity of illness based on the Ross classification showed significant correlation with BNP level and age in patients.

  13. Study on the changes of serum procalcitonin and interleukin - 6 levels among the neonates with sepsis%新生儿败血症患儿血清降钙素原及白介素-6水平变化研究

    陆彩霞; 王海兰; 李春娥

    2012-01-01

    Objective; To explore the values of serum procalcitonin and interleukin -6 levels in early diagnosis of neonatal sepsis. Methods; Forty neonates with sepsis and forty healthy neonates were selected as research objects, the serum procalcitonin and interleukin - 6 levels during acute phase and recovery phase in sepsis group and control group were detected. Results: Hie serum procalcitonin and interleukin - 6 levels during acute phase in sepsis group were significantly higher than those in control group ( P 0. 05 ) . The serum procalcitonin and interleukin -6 levels during acute phase in sepsis group were significantly higher than those during recovery phase in sepsis group (P <0.05) . Conclusion: There is a positive correlation between serum procalcitonin and interleukin -6 levels and the degree of severity of neonatal sepsis, serum procalcitonin and interleukin -6 levels can be used as important indexes for early diagnosis and evaluation of prognosis in the neonates with sepsis.%目的:探讨血清降钙素原及白介素-6水平在新生儿败血症早期诊断中的价值.方法:选择40例败血症新生儿及40例健康新生儿作为研究对象,测定败血症组急性期、恢复期及健康对照组血清降钙素原及白介素-6水平.结果:败血症组急性期血清降钙素原及白介素-6水平显著高于对照组(P<0.05).败血症组恢复期和对照组血清降钙素原及白介素-6水平比较,差别无统计学意义(P>0.05).败血症组急性期血清降钙素原及白介素-6水平显著高于恢复期(P<0.05).结论:血清降钙素原及白介索-6水平和新生儿败血症严重程度呈正相关性,血清降钙素原及白介素-6水平可作为新生儿败血症早期诊断及评价预后的重要指标.

  14. Procalcitonin Strip Test as an Independent Predictor in Acute Pancreatitis.

    Dias, Brendan Hermenigildo; Rozario, Anthony Prakash; Olakkengil, Santosh Antony; V, Anirudh

    2015-12-01

    Plasma procalcitonin (PCT) is a highly specific marker for the diagnosis of bacterial infection and sepsis. Studies have demonstrated its role in the setting of sepsis and acute pancreatitis. This study aims to analyze and compare the prognostic efficacy of plasma procalcitonin strip test in acute pancreatitis. A prospective study was conducted in the department of general surgery from June 2012 to June 2013. Plasma procalcitonin was estimated by the semiquantitative strip test. The study included a total of 50 patients diagnosed to have acute pancreatitis. Data was collected and statistically analyzed using SPSS version 17. Thirty-nine out of the 50 patients (78 %) were males with a mean age of 46.8 years (range, 25-78 years) and 25 patients (50 %) had ethanol-induced pancreatitis, while 13 patients (26 %) had gall stone pancreatitis. Plasma PCT values were found to correlate better than CRP levels and total leukocyte count with the total duration of hospitalization, ITU, and ICU stay, as well as with the progression to severe acute pancreatitis. A cut off for plasma PCT of >2 ng/mL was found to be 100 % sensitive and 100 % specific and a cut off for CRP of >19 mg/dL was 70 % sensitive and 65 % specific for predicting the progression to severe acute pancreatitis. Plasma PCT also correlated well with antibiotic requirement. A cut off value of >0.5 ng/mL for plasma PCT was 100 % sensitive and 80 % specific and a cut off value of >18 mg/dL for CRP was 86 % sensitive and 63 % specific for predicting antibiotic requirement. Plasma procalcitonin is an early and reliable prognostic indicator in acute pancreatitis. The procalcitonin strip test is a rapid test which is useful in analyzing prognosis in patients with acute pancreatitis. PMID:27011501

  15. The Value of C-Reactive Protein and Procalcitonin in Febrile Neutropenia

    Solmaz Çelebi

    2009-06-01

    Full Text Available Aim: Febrile neutropenia is the major cause of mortality and morbidity in cancer patients. For this reason, early diagnosis of severe infections and appropriate antimicrobial therapy are very important. The aim of this study was to investigate the difference between C-reactive protein (CRP and procalcitonin in determining the sepsis and its severity. Materials and Method: A total of 30 children (35 episodes with febrile neutropenia who were hospitalized in the Uludag University, Pediatric Hematology and Oncology Unit were included in this prospective study. The blood samples for CRP and procalcitonin were collected daily between 0 to 5th days. Serum CRP and procalcitonin levels were compared with culture positivity, prolonged fever, mucositis and absolute granulosit count (AGC. Results: A total of 16 patients (56% diagnosed with acute leukemia and, 14 patients (46% having solid tumours were evaluated. In sequential analysis of febrile episodes, both the median of procalcitonin and the CRP concentrations showed the same tendency and there was no significant correlation between them (r=0.2, p>0.05. There was no significant association between CRP and procalcitonin among those having positive culture and mucositis. However, CRP values at the 3rd, 4th and 5th days were significantly higher in the patients with AGC100/mm3. Similarly, CRP values were significantly higher at the 1st, 2nd, 3rd and 4th days among the patients having prolonged fever. Conclusion: Our study suggests that there is no difference between CRP and procalcitonin in determining sepsis and its severity. Although procalcitonin is a valuable acute phase reactant in non-neutropenic patients, larger prospective investigations are needed to show the prognostic value of procalcitonin in neutropenic patients. (Journal of Current Pediatrics 2009; 7: 7-12

  16. Evaluation of Diagnostic Value of Procalcitonin as a Marker of Neonatal Bacterial Infections

    Alireza Monsef

    2012-09-01

    Full Text Available Objective: This study tried to assess sensitivity, specificity, positive and negative predictive value of procalcitonin for diagnosis of neonatal bacterial infections.Methods: This prospective cross sectional study was carried out during an 18-month period in NICU and neonatal wards of Besat Hospital in Hamedan province, Iran. 39 symptomatic infants with clinical and laboratory findings in favor of bacterial infection with a positive blood, CSF, and/or supra pubic urine cultureentered the study; 32 newborns without any bacterial infection served as control group. Quantitative procalcitonin level ≥0.5 ng/ml was accepted as pathological. Finally sensitivity, specificity, positive (PPV and negative predictive value (NPV were calculated for procalcitonin test.Findings: 20 blood cultures, 17 urine cultures and 8 CSF cultures were positive. Sensitivity, specificity, PPV and NPV for procalcitonin test was 76.9%, 100%, 100% and 78% respectively. Diagnostic value of procalcitonin test in accordance with blood culture for mentioned items was 85%, 100%, 100% and 91.4%respectively. Its diagnostic value according to urine culture was: sensitivity 70.6%, specificity 100%, PPV 100% and NPV 86.4%, and according to CSF culture was: sensitivity 75%, specificity 100%, PPV 100% and NPV 94.1% respectively.Conclusion: The results show that the procalcitonin test has high sensitivity, specificity, PPV and NPV for diagnosis of neonatal infections.

  17. PROCALCITONIN TEST IN RHEUMATIC DISEASES

    G. M. Tarasova

    2014-01-01

    Full Text Available Estimation of serum procalcitonin (PCT levels is of great interest in rheumatology in both the diagnosis of coinfectionsand the differential diagnosis between rheumatic disease activity and the current infectious process.Objective: to estimate the value of PCT as a specific marker for generalized and local infection in rheumatic patients.Subjects and methods. A retrospective study investigated the case histories of 100 inpatients examined and treated at the V.A. Nasonova Research Institute of Rheumatology. Serum PCT concentrations were determined by a quantitative electrochemiluminescence assay using a Cobas E 411 analyzer (Roche, Switzerland.Results. Infectious diseases were diagnosed in 41 of the 100 patients. The infectious process was generalized and local in 11 and 30 cases, respectively. In the patients with generalized infection, the level of PCT was more than 2.0 ng/ml in 81.8% of the cases. In the local infection and non-infection groups, it was below 0.5 mg/ml in 70 and 84.7% ofcases, respectively. In the generalized infection group, the content of PCT was significantly higher (3.6 [2.3; 10.5] than in the local infection (0.24 [0.15; 0.7]; р = 0.004 and non-infection (0.15 [0.09; 0.26]; р = 0.0001 groups. It did not depend on rheumatic disease activity. C-reactive protein (CRP levels and erythrocyte sedimentation rate (ESRcorrelated with PCT concentrations in different patient groups. ROC analysis showed the optimal sensitivity (82% and specificity (98% of PCT as a marker of systemic infection only in the rheumatic patients with its concentration of ≥2.3 ng/ml.Conclusion. The determination of PCT is certain to contribute to the diagnosis of generalized infections and the differential diagnosis of systemic rheumatic diseases and infectious ones.

  18. Serum procalcitonin is a marker for prediction of readmission from an intermediate care to an acute care hospital in neurosurgical patients

    Jia Xu Lim

    2015-01-01

    Conclusion: Procalcitonin is a pro-hormone known to correlate with infection and poor neurological status. We have found that its serum values correlate significantly with the readmission rates of neurosurgical patients in our study. We postulate that by ensuring normality in procalcitonin levels prior to transfer to an intermediate care facility, potentially half of neurosurgical readmissions can be prevented.

  19. Diagnostic Accuracy of Procalcitonin in Bacterial Meningitis Versus Nonbacterial Meningitis

    Wei, Ting-Ting; Hu, Zhi-De; Qin, Bao-Dong; Ma, Ning; Tang, Qing-Qin; Wang, Li-li; ZHOU, Lin; Zhong, Ren-Qian

    2016-01-01

    Abstract Several studies have investigated the diagnostic accuracy of procalcitonin (PCT) levels in blood or cerebrospinal fluid (CSF) in bacterial meningitis (BM), but the results were heterogeneous. The aim of the present study was to ascertain the diagnostic accuracy of PCT as a marker for BM detection. A systematic search of the EMBASE, Scopus, Web of Science, and PubMed databases was performed to identify studies published before December 7, 2015 investigating the diagnostic accuracy of ...

  20. Evapotranspiration Partitioning and Response to Abnormally Low Water Levels in a Floodplain Wetland in China

    Xiaosong Zhao; Yuanbo Liu

    2016-01-01

    Evapotranspiration (ET) is an important component of the wetland water budget. Water level declines in Poyang Lake, the largest freshwater lake in China, have caused concerns, especially during low water levels. However, how wetland ET and its partitioning respond to abnormally low water levels is unclear. In this study, wetland ET was estimated with MODIS data and meteorological data. The wetland ET partitioning and its relationship with abnormally low water levels were analyzed for 2000–201...

  1. Procalcitonin kinetics as a prognostic marker in severe sepsis/septic shock

    Banani Poddar

    2015-01-01

    Full Text Available Background and Aims: To evaluate the prognostic value of change (fall in serum procalcitonin level (PCT in critically ill adults with severe sepsis/septic shock. Methods: This was a prospective observational study in a general purpose Intensive Care Unit of a teaching Institute. PCT was measured at admission (D0 and after 72-96 h (D4 by electrochemi-luminescence immunoassay (BRAHMS PCT kit in adults (>18 years admitted with severe sepsis or septic shock. Change in procalcitonin values from D0 to D4 was correlated with the primary outcome, that is, 28 days mortality. All results are reported as median (interquartile range. Results: A total of 171 (100 males of 181 patients were included. The median age was 46 years (range 19-79. 137 patients were in septic shock and 34 in severe sepsis. The sequential organ failure assessment (SOFA score in all patients was 11 (9-14.91 (53.2% patients survived at 28 days (survivors. The baseline procalcitonin was similar in two groups (3.48 [1.04-15.85] vs. 5.27 [1.81-23.57] ng/ml in survivors and nonsurvivors [NS] respectively. The procalcitonin change was 1.58 (0.20-8.52 in survivors and 0.28 (-1.38-6.17 in NS (P = 0.01. The C-statistic of percentage change in procalcitonin from D0 to D4 to predict survival was 0.73 (95% confidence interval [CI]: 0.65-0.82 when compared to 0.78 (95% CI: 0.71-0.86 for change of SOFA score. For an absolute fall in procalcitonin of >1 ng/ml, a 70% fall predicted survival with 75% sensitivity and 64% specificity. Conclusions: In critically ill-patients with severe sepsis/septic shock, change (fall in procalcitonin is associated with good outcome.

  2. Value of soluble TREM-1, procalcitonin, and C-reactive protein serum levels as biomarkers for detecting bacteremia among sepsis patients with new fever in intensive care units: a prospective cohort study

    Su Longxiang

    2012-07-01

    Full Text Available Abstract Background The purpose of this study was to explore the diagnostic value of soluble triggering receptor expressed on myeloid cells 1 (sTREM-1, procalcitonin (PCT, and C-reactive protein (CRP serum levels for differentiating sepsis from SIRS, identifying new fever caused by bacteremia, and assessing prognosis when new fever occurred. Methods We enrolled 144 intensive care unit (ICU patients: 60 with systemic inflammatory response syndrome (SIRS and 84 with sepsis complicated by new fever at more than 48 h after ICU admission. Serum sTREM-1, PCT, and CRP levels were measured on the day of admission and at the occurrence of new fever (>38.3°C during hospitalization. Based on the blood culture results, the patients were divided into a blood culture-positive bacteremia group (33 patients and blood culture-negative group (51 patients. Based on 28-day survival, all patients, both blood culture-positive and -negative, were further divided into survivor and nonsurvivor groups. Results On ICU day 1, the sepsis group had higher serum sTREM-1, PCT, and CRP levels compared with the SIRS group (P P Conclusions Serum sTREM-1, PCT, and CRP levels each have a role in the early diagnosis of sepsis. Serum sTREM-1, with the highest sensitivity and specificity of all indicators studied, is especially notable. sTREM-1, PCT, and CRP levels are of no use in determining new fever caused by bacteremia in ICU patients, but sTREM-1 levels reflect the prognosis of bacteremia. Trial registration ClinicalTrial.gov identifier NCT01410578

  3. Procalcitonin increase in early identification of critically ill patients at high risk of mortality

    Jensen, Jens Ulrik; Heslet, L; Jensen, TH;

    2006-01-01

    OBJECTIVE: To investigate day-by-day changes in procalcitonin and maximum obtained levels as predictors of mortality in critically ill patients. DESIGN: Prospective observational cohort study. SETTING:: Multidisciplinary intensive care unit at Rigshospitalet, Copenhagen University Hospital, a...... tertiary reference hospital in Denmark. PATIENTS: Four hundred seventy-two patients with diverse comorbidity and age admitted to this intensive care unit. INTERVENTIONS: Equal in all patient groups: antimicrobial treatment adjusted according to the procalcitonin level. MEASUREMENTS AND MAIN RESULTS: Daily...... procalcitonin measurements were carried out during the study period as well as measurements of white blood cell count and C-reactive protein and registration of comorbidity. The primary end point was all-cause mortality in a 90-day follow-up period. Secondary end points were mortality during the stay in the...

  4. Use of a semiquantitative procalcitonin kit for evaluating severity and predicting mortality in patients with sepsis

    Kenzaka T

    2012-05-01

    mortality in septic patients. Based on the level of semiquantitative procalcitonin measured in patients with suspected sepsis, a timely decision can be reliably made to transfer them to a tertiary hospital with an intensive care unit for optimal care.Keywords: sepsis, semiquantitative procalcitonin, Sequential Organ Failure Assessment, Acute Physiology and Chronic Health Evaluation II, mortality, procalcitonin

  5. Clinical Significance of Dynamic Determination of Serum Procalcitonin Levels in Patients with Malignant Tumor in ICU%动态监测ICU恶性肿瘤患者血清降钙素原水平的临床意义

    张爱敏; 张鹏

    2011-01-01

    探讨血清降钙素原(procalcitonin,PCT)测定在重症监护病房(intensive care unit,ICU)恶性肿瘤患者感染的早期诊断、鉴别诊断和临床治疗中的意义.选择85例恶性肿瘤患者,其中感染组55例,非感染对照组30例.在拟诊感染的第一天,抽静脉血做血培养,同时采用半定量固相免疫色谱法(PCT-Q)检测血清PCT浓度.并根据PCT结果指导临床使用抗生素,动态监测PCT水平,观察3~7天的疗效.结果显示,血清PCT浓度在感染组与对照组间差别有统计学意义(P<0.01),PCT-Q 检测,PCT>0.5ng/mL可早期预测恶性肿瘤患者感染,其灵敏度为90.9%,特异度为96.7%.对PCT阳性患者使用适当抗生素治疗3~7天后,PCT转为正常(<0.5ng/mL).PCT-Q法较普通血培养法灵敏( P<0.01),对ICU危重恶性肿瘤患者感染早期诊断、鉴别诊断及临床抗生素治疗有指导意义.%To explore the clinical significance of determination of serum procalcitonin (PCT) levels in the early diag nosis and differential diagnosis and clinical treatment in patients with malignant tumor and infections in ICU. 85 ca ses were divided into two groups:55 patients with infection and 30 patients with no infection. Blood culture and PCT were evaluated at onset of signs of infection. PCT levels in serum were investigated by semi-quantitative solid-phase immune chromatography. The antibacterial agents were used according to the results of PCT. The curative effects were evaluated until one week. The results showed that there were statistically different (P <0.01) between infection group and no infection group in PCT levels. The PCT serum level greater than 0.5ng/mL predicted an infection and with a sensitivity of 90.9% and specificity of 96.7%. The method of PCT-Q was more sensitive than the blood cul ture(P <0.01). PCT values returned to normal(<0.5ng/mL)by 3 to 7 days of appropriate antibiotic therapy. The method of PCT-Q is more sensitive for early diagnosis of pathogens

  6. Comparing the Morphological Changes in Burn Wound Tissues and the Procalcitonin Concentration

    Ludmila I. Budkevich, PhD, ScD²

    2013-03-01

    Full Text Available The problem of early diagnostics of bacterial complications is particularly true for children with extensive burn trauma (BT. Procalcitonin concentration levels considerably facilitate the diagnosis of sepsis. In all, 50 children with severe burns were included in our research. We conducted histological tests of the burn wound tissues from 13 patients. On comparison of the results of the PCT-tests with the results of the morphological investigation, we observed that the depth of the penetration of the microorganisms in the damaged tissues quite precisely corresponded to changes in the procalcitonin concentration.

  7. Evapotranspiration Partitioning and Response to Abnormally Low Water Levels in a Floodplain Wetland in China

    Xiaosong Zhao

    2016-01-01

    Full Text Available Evapotranspiration (ET is an important component of the wetland water budget. Water level declines in Poyang Lake, the largest freshwater lake in China, have caused concerns, especially during low water levels. However, how wetland ET and its partitioning respond to abnormally low water levels is unclear. In this study, wetland ET was estimated with MODIS data and meteorological data. The wetland ET partitioning and its relationship with abnormally low water levels were analyzed for 2000–2013. The results showed that the water evaporation rate (Ewater was larger than the land ET rate (ETland; the ETland/Ewater ranged from 0.77 to 0.99. When the water level was below 12.8 m, the ET partition ratio was larger than 1, which indicates that wetland ET comes from land surface ET more than water evaporation. The negative standardized water level index (SWI was used to represent an abnormally low water level in the wetland. Although the monthly wetland ET decreased as the negative SWI decreased, ETland was higher than the average under negative SWI conditions from September to December, when the water level decreased. The abnormally low water level induced more water loss from the land surface, especially when the water level decreased, which reduced the available water resources along the wetland shore.

  8. Research on the relation between changes of serum procalcitonin level and abdominal infection%血清降钙素原水平变化与腹腔感染的关系研究

    苏宏; 蔡慧云; 于波; 白雪; 魏晓军; 聂玉辉

    2011-01-01

    Objective To analyze the relation between changes of serum procalcitonin (PCT) level and abdominal infection.Methods Serum levels of PCT were detected in 58 cases of abdominal infection.And comparative analysis of PCT levels was performed between general and severe abdominal infection groups.Results In the general infection group of 25 cases, serum PCT was ( 15.88 ±6.67) μg/L, and in the severe group of 33 cases, serum PCT was (69.83 ± 17.82) μg/L.Serum PCT of general infection group was significant higher than that of severe group ( P < 0.05 ).There were a significant positive correlation between PCT level and the APACHE- Ⅱ score in the severe group ( r = 0.791, P < 0.05 ).Pyemia occurred in 8 cases, of which PCT levels exceeded 70μ g/L, and three dead, whose PCT levels over 90μg/L.Conclusion Detecting serum PCT levels were helpful to assess the efficacy and the prognosis in patients with abdominal infection.%目的 探讨血清降钙素原(PCT)水平与腹腔感染的关系.方法 检测58例腹腔感染患者血PCT水平,对比分析一般感染组与重症感染组PCT水平.结果 一般感染组25例,PCT为(15.88 ± 6.67)μg/L.重症感染组33例,PCT为(69.83 ± 17.82)μg/L.重症感染组PCT水平显著高于一般感染组(P<0.05).对比分析重症感染组患者PCT水平与APACHE-Ⅱ评分呈正相关(r=0.791,P<0.05).重症感染组有8例出现脓毒血症,血PCT水平均>70 μg/L,3例死亡患者血PCT水平>90 μg/L.结论 对腹腔感染患者,监测血PCT变化,对评估疗效和预后有重要意义.

  9. Diagnostic value of procalcitonin for acute complicated appendicitis

    Yamashita, Hiromasa; Yuasa, Norihiro; Takeuchi, Eiji; Goto, Yasutomo; Miyake, Hideo; Miyata, Kanji; Kato, Hideki; Ito, Masafumi

    2016-01-01

    ABSTRACT A rapid and reliable test for detection of complicated appendicitis would be useful when deciding whether emergency surgery is required. We investigated the clinical usefulness of procalcitonin for identifying acute complicated appendicitis. We retrospectively analyzed 63 patients aged ≥15 years who underwent appendectomy without receiving antibiotics before admission and had preoperative data on the plasma procalcitonin level (PCT), body temperature (BT), white blood cell count (WBC), neutrophil / lymphocyte ratio (N/L ratio), and C-reactive protein level (CRP). Patients were classified into 3 groups: group A (inflammatory cell infiltration of the appendix with intact mural architecture), group B (inflammatory cell infiltration with destruction of mural architecture, but without abscess or perforation), and group C (macroscopic abscess and/or perforation). For identifying destruction of mural architecture, the diagnostic accuracy of PCT was similar to that of BT or CRP. However, the diagnostic accuracy of PCT was highest among the five inflammatory indices for identifying abscess and/or perforation, with the positive predictive value of PCT for abscess and/or perforation being higher than that of CRP (73% vs. 48%). Univariate analysis of the predictors of abscess and/or perforation revealed that a plasma PCT level ≥0.46 ng/mL had the highest odds ratio (30.3 [95% confidence interval: 6.5–140.5] versus PCT <0.46 ng/mL). These findings indicate that procalcitonin is a useful marker of acute appendicitis with abscess and/or perforation. PMID:27019529

  10. [Serum procalcitonin and respiratory tract infections].

    Zarka, V; Valat, C; Lemarié, E; Boissinot, E; Carré, P; Besnard, J C; Diot, P

    1999-12-01

    The aim of our study was to evaluate the prognostic value of serum procalcitonine (PCT) assay in adult respiratory infections. Forty-nine patients admitted with pleurisy, community-acquired pneumonia, tuberculosis, infection were included in this prospective study. PCT was assayed on admission and discharge. Biological and clinical parameters of gravity were also evaluated. Twenty patients had elevated PCT of more than 0.50 ng/ml. In 29 patients, PCT was undetectable. The serum PCT level was normal in the patients with tuberculosis, infection, pneumocytosis. PCT did not correlate with the biological and clinical markers of the disease severity but the evolution of PCT correlated with the evolution of C-reactive-protein (r = 0.58, p < 0.05). PCT seems to be an early marker of the evolution of respiratory infections, but it does not help to establish prognosis. Further studies are necessary to assess the potential value of PCT in more severe respiratory infections requiring assisted ventilation. PMID:10685471

  11. Synergistic effects of elevated homocysteine level and abnormal blood lipids on the onset of stroke

    Lu Hao; Zhenzhen Cheng; Qiang Wu; Shuzhang Li; Liming Chen; Xiaoyong Sai; Zhefeng Liu; Guang Yang; Rongzeng Yan; Lili Wang; Caiyun Fu; Xuan Xu

    2013-01-01

    Hyperhomocysteinemia and abnormal blood lipids are independent risk factors for stroke. However, whether both factors exert a synergistic effect in the onset of stroke remains unclear. The present study is a retrospective analysis of 2 089 cases of stroke and 2 089 control cases of simple inter-vertebral disk protrusion using a paired multivariate logistic regression method. Adjusting for known confounding variables including the patients’ age, gender, smoking status, alcohol consumption status, patient and family medical history, and clinical biochemical indices, elevated homocysteine level was related to the onset of stroke. Patients with elevated homocysteine levels and abnormal blood lipids showed a 40.9%increase in the risk for stroke compared to patients with normal ho-mocysteine levels and blood lipids (odds ratio 1.409;95%confidence interval 1.127-1.761). These results indicate that elevated homocysteine and abnormal blood lipids exert synergistic effects in the onset of stroke. Patients with elevated homocysteine levels and abnormal blood lipids are predis-posed to stroke.

  12. Retrospective study on prognostic importance of serum procalcitonin and amino - terminal pro - brain natriuretic peptide levels as compared to Acute Physiology and Chronic Health Evaluation IV Score on Intensive Care Unit admission, in a mixed Intensive Care Unit population

    Chitra Mehta; Babita Dara; Yatin Mehta; Tariq, Ali M.; George V Joby; Singh, Manish K

    2016-01-01

    Background: Timely decision making in Intensive Care Unit (ICU) is very essential to improve the outcome of critically sick patients. Conventional scores like Acute Physiology and Chronic Health Evaluation (APACHE IV) are quite cumbersome with calculations and take minimum 24 hours. Procalcitonin has shown to have prognostic value in ICU/Emergency department (ED) in disease states like pneumonia, sepsis etc. NTproBNP has demonstrated excellent diagnostic and prognostic importance in cardiac d...

  13. 血清降钙素原水平在尿路感染中的定位作用研究%Study on Orientating Function of Serum Procalcitonin Level in Urinary Tract Infection

    彭凯丰; 周志芳

    2012-01-01

    目的 探讨血清降钙素原(PCT)在尿路感染中的定位作用.方法 选取尿路感染患者106例,同期健康体检者100例,用化学发光免疫法测定血清中的PCT和C-反应蛋白(CRP)水平,同时检测患者外周血白细胞计数(WBC).结果 上尿路感染组患者血清PCT水平明显高于下尿路感染患者组(P<0.01),PCT对上尿路感染诊断的敏感性为81.1%,特异性为85.5%,阳性预测值为80.3%,阴性预测值为92.5%,均高于CRP和WBC.结论 血清PCT水平的测定对尿路感染有定位作用.%Objective To explore the location role of serum procalcitonin (PCT) in the diagnosis of urinary tract infection (UTI). Methods One hundred and six patients with urinary tract infection and 100 health examinees were enrolled in this study. The serum PCT and C- reactive protein (CRP) levels were measured by chemiluminescent immunoassay; meanwhile, peripheral white blood cells were counted. Results The serum level of PCT in upper urinary tract infection group was significantly higher than that in lower urinary tract infection group (P<0.01). The sensitivity and specificity of PCT in diagnosis of upper urinary tract infection were 81.1% and 85.5% respectively, positive predictive value was 80.3% and negative predictive value was 92.5 % , which were all higher than CRP and WBC. Conclusions The serum level of PCT can be used as a marker to differentially diagnose the upper and lower urinary tract infections.

  14. 急性胰腺炎大鼠血和组织中降钙素原水平的变化%Levels of procalcitonin in blood and tissue of acute pancreatitis rats

    李红昌; 韩天权; 汤耀卿; 张圣道; 雷若庆; 许志伟; 王庆刚; 柴春宇; 邓漾; 吴旭波; 武钧; 陈胜

    2010-01-01

    目的 观察急性胰腺炎(AP)大鼠血和组织中降钙素原(procalcitonin,PCT)水平的变化,并探讨其意义.方法 将102只雄性Wistar大鼠按数字表法随机分为正常对照组(6只)、脂多塘(LPS)组(24只)、急性水肿性胰腺炎(AEP)组(24只)、急性坏死性胰腺炎(ANP)组(24只)和ANP+LPS组(24只).皮下注射雨蛙素制备AEP模型,逆行胆胰管注射牛磺胆酸钠制备ANP模型.术后3、6、18、24 h分批处死动物,胰腺组织常规病理检查并评分;取血检测PCT水平;取肝、肺、脾、胰腺、小肠及大肠组织检测PCT含量.结果 AEP和ANP模型制备成功.术后6 h时,对照组、LPS组、AEP组、ANP组和ANP+LPS组血PCT水平分别为(0.0144±0.0082)ng/ml、(0.1722±0.0449)ng/ml、(0.4751±0.0572)ng/ml、(0.7070±0.1040)ng/ml和(1.1960±0.8644)ng/ml,各组间相差显著(P<0.05).正常大鼠肝、肺、脾、胰腺、小肠及大肠组织均检测到PCT.与之相比,ANP组肝和胰腺PCT含量无明显变化;肺、脾及大肠PCT含量显著降低[分别为(5.63±0.62)ng/ml对(6.85±0.46)ng/ml,(4.73±1.27)ng/ml对(6.88±0.31)ng/ml,(1.08±0.52)ng/ml对(4.12±1.02)ng/ml,P值均<0.01],而小肠组织明显升高[(2.51±0.90)ng/m1对(0.98±0.20)ng/ml,P<0.01].结论 血清PCT水平与AP的严重程度及感染相关,AP时各组织PCT含量的不同变化可能与器官功能的改变有一定的关系.%Objective To investigate the variation of procalcitonin(PCT) in blood and tissue level of acute pancreatitis rats and probe its significant. Methods One hundred and two male Wistar rats were randomly divided into control group ( n = 6 ), lipopolysaccharide group ( LPS, n = 24 ), acute edematous pancreatitis (AEP) group ( n = 24), acute necrotizing pancreatitis (ANP) group ( n = 24), AN P + LPS group ( n = 24). Subcutaneous injection of cerulein was used for AEP induction, while ANP model was induced by retrograde injection of sodium taurocholate into the biliary and pancreatic duct. The rats were

  15. Procalcitonin implication in renal cell apoptosis induced by acute pyelonephritis in children

    Belhadj-Tahar, Hafid; Coulais, Yvon; Tafani, Mathieu; Bouissou, François

    2008-01-01

    The aim of this biomedical trial was to clarify the physiological role of procalcitonin (PCT) in renal parenchyma apoptosis and fibrosis caused by acute childhood pyelonephritis. This prospective study enrolled 183 children. All children were treated with bi-therapy according to the French consensus on acute pyelonephritis treatment dated November 16, 1990: intra-vascular administration of ceftriaxone 50 mg/kg/day and netromicine 7 mg/kg/day during the first 48 hours, followed by specific antibiotherapy suited to antibiogram. On admission, PCT, C-reactive protein, and phospholipase A2 were quantified in serum. Scintigraphy monitoring with 99mTc-DMSA was performed on day 4 and 9 months later, in the presence of persistent abnormalities. On day 4, 78% presented renal parenchyma alterations and 30% renal fibrosis 9 months after admission. Paradoxically, PCT level was significantly lower in the presence of renal fibrosis due to cell apoptosis (4.19 vs 7.59 μgL−1). A significant increase in PCT indicated favorable progress (recovery 7.55 vs aggravation 3.34) and no difference between recovery and improvement. This result suggests the protective effect of PCT against apoptosis by nitric oxide down-regulation. PMID:21694876

  16. IMPORTANCE OF SERUM PROCALCITONIN IN FEBRILE NEUTROPENIA

    Mohd. Riyaz

    2014-07-01

    Full Text Available Febrile neutropenia is defined as a fever >101°F for 1 hour, with an absolute neutrophil count of ≤500 cells/microliter, or an ANC of ≤1000 cells/microliter with a projected nadir of ≤500 cells/microliter. In haematological malignancies it is the common complication and requires broad-spectrum antibacterial therapy. Clinical examination and cultures fail to detect a pathogen or an infectious focus in 25–50%, which are classified as pyrexia of unknown origin (PUO. Patient with pyrexia of unknown origin may receive long duration of antibiotic treatment as the cause is unclear of being infective or not. Febrile neutropenia is a common complication of many chemotherapeutic regimens for all types of cancers. Mortality and Morbidity is high particularly in elderly, immuno-compromised. Approximately 20- 40 % of patients with severe sepsis and 45-60% patients with septic shock die within 15-20 days. This study was done to know the sources of infection and to assess the diagnostic value of serum Procalcitonin and its relation with mortality in various stages of sepsis. Sepsis incidence was more in patient age more than 55yrs. the most common source of sepsis was respiratory tract infection. Serum PCT proved to be an indicator of sepsis in ill patients, with sensitivity of 91%. Presence of both persistent and profound neutropenia was associated with a much higher mortality. The occurrence of infection is directly proportional to the degree of neutropenia, at the onset of fever the PCT levels will not be helpful for the decision to start or stop the antibacterial therapy, and a PCT value higher than 0.5ng/ml in pyrexia of unknown origin might suggest a possibility of occult infection, i.e. with lacking microbiological and clinical documentation. A delayed PCT peak higher than0.5ng/ml contributes to the early diagnosis of fungal disease.

  17. 血清降钙素原水平变化在脑梗死患者肺部感染检测中的临床价值%Detection of serum procalcitonin levels in patients with cerebral infarction and lung infection and its clinical value

    田晓; 于柏青; 李红金; 姚楠; 周盛年

    2015-01-01

    OBJECTIVE To study the change of serum procalcitonin levels in cerebral infarction patients combined with lung infection and its clinical value ,so as to provide a reference for diagnosis and treatment of cerebral infarc‐tion complicated with lung infection .METHODS Totally 100 cases of patients with cerebral infarction and lung in‐fection in our hospital from Aug .2011 to Sep .2013 were enrolled in observation group and 100 cases of healthy people received physical examination in the same period were enrolled in control group .Then procalcitonin ,C‐re‐active protein and blood routine were detected and the remission condition of clinical symptoms and signs of pa‐tients infected by bacteria were observed .SPSS18 .0 software was used for statistical analysis .RESULTS In the ob‐servation group ,the serum procalcitonin was (13 .8 ± 2 .5)μg/L ,C reactive protein level was (14 .27 ± 2 .68)mg/L ,white blood cell counted (14 .8 ± 1 .9) × 109/L ,neutrophile granulocyte ratio was (71 .4 ± 10 .4)% .These were all higher than those of control group;lymphocyte ratio were lower than control group;the positive rate of serum procalcitonin was more than those of control group .The sensitivity and specificity of procalcitonin detection were 94% and 96% separately ,which were higher than blood routine and C reaction protein detection .The levels of procalcitonin were positively correlated with cough , sputum , asthma , pulmonary rales remission time . CONCLUSION Combined detection of serum procalcitonin is an ideal auxiliary examination index for it can improve the sensitivity and specificity of diagnosis of bacterial infections in the patients with cerebral infarction and has cor‐relation with remission of clinical symptoms and signs .%目的:研究血清降钙素原水平变化在脑梗死肺部感染的检测及临床价值,为诊治脑梗死患者肺部感染提供参考。方法将2011年8月-2013年9月收治的100例脑梗死肺部感染患者

  18. Study on the changes of leptin levels in females with abnormal thyroid function

    Objective: To study the changes of leptin levels in females with abnormal thyroid function. Methods: Serum leptin levels were determined with RIA in 60 cases of hyperthyroidism, 36 cases of hypothyroidism and 30 normal controls. In patients with thyroid dysfunction and treated, serum leptin levels were again measured after completion of therapy. Results: The serum leptin levels were positively correlated to BMI in all the cases (p 0.05). The serum leptin levels in hypothyroid patients after treatment (6.77 ± 2.35 μg/L) were significantly higher than those before treatment (4.19 ± 1.84 μg/L) (p < 0.05). No obvious differences in the levels of serum leptin were observed before and after treatment in the hyperthyroid group. Conclusion: Normal thyroid hormone levels may be an important factor to achieve an adequate leptin gene expression so as to maintain an energy metabolic balance and thyroid dysfunction will influence the normal regulation of leptin

  19. The Importance of Serum Procalcitonin in Diagnosis and Treatment of Serious Bacterial Infections and Sepsis

    Mehanic, Snjezana; Baljic, Rusmir

    2013-01-01

    The clinical utility of serum procalcitonin (PCT) levels continues to evolve. PCT is regarded as a promising candidate marker for making a diagnosis and antibiotic stewardship in patients with systemic infections. The aim of this review is to summarize the current evidence for PCT in different infections and clinical settings, and to discuss the reliability of this marker when used with validated diagnostic algorithms. PMID:24511275

  20. Can Procalcitonin Be an Accurate Diagnostic Marker for the Classification of Diabetic Foot Ulcers?

    Jonaidi Jafari, Nematollah; Safaee Firouzabadi, Mahdi; Izadi, Morteza; Safaee Firouzabadi, Mohammad Sadegh; Saburi, Amin

    2014-01-01

    Background: The differentiation of infected diabetic foot ulcers (IDFU) from non infected diabetic foot ulcers (NIDFU) is a challenging issue for clinicians. Objectives: Recently, procalcitonin (PCT) was introduced as a remarkable inflammatory marker. We aimed to evaluate the accuracy of PCT in comparison to other inflammatory markers for distinguishing IDFU from NIDFU. Materials and Methods: We evaluated PCT serum level as a marker of bacterial infection in patients with diabetic foot ulcers...

  1. Procalcitonin and C-reactive protein in pericardial fluid for postmortem diagnosis of sepsis

    Schrag, Bettina; Iglesias, Katia; Mangin, Patrice; Palmiere, Cristian

    2016-01-01

    The aim of this study was to investigate the presence and concentrations of procalcitonin and C-reactive protein in pericardial fluid and compare these levels to those found in the postmortem serum obtained from the femoral blood. Two groups were formed, a sepsis-related fatalities group and a control group. Postmortem native CT scans, autopsies, histology, neuropathology and toxicology as well as other postmortem biochemistry investigations were performed in all cases. Pericardial fluid proc...

  2. Age-specific percentile-based reference curve of serum procalcitonin concentrations in Japanese preterm infants

    Noriko Fukuzumi; Kayo Osawa; Itsuko Sato; Sota Iwatani; Ruri Ishino; Nobuhide Hayashi; Kazumoto Iijima; Jun Saegusa; Ichiro Morioka

    2016-01-01

    Procalcitonin (PCT) levels are elevated early after birth in newborn infants; however, the physiological features and reference of serum PCT concentrations have not been fully studied in preterm infants. The aims of the current study were to establish an age-specific percentile-based reference curve of serum PCT concentrations in preterm infants and determine the features. The PCT concentration peaked in infants at 1 day old and decreased thereafter. At 1 day old, serum PCT concentrations in ...

  3. Changes of serum procalcitonin level and its significance in patients with traumatic brain injury%颅脑创伤患者血清降钙素原变化及其临床意义

    赵元元; 连玉峰; 顾云彪; 楼林; 卢刚

    2015-01-01

    Objective To determine the dynamic change of serum procalcitonin (PCT) level after traumatic brain injury and the rclated clinical significance.Methods Serum levels of PCT and adrenocorticotropic hormone (ATCH) in 137 patients with traumatic brain injury and 20 normal volunteers were measured by electrochemiluminescence assay.Correlation between serum PCT level and severity of traumatic brain injury was evaluated.Results Percentage of serum PCT level at low inflammatory-risk threshold detected from day 1 to day 14 after admission was descended from 80.3% to 63.5%.Meanwhile,the percentage of serum PCT level at high inflammatory-risk threshold was a rising-fall-rising trend,but the percentages of serum PCT level at median and definite inflammatory-risk thresholds showed sustained increase from 13.9% to 27.0% and 0.7% to 3.7% separately.Based on the Glasgow Coma Scale (GCS),the dynamic change of serum PCT level demonstrated a distinct bimodal pattern in severe injury group,a gradual falling after rising mode in middle injury group which was significantly and positively correlated with GCS (r =0.463,P < 0.05),and a rising-falling-slight rising tendency in minorinjury group.In addition,the GCS in each group only closely related to the positive detections of serum PCT level detected at days 3 and 7 (x2 =10.32,16.31 respectively P < 0.01).Serum ATCH level at day 1 was far higher than that at day 14 in severe injury group and was significantly higher in severe injurygroup compared with minor and middle injury groups (P < 0.01 or 0.05).Conclusions Positive serum PCT may be predictive of the traumatic brain injury and injury degree within 3-7 days after the injury.The dynamic change of serum PCT is associated with the specialized mechanism of traumatic brain injury and neuronendocrine response,and it may be a useful parameter to assess posttraumatic stress response and prognosis.%目的 探讨颅脑创伤患者血清降钙素原(PCT)的

  4. The relationship between level of procalcitonin and the prognosis of infants with sepsis%血浆降钙素原与脓毒症患儿预后的关系

    张笃飞; 冯小伟

    2007-01-01

    目的 探讨血浆降钙素原(procalcitonin,PCT)与脓毒症患儿预后的关系.方法 采用免疫发光法检测65例脓毒症患儿血浆PCT水平.结果 死亡组入院时血浆PCT水平与同期存活组相比,差异有显著性意义(P<0.05).最初3d血浆PCT水平变化与脓毒症临床不同结局密切相关.结论 血浆PCT检测对脓毒症患儿预后判断具有重要价值.

  5. Retrospective study on prognostic importance of serum procalcitonin and amino - terminal pro - brain natriuretic peptide levels as compared to Acute Physiology and Chronic Health Evaluation IV Score on Intensive Care Unit admission, in a mixed Intensive Care Unit population

    Chitra Mehta

    2016-01-01

    Full Text Available Background: Timely decision making in Intensive Care Unit (ICU is very essential to improve the outcome of critically sick patients. Conventional scores like Acute Physiology and Chronic Health Evaluation (APACHE IV are quite cumbersome with calculations and take minimum 24 hours. Procalcitonin has shown to have prognostic value in ICU/Emergency department (ED in disease states like pneumonia, sepsis etc. NTproBNP has demonstrated excellent diagnostic and prognostic importance in cardiac diseases. It has also been found elevated in non-cardiac diseases. We chose to study the prognostic utility of these markers on ICU admission. Settings and Design: Retrospective observational study. Materials and Methods: A Retrospective analysis of 100 eligible patients was done who had undergone PCT and NTproBNP measurements on ICU admission. Their correlations with all cause mortality, length of hospital stay, need for ventilator support, need for vasopressors were performed. Results: Among 100 randomly selected ICU patients, 28 were non-survivors. NTproBNP values on admission significantly correlated with all cause mortality (P = 0.036, AUC = 0.643 and morbidity (P = 0.000, AUC = 0.763, comparable to that of APACHE-IV score. PCT values on admission did not show significant association with mortality, but correlated well with morbidity and prolonged hospital length of stay (AUC = 0.616, P = 0.045. Conclusion: The current study demonstrated a good predictive value of NTproBNP, in terms of mortality and morbidity comparable to that of APACHE-IV score. Procalcitonin, however, was found to have doubtful prognostic importance. These findings need to be confirmed in a prospective larger study.

  6. Deletion of PTH rescues skeletal abnormalities and high osteopontin levels in Klotho-/- mice.

    Quan Yuan

    Full Text Available Maintenance of normal mineral ion homeostasis is crucial for many biological activities, including proper mineralization of the skeleton. Parathyroid hormone (PTH, Klotho, and FGF23 have been shown to act as key regulators of serum calcium and phosphate homeostasis through a complex feedback mechanism. The phenotypes of Fgf23(-/- and Klotho(-/- (Kl(-/- mice are very similar and include hypercalcemia, hyperphosphatemia, hypervitaminosis D, suppressed PTH levels, and severe osteomalacia/osteoidosis. We recently reported that complete ablation of PTH from Fgf23(-/- mice ameliorated the phenotype in Fgf23(-/-/PTH(-/- mice by suppressing serum vitamin D and calcium levels. The severe osteomalacia in Fgf23(-/- mice, however, persisted, suggesting that a different mechanism is responsible for this mineralization defect. In the current study, we demonstrate that deletion of PTH from Kl(-/- (Kl(-/-/PTH(-/- or DKO mice corrects the abnormal skeletal phenotype. Bone turnover markers are restored to wild-type levels; and, more importantly, the skeletal mineralization defect is completely rescued in Kl(-/-/PTH(-/- mice. Interestingly, the correction of the osteomalacia is accompanied by a reduction in the high levels of osteopontin (Opn in bone and serum. Such a reduction in Opn levels could not be observed in Fgf23(-/-/PTH(-/- mice, and these mice showed sustained osteomalacia. This significant in vivo finding is corroborated by in vitro studies using calvarial osteoblast cultures that show normalized Opn expression and rescued mineralization in Kl(-/-/PTH(-/- mice. Moreover, continuous PTH infusion of Kl(-/- mice significantly increased Opn levels and osteoid volume, and decreased trabecular bone volume. In summary, our results demonstrate for the first time that PTH directly impacts the mineralization disorders and skeletal deformities of Kl(-/-, but not of Fgf23(-/- mice, possibly by regulating Opn expression. These are significant new perceptions into

  7. Use of procalcitonin for the differential diagnosis of fever in cancer patients: an observational study

    Daria Macchioni

    2013-09-01

    Full Text Available Fever often occurs in cancer patients and the possibility of having a reliable marker for the differential etiological diagnosis is desirable. The aim of this study was to investigate the eligibility of the use of procalcitonin (PCT in hemato-oncological patients for the differential diagnosis of fever. We prospectively enrolled 98 cancer patients and divided them into two groups: those with active disease and those with non-active disease. Procalcitonin was dosed at Time 0 (recruitment and at the onset of fever. On enrollment, PCT values were 0.1 ng/mL in 83% patients with active disease, and lower than 0.5 ng/mL in 23%, which is usually considered not suggestive of bacterial infection. Four percent of patients had values over 0.5 ng/mL and these were mainly patients with neuroendocrine tumors or affiliates. On enrollment, there were also no statistically significant differences in PCT values between the two groups of patients. This showed that active cancer is unable by itself to change PCT levels. In the active disease group, 21 episodes of fever due to bacterial infection were registered, and in all of them an increase in PCT values was observed. This demonstrates the ability of PCT to detect an infection-induced fever in cancer patients. Procalcitonin concentrations are not significantly altered by active neoplastic disease. On the contrary, in the course of fever due to a bacterial infection, PCT values increase and can, therefore, be considered a useful tool in the differential diagnosis between infection-induced fever and drug-related or tumor associated-fever. Procalcitonin may be a useful marker of bacterial infection even in cancer patients.

  8. Detection of abnormalities in ultrasound lung image using multi-level RVM classification.

    Veeramani, Senthil Kumar; Muthusamy, Ezhilarasi

    2016-06-01

    The classification of abnormalities in ultrasound images is the monitoring tool of fluid to air passage in the lung. In this study, the adaptive median filtering technique is employed for the preprocessing step. The preprocessed image is then extracted the features by the convoluted local tetra pattern, histogram of oriented gradient, Haralick feature extraction and the complete local binary pattern. The extracted features are selected by applying particle swarm optimization and differential evolution feature selection. In the final stage, classifiers namely relevance vector machine (RVM), and multi-level RVM are employed to perform classification of the lung diseases. The diseases respiratory distress syndrome (RDS), transient tachypnea of the new born, meconium aspiration syndrome, pneumothorax, bronchiolitis, pneumonia, and lung cancer are used for training and testing. The experimental analysis exhibits better accuracy, sensitivity, specificity, pixel count and fitness value than the other existing methods. The classification accuracy of above 90% is accomplished by multi-level RVM classifier. The system has been tested with a number of ultrasound lung images and has achieved satisfactory results in classifying the lung diseases. PMID:26135771

  9. DYNAMICS OF PROCALCITONIN AT THE PATIENT AFTER COMBINED ORGAN TRANSPLANTATION

    M. Sh. Khubutia

    2010-01-01

    Full Text Available Case report represents two episodes of procalcitonin elevation in dynamics, connected with different induction mechanisms of this sepsis marker at the patient after combined pancreas and kidney transplantation. 

  10. Impact of Low Procalcitonin Results on Antibiotic Administration in Hospitalized Patients at a Tertiary Care Center

    Brennan, Meghan B.; Osterby, Kurt; Schulz, Lucas; Lepak, Alexander J.

    2016-01-01

    Procalcitonin is a sensitive and specific marker of bacterial infection; low results allow clinicians to safely de-escalate antibiotics. This retrospective cohort study aimed to determine the effect of low procalcitonin results on withholding, discontinuing, or de-escalating antibiotics in hospitalized patients at a tertiary care center. Antibiotics were initiated or continued without de-escalation in 55% of patients with low procalcitonin results. Among patients with low procalcitonin result...

  11. Hepatic glycogen deposition in a patient with anorexia nervosa and persistently abnormal transaminase levels.

    Kransdorf, Lisa N; Millstine, Denise; Smith, Maxwell L; Aqel, Bashar A

    2016-04-01

    Anorexia nervosa and other eating disorders characterized by calorie restriction have been associated with a variety of hepatic abnormalities. Fatty steatosis has been described in eating disorder patients. We report the rare finding of glycogen accumulation in the liver in a patient with anorexia nervosa, which to our knowledge is only the second such case reported in the literature. This case highlights the importance of monitoring for liver abnormalities in patients with restrictive eating disorders. PMID:26066296

  12. Method for the selective measurement of amino-terminal variants of procalcitonin.

    Struck, J.; Strebelow, M.; Tietz, S.; Alonso, C.; Morgenthaler, N.G.; Hoeven, J.G. van der; Pickkers, P.; Bergmann, A.

    2009-01-01

    BACKGROUND: Procalcitonin (PCT) is an established marker for diagnosing and monitoring bacterial infections. Full-length PCT [116 amino acids that make up procalcitonin (PCT1-116)] can be truncated, leading to des-Ala-Pro-PCT (des-Alanin-Prolin-Procalcitonin; PCT3-116). Current immunoassays for PCT

  13. Diagnostic Value of Procalcitonin in ANCA-Associated Vasculitis (AAV) to Differentiate Between Disease Activity, Infection and Drug Hypersensitivity

    Herrmann, K; Schinke, S; Csernok, E.; Moosig, F; Holle, J. U.

    2015-01-01

    Objective: Procalcitonin (PCT) is considered to be a specific marker for severe bacterial infections and sepsis. Elevated PCT levels have been reported in active autoimmune diseases without infection. The aim of this study was to assess the diagnostic value of PCT serum levels in ANCA-associated vasculitis (AAV) patients with respect to infection, disease activity and drug fever using a high sensitive PCT detection method. Methods: In 53 AAV patients with elevated C-reactive protein (CRP) PCT...

  14. Procalcitonin in sepsis and bacterial infections

    Abhijit Chaudhury

    2013-10-01

    Full Text Available The differentiation of sepsis and systemic bacterial infections from other causes of systemic inflammatory response is crucial from the therapeutic point of view. The clinical signs and symptoms are non-specific and traditional biomarkers like white cell count, erythrocyte sedimentation rate and C-reactive protein are not sufficiently sensitive or specific to guide therapeutic decisions. Procalcitonin (PCT is considered a reliable marker for the diagnosis and prognosis of moderate to severe bacterial infections, and it has also been evaluated to guide the clinicians in the rational usage of antibiotics. This review describes the diagnostic and prognostic role of PCT as a biomarker in various clinical settings along with the laboratory aspects and its usefulness in risk stratification and antibiotic stewardship.

  15. Negative predictive value of procalcitonin in medullary thyroid carcinoma.

    Lim, Soo Kyung; Guéchot, Jérôme; Vaubourdolle, Michel

    2016-01-01

    Calcitonin (CT), the major biochemical marker in medullary thyroid carcinoma (MTC) is prone to in vitro instability and suffers from scarcity of clinical laboratory platforms. Procalcitonin (PCT), the precursor of CT, free of these shortcomings, has been reported as a potential MTC marker. The aim of this study was to assess the negative predictive value (NPV) of PCT as a first-line marker in MTC. 476 serum samples referred to our laboratory for CT measurements were analyzed for PCT. NPVs of PCT were assessed at 3 cut-offs (0.05, 0.10 and 0.15 ng/mL) and the diagnosis of MTC was based on CT levels. PCT and CT levels were correlated (r=0.7554 for CT levels above 10 pg/mL, n=66). Accepting the CT cut-off based on the upper reference limit the NPV of PCT were 98.1% (0.05 ng/mL), 96.3% (0.10 ng/mL) and 95.4% (0.15 ng/mL) respectively. For a CT cut-off of 100 pg/mL the NPVs of PCT were 100% for all PCT thresholds. Serum PCT has a strong NPV and could be a good candidate for a first-line screening test to exclude MTC in patients with suspicious thyroid nodules or suggestive symptoms. Larger prospective studies are necessary to confirm our results. PMID:26806393

  16. Utility of blood procalcitonin concentration in the management of cancer patients with infections

    Durnaś, Bonita; Wątek, Marzena; Wollny, Tomasz; Niemirowicz, Katarzyna; Marzec, Michał; Bucki, Robert; Góźdź, Stanisław

    2016-01-01

    Diagnosis of infections in cancer patients is usually problematic since differentiating between infection and fever of unknown origin is often a considerable clinical challenge. In general, increase concentration of blood procalcitonin (PCT) is associated with severe bacterial infection. PCT with an optimal cutoff level of 0.5 ng/mL seems to be the most helpful biochemical parameter in detecting severe infections, mainly bloodstream infection, in patients with hematological cancers. In all clinical situations, the elevated level of PCT should be carefully analyzed, always with a thorough physical examination and an appropriate microbiological assessment. PMID:26858528

  17. Diagnostic approach to phlogoses: the validity of procalcitonin

    E. Dimitri

    2013-12-01

    Full Text Available Aim. The aim of our study is to compare the potential usefulness of procalcitonin with the CRP as a diagnostic marker of pediatric diseases and to define the diagnostic accuracy and relation with the inflammation etiology and severity of procalcitonin. Methods. The analysis focused on a sample of 141 children, hospitalized for fever with bacterial, viral or inflammatory etiology, studied at the time of admission in the Hospital, and after defervescence. The sensitivity, the specificity, the positive and negative predictive value have been calculated for the both tests, explained above. Results. The diagnostic accuracy of procalcitonin is the same as the one of PCR in all cases. The result of the test has been positive in 85,7% of the serious infections and has been useful to identifiy the etiology of infections in almost 2/3 of patients. Conclusion. Procalcitonin seems to be a promising marker of infections because of its following features: a larger contribution in the monitoring phase (fast positivization and normalization; the diagnostic accuracy and a good correlation with the etiology and the severity of infections. Nonetheless, the routine use of procalcitonin is not recommended in the light of

  18. A comparison of high-mobility group-box 1 protein, lipopolysaccharide-binding protein and procalcitonin in severe community-acquired infections and bacteraemia: a prospective study

    Gaïni, Shahin; Koldkjaer, Ole G; Møller, Holger J;

    2008-01-01

    immune response when the host is challenged by bacterial pathogens. Procalcitonin (PCT) has been suggested as a marker of severe bacterial infections and sepsis. The aim of the present study was to investigate levels of HMGB1, LBP and PCT in a well-characterised sepsis cohort. The study plan included...

  19. Procalcitonin and C-reactive protein-based decision tree model for distinguishing PFAPA flares from acute infections

    Barbara Kraszewska-Głomba; Zofia Szymańska-Toczek; Leszek Szenborn

    2016-01-01

    As no specific laboratory test has been identified, PFAPA (periodic fever, aphthous stomatitis, pharyngitis and cervical adenitis) remains a diagnosis of exclusion. We searched for a practical use of procalcitonin (PCT) and C-reactive protein (CRP) in distinguishing PFAPA attacks from acute bacterial and viral infections. Levels of PCT and CRP were measured in 38 patients with PFAPA and 81 children diagnosed with an acute bacterial (n=42) or viral (n=39) infection. Statistical analysis with t...

  20. The analysis of correlation between serum procalcitonin concentration and microbial infectionsin patients with sepsis

    孙胜男

    2013-01-01

    Objective To investigate the diagnostic and predict value of procalcitonin (PCT) in ICU patients with sepsis and the correlation between PCT concentration and positive results of bacterial culture.Methods A total of 278patients with sepsis were admitted into emergency ICU,general ICU and respiratory ICU from October 2011 to September 2012.Of them,193 patients had definite microbial infection evidence.Serum PCT levels among groups of different pathogens were compared.The analysis of correlation between the PCT concentration of the

  1. Diagnostic and Prognostic Role of Procalcitonin in Infections

    Maria Hatzistilianou

    2010-01-01

    Full Text Available Despite several consensus conferences, the criteria for the definition of sepsis are still considered too sensitive and insufficiently specific. The traditional clinical signs of infection and routine laboratory tests used to diagnose bacterial infection and sepsis lack diagnostic accuracy and can be misleading, particularly in patients with immunodeficiencies. The problems with sepsis definitions and diagnoses are indications of the need to focus on biochemical mediators capable not only of distinguishing the inflammatory response to infection from other types of inflammation, but also of indicating the severity and prognosis of the disease. Thus, physicians need an early and rapid marker for detecting bacterial infection and distinguishing it from viral infection. Several studies revealed that elevated procalcitonin (PCT levels in human blood could be detected in cases of sepsis and bacterial infection. PCT is a protein that can act as a hormone and a cytokine. It can be produced by several cell types and many organs in response to proinflammatory stimuli, particularly bacterial infection. It provides a rapid diagnostic test, available at the patient's bedside, and its half-life is suitable for daily monitoring of the disease progress.

  2. Diagnostic Accuracy of Procalcitonin in Bacterial Meningitis Versus Nonbacterial Meningitis

    Wei, Ting-Ting; Hu, Zhi-De; Qin, Bao-Dong; Ma, Ning; Tang, Qing-Qin; Wang, Li-Li; Zhou, Lin; Zhong, Ren-Qian

    2016-01-01

    Abstract Several studies have investigated the diagnostic accuracy of procalcitonin (PCT) levels in blood or cerebrospinal fluid (CSF) in bacterial meningitis (BM), but the results were heterogeneous. The aim of the present study was to ascertain the diagnostic accuracy of PCT as a marker for BM detection. A systematic search of the EMBASE, Scopus, Web of Science, and PubMed databases was performed to identify studies published before December 7, 2015 investigating the diagnostic accuracy of PCT for BM. The quality of the eligible studies was assessed using the revised Quality Assessment for Studies of Diagnostic Accuracy method. The overall diagnostic accuracy of PCT detection in CSF or blood was pooled using the bivariate model. Twenty-two studies involving 2058 subjects were included in this systematic review and meta-analysis. The overall specificities and sensitivities were 0.86 and 0.80 for CSF PCT, and 0.97 and 0.95 for blood PCT, respectively. Areas under the summary receiver operating characteristic curves were 0.90 and 0.98 for CSF PCT and blood PCT, respectively. The major limitation of this systematic review and meta-analysis was the small number of studies included and the heterogeneous diagnostic thresholds adopted by eligible studies. Our meta-analysis shows that PCT is a useful biomarker for BM diagnosis. PMID:26986140

  3. Nerve conduction abnormalities in untreated maturity-onset diabetes: relation to levels of fasting plasma glucose and glycosylated hemoglobin.

    Graf, R J; Halter, J B; Halar, E; Porte, D

    1979-03-01

    The role of metabolic abnormalities in the development of diabetic neuropathy is controversial. To investigate the influence of hyperglycemia on nerve conduction, we studied 20 untreated maturity-onset diabetic patients and 23 normal control subjects of similar age. Nerve conduction velocity of motor (median, peroneal, and tibial) and sensory (median and sural) nerves in diabetic patients was significantly slowed and H-reflex latency time prolonged. Levels of fasting plasma glucose in diabetic subjects were correlated with slowed motor conduction velocity of the median, peroneal, and tibial nerves but not with sensory nerve conduction velocities. Levels of glycosylated hemoglobin, an index of long-term glycemia, were correlated with slowing of peroneal motor conduction velocity in diabetic patients. These associations could not be explained by patient age or duration of diabetes. These findings suggest that the degree of hyperglycemia of untreated maturity-onset diabetes contributes to the motor nerve conduction abnormalities in this disease. PMID:426398

  4. Diastolic Dysfunction Induced by a High-Fat Diet Is Associated with Mitochondrial Abnormality and Adenosine Triphosphate Levels in Rats

    Kang, Ki-Woon; Kim, Ok-Soon; Chin, Jung Yeon; Kim, Won Ho; Park, Sang Hyun; Choi, Yu Jeong; Shin, Jong Ho; Jung, Kyung Tae; Lim, Do-Seon; Lee, Seong-Kyu

    2015-01-01

    Background Obesity is well-known as a risk factor for heart failure, including diastolic dysfunction. However, this mechanism in high-fat diet (HFD)-induced obese rats remain controversial. The purpose of this study was to investigate whether cardiac dysfunction develops when rats are fed with a HFD for 10 weeks; additionally, we sought to investigate the association between mitochondrial abnormalities, adenosine triphosphate (ATP) levels and cardiac dysfunction. Methods We examined myocardia...

  5. Serum Procalcitonin and Procalcitonin Clearance as a Prognostic Biomarker in Patients with Severe Sepsis and Septic Shock

    Min-Yi Huang

    2016-01-01

    Full Text Available We evaluated the tendency of the plasma concentration and procalcitonin (PCT clearance (PCTc to act as biomarkers of prognosis in patients with severe sepsis and septic shock. From 2011 to 2013, we prospectively analyzed patients with sepsis admitted to the intensive care unit (ICU. The serum PCT was evaluated at the time of sepsis diagnosis and again after 48 h (day 3 and 96 h (day 5. PCTc after 48 h (PCTc-day 3 and 96 h (PCTc-day 5 was also calculated to evaluate the prognostic value for survival in patients with sepsis. A total of 48 patients were included. Overall mortality was 16.7% (8 patients. PCTc was higher in survivors than in nonsurvivors, with significant differences on day 3 and day 5 (p=0.033; p=0.002, resp.; however, serum PCT levels on day 1, day 3, and day 5 were not significant prognostic factors for survival. The prognosis of patients with severe sepsis and septic shock may be associated with PCTc. Dynamic changes of PCT reflected as PCTc at 48 h (day 3 and 96 h (day 5 after admission to the ICU may serve as a predictor of survival in critically ill patients with severe sepsis.

  6. Serum Procalcitonin and Procalcitonin Clearance as a Prognostic Biomarker in Patients with Severe Sepsis and Septic Shock

    Huang, Min-Yi; Chen, Chun-Yu; Chien, Ju-Huei; Wu, Kun-Hsi; Chang, Yu-Jun; Wu, Han-Ping

    2016-01-01

    We evaluated the tendency of the plasma concentration and procalcitonin (PCT) clearance (PCTc) to act as biomarkers of prognosis in patients with severe sepsis and septic shock. From 2011 to 2013, we prospectively analyzed patients with sepsis admitted to the intensive care unit (ICU). The serum PCT was evaluated at the time of sepsis diagnosis and again after 48 h (day 3) and 96 h (day 5). PCTc after 48 h (PCTc-day 3) and 96 h (PCTc-day 5) was also calculated to evaluate the prognostic value for survival in patients with sepsis. A total of 48 patients were included. Overall mortality was 16.7% (8 patients). PCTc was higher in survivors than in nonsurvivors, with significant differences on day 3 and day 5 (p = 0.033; p = 0.002, resp.); however, serum PCT levels on day 1, day 3, and day 5 were not significant prognostic factors for survival. The prognosis of patients with severe sepsis and septic shock may be associated with PCTc. Dynamic changes of PCT reflected as PCTc at 48 h (day 3) and 96 h (day 5) after admission to the ICU may serve as a predictor of survival in critically ill patients with severe sepsis. PMID:27088084

  7. Procalcitonin and other acute phase reactants in patients with chronic obstructive pulmonary disease exacerbation

    Cemil Civelek

    2011-06-01

    Full Text Available The aim of this study was to investigate the correlation between procalcitonin and other acute phase reactants, and also analyze their relationship with clinical situation in chronic obstructive pulmonary disease (COPD acute exacerbations.Materials and methods: The study was made with 122 acute COPD exacerbated patients, who were admitted to emergency service. Patients with below 0.25 ng/ml PCT value included Group 1, and the patients with PCT values ≥ 0.25 ng/ml Group 2. Serum procalcitonin levels, erythrocyte sedimentation rate (ESR, C-reactive protein (CRP values and white blood cell (WBC counts were measured. Also, patients hospitalization time and mortality rates were recorded and compared with PCT.Results: Patients were divided in 3 groups according to their clinical diagnosis; Pneumonia (n=27, Mycoplasma-Chlamydia pneumonia (n=11 and the patients with only COPD exacerbation(n=84. Mean PCT values according to the groups were 9.47 ± 8.1 ng/ml, 0.41 ± 0.2 ng/ml, and 0.21 ± 0.05 ng/ml respectively. The relationship between PCT with CRP and white blood cell has been found between significiant (p=0.001, p=0.005 respectively, whereas the relationship between PCT and ESR was nonsignificant (p=0.55. Procalcitonin and CRP had a positive correlation with the hospitalization time (p=0.034, p=0.022 respectively. The mean ± standard error of PCT for the patients who died was 28.3 ± 27.5 ng/ml, and the difference between patients who died or were discharged was statistically significant (p= 0.012.Conclusion: PCT can be a useful indicator for morbidity and prognosis in COPD patients.

  8. 降钙素原在重症肺炎中的临床应用%Application value of procalcitonin in severe pneumonia

    李敏莉; 毛蓓; 袁蓓

    2015-01-01

    Objective To understand the diagnostic value of procalcitonin in severe pneumonia. Methods A total of 46 severe pneumonia patients were selected as experimental group, and 46 healthy people at the same period were chosen as control group. They all received blood routine examination, detection of C-reactive protein, procalcitonin, and body temperature within 1 d. The experimental group was classified by procalcitonin level (as≥10.0μg/L group,0.05). The level of procalcitonin had a correlation with hospital stays, application times of breathing machine, and antibiotics use times of the severe pneumonia patients (P0.05);降钙素原水平与重症肺炎患者住院时间、呼吸机应用次数、抗生素使用时间具有相关性(P<0.05)。结论降钙素原在重症肺炎临床诊断与病情评估中具有重要的指导价值,在临床上应引起足够重视。

  9. [The value of quantitative analysis of procalcitonine in diagnostics of septic complications in patients with autoimmune rheumatic diseases].

    Lapin, S V; Maslianskiĭ, A L; Lazareva, N M; Vasil'eva, E Iu; Totolian, A A

    2013-01-01

    The infections very often complicate the course of autoimmune rheumatic diseases. In diagnostic of septic complications in rheumatic patients the new biomarkers of infections can have a decisive importance. The procalciotonine test is one of them. The issue was to evaluate the diagnostic informativity of this test. The sample included 93 patients. The examination was applied to 65 patients with rheumatic diseases. Among them, 13 patients had bacterial infections. The group consisted of 33 patients with rheumatoid arthritis, 11 patients with systemic lupus erythematous, 6 patients with systemic angiitis, and 15 patients with other rheumatic diseases. The comparative group included 27 patients of cardio-therapeutic profile and 8 of these patients had bacterial infections. The procalcitonine test was applied with quantitative electrochemiluminescent technique. In patients with rheumatoid arthritis the mean levels of procalciotonine test consisted 0.10 +/- 0.13 ng/ml; with systemic lupus erythematous--0.08 +/- 0.06 ng/ml; with systemic angiitis--0.22 +/- 0.2 ng/ml; with other rheumatic diseases--0.12 +/- 0.15 ng/ml; of cardio-therapeutic profile without infections--0.08 +/- 0.06 ng/vl/ With threshold of procalcitonine test higher than 0.5/ml the sensitivity to diagnostic of infections consisted of 58%, specificity--94% in the group with rheumatic diseases. The procalciotonine test in case of no infection process with values higher than 0.5 ng/ml was detected in three patients. The evaluation of dependence of sensitivity and specificity for procalciotonine test and C-reactive protein the area under curve of procalcitonine test was larger in patients with rheumatic diseases (0.85 against 0.79) and in patients of cardio-therapeutic profile (0.92 against 0.90). The quantitative procalcitonine test is the best technique to detect septic complications in rheumatic patients. PMID:23807991

  10. Procalcitonin kinetics – prognostic and diagnostic significance in septic patients

    Mierzchała-Pasierb, Magdalena; Durek, Grażyna

    2016-01-01

    Introduction Severe sepsis and septic shock are advanced clinical conditions representing the patient's response to infection and having a variable but high mortality rate. Early evaluation of sepsis stage and choice of adequate treatment are key factors for survival. Some study results suggest the necessity of daily procalcitonin (PCT) monitoring because of its prognostic and discriminative value. Material and methods An observational and prospective study was conducted to evaluate the prognostic and discriminative value of PCT kinetics in comparison to PCT absolute value measurements. In a group of 50 intensive care unit patients with diagnosis of severe sepsis or septic shock, serum PCT measurements were performed on admission, and on the 2nd, 3rd and 5th day of therapy. The level of PCT was determined with a commercially available test according to the manufacturer's protocol. Results The kinetics of PCT assessed by ΔPCT was statistically significant in the survivors vs. the non-survivors subgroup (ΔPCT3/1, p = 0.022; ΔPCT5/1, p = 0.021). ΔPCT has no statistical significance in the severe sepsis and septic shock subgroups for all analyzed days. Only the 5th day PCT level was significantly higher in the non-survivors vs. survivors group (p = 0.008). The 1st day PCT level in the severe sepsis vs. septic shock group has a discriminative impact (p = 0.009). Conclusions According to the results, single serum PCT measurement, regardless of absolute value, has a discriminative impact but no prognostic significance, during the first 2 days of therapy. The PCT kinetics is of prognostic value from the 3rd day and is of earlier prognostic significance in comparison to changes in the patient's clinical condition evaluated by SOFA score kinetics. PMID:26925126

  11. Utility of blood procalcitonin concentration in the management of cancer patients with infections

    Durnaś B

    2016-01-01

    Full Text Available Bonita Durnaś,1,2 Marzena Wątek,1 Tomasz Wollny,1 Katarzyna Niemirowicz,3 Michał Marzec,4 Robert Bucki,2,3 Stanisław Góźdź1 1Holy Cross Oncology Center of Kielce, Artwinskiego, Kielce, Poland; 2Department of Physiology, Pathophysiology and Microbiology of Infections, The Faculty of Health Sciences of the Jan Kochanowski University in Kielce, Aleja IX Wieków Kielc, Kielce, Poland; 3Department of Microbiological and Nanobiomedical Engineering, Medical University of Bialystok, Bialystok, Poland; 4Department of Pathology and Laboratory Medicine, University of Pennsylvania, Philadelphia, PA, USA Abstract: Diagnosis of infections in cancer patients is usually problematic since differentiating between infection and fever of unknown origin is often a considerable clinical challenge. In general, increase concentration of blood procalcitonin (PCT is associated with severe bacterial infection. PCT with an optimal cutoff level of 0.5 ng/mL seems to be the most helpful biochemical parameter in detecting severe infections, mainly bloodstream infection, in patients with hematological cancers. In all clinical situations, the elevated level of PCT should be carefully analyzed, always with a thorough physical examination and an appropriate microbiological assessment. Keywords: procalcitonin, cancer, infection

  12. Diagnostic value of procalcitonin in acutely hospitalized elderly patients.

    Steichen, O; Bouvard, E; Grateau, G; Bailleul, S; Capeau, J; Lefèvre, G

    2009-12-01

    The aim of this study was to evaluate procalcitonin as an adjunct to diagnose bacterial infections in older patients. One hundred seventy-two patients admitted to an acute-care geriatric unit during a 6-month period were prospectively included, 39 of them with an invasive bacterial infection. The best cut-off value to rule in a bacterial infection was 0.51 microg/l with sensitivity 64% and specificity 94%. The best cut-off value to rule out a bacterial infection was 0.08 microg/l with sensitivity 97% and specificity 20%. Procalcitonin was inconclusive (between 0.08 and 0.51 microg/l) for 112 admissions. Procalcitonin over 0.51 microg/l was useless 22 times out of 33 (infection already ruled in on clinical grounds) and misleading in eight of the 11 remaining cases (no infection). Procalcitonin below 0.08 microg/l was useless 23 times out of 27 (infection already ruled out on clinical grounds) and misleading in one of the four remaining cases (infection). Despite a good overall diagnostic accuracy, the clinical usefulness of PCT to diagnose invasive bacterial infections in elderly patients hospitalized in an acute geriatric ward appears to be very limited. PMID:19727867

  13. Can delayed time to referral to a tertiary level urologist with an abnormal PSA level affect subsequent Gleason grade in the opportunistically screened population?

    O'Kelly, Fardod

    2013-09-01

    There is growing conflict in the literature describing the effect of delayed treatment on outcomes following radical prostatectomy. There is also evidence to suggest progression of low-risk prostate cancer to develop higher grades and volumes of prostate cancer during active surveillance. It is unknown as to what affect a delay in referral of those men with abnormal screened-PSA levels have on subsequent Gleason grade.

  14. Analysis of serum lipid profiles, metal ions and thyroid hormones levels abnormalities in - thalassaemic children of Bangladesh

    Objective: To assess the serum lipid profile of cardiovascular disease free male and female children with - thalassaemia. Levels of zinc, copper and magnesium in the serum were also determined along with the Thyroid profile. Methods: From January to December 2007, we enrolled 121 consecutive patients with -thalassaemia that visited The Thalassaemia Center at Dhaka Shishu (Children) Hospital, Bangladesh every month for routine examinations. Fasting blood lipid levels were measured in all participants. Zinc, Copper and Magnesium levels in serums were determined. Thyroid function was also assessed by evaluating T3, T4 and TSH levels. Results: Of the 121 patients, 65 were males (10.14 +- 3.91 years) and 56 were females (9.08 +- 4.32 years). Data analysis revealed that 2.0% males and 4.35% females had high total serum cholesterol, and 28.57% males and 21.74% females had high triglyceride levels. In addition, mean HDL-cholesterol levels were 21.14 +- 5.82 mg/dl in males and 21.17 +- 6.02 mg/dl in females; total-cholesterol to HDL-cholesterol ratios were 5.47 +- 1.66 and 5.96 +- 2.81 in males and females respectively. About 60% patients showed low serum level of Zn and Cu. Hypothyroidism was detected in 30% patients and 23% patients had abnormal experimental values of all the study parameters. Conclusions: The majority of the patients had blood lipid levels (by the exception of HDL-cholesterol) within the normal range, and consequently the prevalence of lipid abnormalities was much lower as compared to the general population of the same age. Interestingly, the total-cholesterol to HDL-cholesterol ratio was high in our patients, and may underline the importance of this index for the prognosis of future cardiac events in these patients. The serum Zn and Cu levels were low in most of the patients which may cause some metabolic abnormalities in future. Most of the patients also showed hypothyroidism indicating the presence of endocrine complications. (author)

  15. Procalcitonin as an adjunctive biomarker in sepsis

    Mahua Sinha

    2011-01-01

    Full Text Available Sepsis can sometimes be difficult to substantiate, and its distinction from non-infectious conditions in critically ill patients is often a challenge. Serum procalcitonin (PCT assay is one of the biomarkers of sepsis. The present study was aimed to assess the usefulness of PCT assay in critically ill patients with suspected sepsis. The study included 40 patients from the intensive care unit with suspected sepsis. Sepsis was confirmed clinically and/or by positive blood culture. Serum PCT was assayed semi-quantitatively by rapid immunochromatographic technique (within 2 hours of sample receipt. Among 40 critically ill patients, 21 had clinically confirmed sepsis. There were 12 patients with serum PCT ≥10 ng/ml (8, blood culture positive; 1, rickettsia; 2, post-antibiotic blood culture sterile; and 1, non-sepsis; 7 patients with PCT 2-10 ng/ml (4, blood culture positive; 1, falciparum malaria; 2, post-antibiotic blood culture sterile; 3 patients with PCT of 0.5 to 2 ng/ml (sepsis in 1 patient; and 18 patients with PCT < 0.5 ng/ml (sepsis in 2 patients. Patients with PCT ≥ 2 ng/ml had statistically significant correlation with the presence of sepsis (P<0.0001. The PCT assay revealed moderate sensitivity (86% and high specificity (95% at a cut-off ≥ 2 ng/ml. The PCT assay was found to be a useful biomarker of sepsis in this study. The assay could be performed and reported rapidly and provided valuable information before availability of culture results. This might assist in avoiding unwarranted antibiotic usage.

  16. Serum vitamin A levels and associated abnormalities in patients on regular dialysis treatment.

    Werb, R; Clark, W F; Lindsay, R M; Jones, E O; Linton, A L

    1979-08-01

    Multivitamin preparations are commonly administered to regular dialysis treatment (RDT) patients. Serum Vitamin A was measured in 72 patients on RDT. Elevated serum Vitamin A levels (102.29 +/- 26.95 microgram/dl [3.57 +/- 0.94 mumoles/l]) were found in the dialysis population (normal 40.98 +/- 6.71 microgram/dl [1.43 +/- 0.23 mumoles/l]; P less than 0.0005). Serum Vitamin A levels increased with duration (months) of dialysis but not with frequency of dialysis (twice or thrice weekly). Patients taking a VitaminA-containing multivitamin preparation had higher serum Vitamin A levels than those on a non-Vitamin A supplemented diet. Bilaterally nephrectomized patients had the highest serum Vitamin A levels while patients with obstructive uropathy had the lowest levels. Serum Vitamin A levels did not correlate with symptoms of uremia. Positive correlations were found with serum levels of calcium, cholesterol and triglycerides. Patients receiving a Vitamin A supplement had higher serum cholesterol levels than non-supplemented patients. Vitamin A might be a factor in the high incidence of cardiovascular disease in RDT patients. We therefore advise discontinuing the long-term administration of Vitamin A-containing multivitamin supplements to patients on RDT. PMID:527272

  17. Procalcitonin: a diagnostic and prognostic biomarker of sepsis in burned patients

    Mokline, A.; Garsallah, L.; Rahmani, I.; Jerbi, K.; Oueslati, H.; Tlaili, S.; Hammouda, R.; Gasri, B.; Messadi, A.A.

    2015-01-01

    Summary The goal of this study was to analyse plasma procalcitonin (PCT) concentrations during infectious events of burns in ICU. We conducted a prospective, observational study in a 20-bed Burn Intensive Care Unit in Tunisia. A total of 121 patients admitted to the Burn ICU were included in our study. Serum PCT was measured over the entire course of stay in patients with predictive signs of sepsis according to the Americain Burn Association Criteria for the presence of infection. Patients were assigned to two groups depending on the clinical course and outcome: Group A = non septic patients; Group B = septic patients. A PCT cutoff value of 0,69 ng/ml for sepsis prediction was associated with the optimal combination of sensitivity (89%), specificity (85%), positive predictive value (82%) and negative predictive value (88%). Serum procalcitonin levels can be used as an early indicator of septic complication in patients with severe burn injuries as well as in monitoring the response to antimicrobial therapy. PMID:27252609

  18. Delta Procalcitonin Is a Better Indicator of Infection Than Absolute Procalcitonin Values in Critically Ill Patients: A Prospective Observational Study.

    Trásy, Domonkos; Tánczos, Krisztián; Németh, Márton; Hankovszky, Péter; Lovas, András; Mikor, András; Hajdú, Edit; Osztroluczki, Angelika; Fazakas, János; Molnár, Zsolt

    2016-01-01

    Purpose. To investigate whether absolute value of procalcitonin (PCT) or the change (delta-PCT) is better indicator of infection in intensive care patients. Materials and Methods. Post hoc analysis of a prospective observational study. Patients with suspected new-onset infection were included in whom PCT, C-reactive protein (CRP), temperature, and leukocyte (WBC) values were measured on inclusion (t 0) and data were also available from the previous day (t -1). Based on clinical and microbiological data, patients were grouped post hoc into infection- (I-) and noninfection- (NI-) groups. Results. Of the 114 patients, 85 (75%) had proven infection. PCT levels were similar at t -1: I-group (median [interquartile range]): 1.04 [0.40-3.57] versus NI-group: 0.53 [0.16-1.68], p = 0.444. By t 0 PCT levels were significantly higher in the I-group: 4.62 [1.91-12.62] versus 1.12 [0.30-1.66], p = 0.018. The area under the curve to predict infection for absolute values of PCT was 0.64 [95% CI = 0.52-0.76], p = 0.022; for percentage change: 0.77 [0.66-0.87], p value for delta-PCT to indicate infection was 0.76 ng/mL (sensitivity 80 [70-88]%, specificity 86 [68-96]%). Neither absolute values nor changes in CRP, temperature, or WBC could predict infection. Conclusions. Our results suggest that delta-PCT values are superior to absolute values in indicating infection in intensive care patients. This trial is registered with ClinicalTrials.gov identifier: NCT02311816. PMID:27597981

  19. Abnormal plasma levels of serine, methionine, and taurine in transient acute polymorphic psychosis

    D. Fekkes (Durk)

    1994-01-01

    textabstractThe present study explored the usefulness of plasma amino acid concentrations in discriminating a subgroup of patients with transient acute polymorphic psychoses characterized by psychosensory symptoms (APP+ patients). Levels of amino acids in the plasma of APP+ patients were compared wi

  20. Clinical significance of serum procalcitonin and C-reaction protein in the patients with ulcerative colitis

    李楠

    2014-01-01

    Objective To approach on clinical value of serum procalcitonin(PCT)and C-reactive protein(CRP)in diagnosis of ulcerative colitis(UC).Methods The PCT and CRP levels in 120 UC patients and 20 healthy volunteers were measured.Results The levels of serum T PCT and CRP levels in active UC and catabolic UC were higher than control group[(1.56±0.36)vs(0.33±0.16)μg/L,(6.57±2.96)vs(0.33±0.16)μg/L,(6.78±3.85)vs(0.68±0.23)mg/L,(23.46±12.53)vs(0.68±0.23)

  1. Pro-calcitonin and inflammation in chronic hemodialysis

    Hernán Trimarchi

    2013-10-01

    Full Text Available Procalcitonin (PCT has emerged as a marker of infection, a frequent complication in hemodialysis (HD. We analyzed PCT levels in chronic non-acutely infected HD subjects, assessed its correlation with inflammatory and nutritional markers and propose a PCT reference value for non-infected HD patients.In an observational cross-sectional study, 48 chronic HD patients and 36 controls were analyzed. Variables: age, gender, time on HD; diabetes; vascular access, PCT, C-reactive protein (CRP, albumin, malnutrition inflammatory score (MIS, hematocrit, leukocyte count, and body mass index (BMI. Subsequently, control (G1, n = 36, 43% vs. non-infected patients (G2, n = 48, 57% groups were compared. In control subjects (G1, age: 54.3 ± 13.7 years, range (r: 30-81; males: 19 (53%; median PCT 0.034 ng/ml (r: 0.02-0.08; median CRP 0.80 mg/dl (r: 0.36-3.9; p95 PCT level: 0.063 ng/ml. In G2, age: 60.2 ± 15.2 years; males 32 (67%, time on HD: 27.0 ± 24.4; diabetics: 19 (32%; median PCT: 0.26 ng/ml (r: 0.09-0.82; CRP: 1.1 mg/dl (r: 0.5-6.2; p95 PCT level: 0.8 ng/ml. In control subjects, PCT and CRP were significantly lower than in G2: PCT: 0.034 vs. 0.26 ng/ml, p = 0.0001; CRP: 0.8 vs. 1.1 mg/dl, p = 0.0004. PCT-CRP correlation in G2: ρ = 0.287, p = 0.048. PCT and CRP concentrations are elevated in chronic non-acutely infected HD subjects, independently of infection, diabetes and vascular access. A p95 PCT level of 0.8 ng/ml may be considered as the upper normal reference value in non-acutely infected HD subjects. The PCT cut-off level in HD is yet to be determined in HD.

  2. Procalcitonin determined at emergency department as an early indicator of progression to septic shock in patient with sepsis associated with ureteral calculi

    Young Hwii Ko; Yoon Seob Ji; Sin-Youl Park; Su Jin Kim; Phil Hyun Song

    2016-01-01

    ABSTRACT Introduction: To investigate the role of initial procalcitonin (PCT) level as an early predictor of septic shock for the patient with sepsis induced by acute pyelonephritis (APN) secondary to ureteral calculi. Materials and Methods: The data from 49 consecutive patients who met criteria of sepsis due to APN following ureteral stone were collected and divided into two groups: with (n=15) or without (n=34) septic shock. The clinical variables including PCT level for this outcome were...

  3. Association of Serum Ferritin Level with Risk of Incident Abnormal Glucose Metabolism in Southwestern China: a Prospective Cohort Study.

    Zhou, Fangli; Zhao, Zhuoxian; Tian, Li; Zheng, Tianpeng; Gao, Yun; Chen, Tao; Yan, Fangfang; Tian, Haoming

    2016-01-01

    This prospective cohort study aimed to analyze the association between serum ferritin levels and the risk of abnormal glucose metabolism (AGM) in Southwestern Chinese population. The 383 subjects who are aged ≥20 years and free of AGM at baseline between in 2007 and in 2008 were included in Southwestern China, and their baseline serum ferritin levels were measured. Among these subjects, 140 subjects were developed into AGM during the follow-up (2008-2012). In logistic regression models, the relative risk in the top versus that in the lowest quartile of serum ferritin levels was 2.86 (p = 0.013) in females and 3.50 (p = 0.029) in males after adjusting the age, gender, family history of diabetes, current smoking, and alcohol; however, serum ferritin levels were not significantly associated with incident of AGM after controlling for metabolic factors (waist circumference, systolic pressure (SBP), triglyceride (TG), and homeostasis model assessment formula insulin resistance (HOMA-IR)). Elevated serum ferritin levels are associated with AGM but not an independent risk factor. PMID:26073512

  4. Procalcitonin: A Key Marker in Children with Urinary Tract Infection

    Sandrine Leroy

    2011-01-01

    Full Text Available Urinary tract infections (UTIs are the most common source of bacterial infections among young febrile children. Accurate diagnosis of acute pyelonephritis (APN and vesicoureteral reflux (VUR is important because of their association with renal scarring, leading in the cases to long-term complications. However, the gold standard examinations for both are either DMSA scan (for APN and scar or cystography (for VUR and present limitations (feasibility, pain, cost, etc.. Procalcitonin, a reliable marker of bacterial infections, was demonstrated to be a good predictor of both renal parenchymal involvement in the acute phase and late renal scars. Furthermore, it was also found to be associated with high-grade VUR and was the key tool of a clinical decision rule to predict high-grade VUR in children with a first UTI. Therefore, procalcitonin may certainly be found playing a role in the complex and still debated picture of which examination should be performed after UTI in children.

  5. Significance of procalcitonin concentration in blood plasma in septic state diagnostic

    V.V. Morrison

    2010-06-01

    Full Text Available The article highlights and generalizes data presented in native and foreign scientific literature. It is devoted to the structure, synthesis and procalcitonin secretion by different cells. The main objective of the work is the significance of procalcitonin determination in septic state diagnostics

  6. The diagnostic accuracy of procalcitonin for bacteraemia: A systematic review and meta-analysis

    S.H. Hoeboer (Sandra); P.J. van der Geest (Patrick); D. Nieboer (Daan); A.B.J. Groeneveld (A.B. Johan)

    2015-01-01

    textabstractThe diagnostic use of procalcitonin for bacterial infections remains a matter of debate. Most studies have used ambiguous outcome measures such as sepsis instead of infection. We performed a systematic review and meta-analysis to investigate the diagnostic accuracy of procalcitonin for b

  7. Comparison of serum procalcitonin in respiratory infections and bloodstream infections

    Zhu, Yanhui; Yuan, Yulin; Huang, Huayi

    2015-01-01

    Purpose: This study observed the relationship between procalcitonin (PCT) and results of sputum culture, the relationship between PCT and results of blood culture to evaluate and compare the value of PCT in respiratory and bloodstream infections. Methods: We analyzed 1616 patients in which PCT and sputum culture were concurrently ordered and analyzed, and 1096 patients in which PCT and blood culture were concurrently ordered and analyzed from January 2014 to May 2015. PCT concentrations were ...

  8. Procalcitonin Sebagai Marker dan Hubungannya dengan Derajat Keparahan Sepsis

    Purba, Donald Boy P.

    2011-01-01

    Background : The mortality on sepsis is still high. It’s because of delayed ofthe treatment resulted from the diagnosis of sepsis estabilished more frequently imprecise. The inflammatory makers as c reactive protein and leucocyte apparently have high sensitivity and specifity where do contemn whereas blood culture examination required so long time and the result of culture often negatively. Research on Procalcitonin (PCT) formering have important of the role for the establishment diagnos...

  9. Kadar Procalcitonin sebagai marker dan hubungannya dengan derajat keparahan sepsis.

    Purba, Donald Boy P.

    2012-01-01

    Background : The mortality on sepsis is still high. It’s because of delayed ofthe treatment resulted from the diagnosis of sepsis estabilished more frequently imprecise. The inflammatory makers as c reactive protein and leucocyte apparently have high sensitivity and specifity where do contemn whereas blood culture examination required so long time and the result of culture often negatively. Research on Procalcitonin (PCT) formering have important of the role for the establishment diagnos...

  10. Diagnostic accuracy of procalcitonin in critically ill immunocompromised patients

    Legriel Stéphane; Feugeas Jean-Paul; Coquet Isaline; Darmon Michael; Bele Nicolas; Adaoui Nadir; Schlemmer Benoît; Azoulay Élie

    2011-01-01

    Abstract Background Recognizing infection is crucial in immunocompromised patients with organ dysfunction. Our objective was to assess the diagnostic accuracy of procalcitonin (PCT) in critically ill immunocompromised patients. Methods This prospective, observational study included patients with suspected sepsis. Patients were classified into one of three diagnostic groups: no infection, bacterial sepsis, and nonbacterial sepsis. Results We included 119 patients with a median age of 54 years ...

  11. Procalcitonin as a marker of bacterial infection Review

    Çelebi, Gönen; Taştan, Yücel

    2002-01-01

    Because of the early diagnosis and treatment of bacterial infection markedly improves the outcome the use of nonspecific screening tests for assesment of the potentially infected patient are often employed Inflammatory markers currently in use such as leucocyte count C reactive protein and erythrocyte sedimentation rate do not reliably differentiate between bacterial and viral infection The ability to screen for bacterial infection has been evolving over time Procalcitonin is a newer marker o...

  12. Procalcitonin as a marker for the diagnosis of sepsis

    C. G. Chivate; G. J. Belwalkar; R. P. Limaye; Rahul V. Patil

    2016-01-01

    Background: Quick diagnosis of sepsis in intensive care unit patients is challenging for physicians. Methods: The prospective study was conducted at our hospital. We studied the efficacy of procalcitonin as a marker of sepsis in 87 adults admitted to our intensive care unit with symptoms of systemic infection. The study samples included all patients aged above 18 years with acute sepsis. Statistical analyses were done using SPSS. PCT and various other relevant factors were measured in all...

  13. Procalcitonin for detecting community-acquired bacterial pneumonia

    Devi Gusmaiyanto; Finny Fitry Yani; Efrida Efrida; Rizanda Machmud

    2016-01-01

    Background Pneumonia is a major cause of morbidity andmortality in children under five years of age. Pneumonia can be ofbacterial or viral origin. It is difficult to distinguish between thesetwo agents based on clinical manifestations, as well as radiologicaland laboratory examinations. Furthermore, bacterial cultures taketime to incubate and positive results may only be found in 10-30%of bacterial pneumonia cases. Procalcitonin has been used as amarker to distinguish etiologies, as bacterial...

  14. Procalcitonin kinetics – prognostic and diagnostic significance in septic patients

    Lipińska-Gediga, Małgorzata; Mierzchała-Pasierb, Magdalena; Durek, Grażyna

    2016-01-01

    Introduction Severe sepsis and septic shock are advanced clinical conditions representing the patient's response to infection and having a variable but high mortality rate. Early evaluation of sepsis stage and choice of adequate treatment are key factors for survival. Some study results suggest the necessity of daily procalcitonin (PCT) monitoring because of its prognostic and discriminative value. Material and methods An observational and prospective study was conducted to evaluate the progn...

  15. A novel marker procalcitonin may help stem the antibiotic overuse in emergency setting.

    Kaur, Kamalpreet; Mahajan, Rajiv; Tanwar, Aparna

    2013-07-01

    The day the wonder drugs, antibiotics, were available for cure to humans; dramatic rise of average life expectancy has been recorded compared to past. However, disease-causing microbes that have developed resistance to antibiotics are an increasing public health problem. Recently, superbug emergence was reported in some countries including India. One of the reasons quoted was misuse of antibiotics. Clinical signs and symptoms of infection often do not point towards the etiology. The dilemma occurs as diagnosis of sepsis is difficult because of nonspecificity of clinical signs and symptoms, and frequent overlapping of symptoms with other noninfectious causes of systemic inflammation. Key for improving survival rates lies in early diagnosis and treatment. Serum procalcitonin (PCT) levels measuring in sick patients during infection may be valuable in diagnosing the conditions, and its changing levels have some prognostic value too. PMID:24083140

  16. Procalcitonin guidance for reduction of antibiotic use in patients hospitalized with severe acute exacerbations of asthma: a randomized controlled study with 12-month follow-up

    Long, Wei; Li, Li-juan; Huang, Gao-zhong; Zhang, Xue-Min; Zhang, Yi-cui; Tang, Jian-Guo; Zhang, Yu; Lu, Gang

    2014-01-01

    Introduction Patients with severe acute exacerbations of asthma often receive inappropriate antibiotic treatment. We aimed to determine whether serum procalcitonin (PCT) levels can effectively and safely reduce antibiotic exposure in patients experiencing exacerbations of asthma. Methods In this randomized controlled trial, a total of 216 patients requiring hospitalization for severe acute exacerbations of asthma were screened for eligibility to participate and 169 completed the 12-month foll...

  17. Is procalcitonin increased in cases of invasive amoebiasis? A retrospective, observational study.

    Recipon, Guillaume; Piver, Éric; Caille, Agnès; Le Pape, Patrice; Pihet, Marc; Pagès, Jean-Christophe; Chandenier, Jacques; Desoubeaux, Guillaume

    2015-12-01

    Procalcitonin (PCT) levels are commonly used for diagnostic guidance in routine bacterial infections. By contrast, little data are currently available regarding PCT in parasitic diseases, and its role in cases of invasive amoebiasis has not yet been described. For this purpose, 35 adult patients with a proven diagnosis of invasive or digestive amoebiasis were included in a 4-year study period. Serum PCT was retrospectively assessed. Results were analysed with regard to the usual inflammatory biomarkers, like C-reactive protein (CRP). PCT was significantly higher in patients with proven invasive amoebiasis than in digestive amoebiasis (mean value: 4.03 μg/L versus 0.07 μg/L, respectively; P < 0.001), but the SD was greater than with CRP, and the effect was less than that demonstrated in bacterial infections. By contrast, PCT was not shown to be elevated during digestive amoebiasis. PMID:26388549

  18. Abnormal nociception and opiate sensitivity of STOP null mice exhibiting elevated levels of the endogenous alkaloid morphine

    Aunis Dominique

    2010-12-01

    Full Text Available Abstract Background- Mice deficient for the stable tubule only peptide (STOP display altered dopaminergic neurotransmission associated with severe behavioural defects including disorganized locomotor activity. Endogenous morphine, which is present in nervous tissues and synthesized from dopamine, may contribute to these behavioral alterations since it is thought to play a role in normal and pathological neurotransmission. Results- In this study, we showed that STOP null brain structures, including cortex, hippocampus, cerebellum and spinal cord, contain high endogenous morphine amounts. The presence of elevated levels of morphine was associated with the presence of a higher density of mu opioid receptor with a higher affinity for morphine in STOP null brains. Interestingly, STOP null mice exhibited significantly lower nociceptive thresholds to thermal and mechanical stimulations. They also had abnormal behavioural responses to the administration of exogenous morphine and naloxone. Low dose of morphine (1 mg/kg, i.p. produced a significant mechanical antinociception in STOP null mice whereas it has no effect on wild-type mice. High concentration of naloxone (1 mg/kg was pronociceptive for both mice strain, a lower concentration (0.1 mg/kg was found to increase the mean mechanical nociceptive threshold only in the case of STOP null mice. Conclusions- Together, our data show that STOP null mice displayed elevated levels of endogenous morphine, as well as an increase of morphine receptor affinity and density in brain. This was correlated with hypernociception and impaired pharmacological sensitivity to mu opioid receptor ligands.

  19. Decreased levels of genuine large free hCG alpha in men presenting with abnormal semen analysis

    Plas Eugen

    2011-08-01

    Full Text Available Abstract Background The pregnancy hormone human chorionic gonadotropin (hCG and its free subunits (hCG alpha, hCG beta are produced in the male reproductive tract and found in high concentrations in seminal fluid, in particular hCG alpha. This study aimed to elucidate changes in peptide hormone profiles in patients showing abnormal semen analyses and to determine the genuineness of the highly abundant hCG alpha. Methods Seminal plasma was obtained from 45 male patients undergoing semen analysis during infertility workups. Comprehensive peptide hormone profiles were established by a panel of immunofluorometric assays for hCG, hCG alpha, hCG beta and its metabolite hCG beta core fragment, placental lactogen, growth hormone and prolactin in seminal plasma of patients with abnormal semen analysis results (n = 29 versus normozoospermic men (n = 16. The molecular identity of large hyperglycosylated hCG alpha was analyzed by mass-spectrometry and selective deglycosylation. Results hCG alpha levels were found to be significantly lower in men with impaired semen quality (1346 +/- 191 vs. 2753 +/- 533 ng/ml, P = 0.022. Moreover, patients with reduced sperm count had reduced intact hCG levels compared with normozoospermic men (0.097 +/- 0.022 vs. 0.203 +/- 0.040 ng/ml, P = 0.028. Using mass-spectrometry, the biochemical identity of hCG alpha purified from seminal plasma was verified. Under non-reducing conditions in SDS-PAGE, hCG alpha isolated from seminal plasma migrated in a manner comparable with large free hCG alpha with an apparent molecular mass (Mr, app of 24 kDa, while hCG alpha dissociated from pregnancy-derived holo-hCG migrated at approximately 22 kDa. After deglycosylation with PNGase F under denaturing conditions, all hCG alpha variants showed an Mr, app of 15 kDa, indicating identical amino acid backbones. Conclusions The findings indicate a pathophysiological relevance of hCG, particularly its free alpha subunit, in spermatogenesis. The

  20. Do abnormal serum lipid levels increase the risk of chronic low back pain? The Nord-Trondelag Health Study.

    Ingrid Heuch

    Full Text Available Cross-sectional studies suggest associations between abnormal lipid levels and prevalence of low back pain (LBP, but it is not known if there is any causal relationship.The objective was to determine, in a population-based prospective cohort study, whether there is any relation between levels of total cholesterol, high density lipoprotein (HDL cholesterol and triglycerides and the probability of experiencing subsequent chronic (LBP, both among individuals with and without LBP at baseline.Information was collected in the community-based HUNT 2 (1995-1997 and HUNT 3 (2006-2008 surveys of an entire Norwegian county. Participants were 10,151 women and 8731 men aged 30-69 years, not affected by chronic LBP at baseline, and 3902 women and 2666 men with LBP at baseline. Eleven years later the participants indicated whether they currently suffered from chronic LBP.Among women without LBP at baseline, HDL cholesterol levels were inversely associated and triglyceride levels positively associated with the risk of chronic LBP at end of follow-up in analyses adjusted for age only. Adjustment for the baseline factors education, work status, physical activity, smoking, blood pressure and in particular BMI largely removed these associations (RR: 0.96, 95% CI: 0.85-1.07 per mmol/l of HDL cholesterol; RR: 1.16, 95% CI: 0.94-1.42 per unit of lg(triglycerides. Total cholesterol levels showed no associations. In women with LBP at baseline and men without LBP at baseline weaker relationships were observed. In men with LBP at baseline, an inverse association with HDL cholesterol remained after complete adjustment (RR: 0.83, 95% CI: 0.72-0.95 per mmol/l.Crude associations between lipid levels and risk of subsequent LBP in individuals without current LBP are mainly caused by confounding with body mass. However, an association with low HDL levels may still remain in men who are already affected and possibly experience a higher pain intensity.

  1. Role of Maternal Serum Procalcitonin, Interleukin-6 and hs-C Reactive Protein in Prediciton of Subclinical (Intrauterine Infection in Preterm Premature Rupture of Membranes

    Amany M.E. Abd Elmegeed*, Sabah I. Abd Elreheem*, Al-Shimaa Allam Abd

    2011-04-01

    Full Text Available To evaluate the role of procalcitonin (PCT, high senstive C-reactive protein (hs-CRP and Interleukin-6 (IL-6 for prediction of subclinical intrauterine infection in pregnant women with preterm premature rupture of membranes. Methods: Twenty patients with preterm premature rupture of membranes PPROM (study group and twenty apparently healthy pregnant women (control group between 26-34 weeks of pregnancy were enrolled in this study. In all cases analysis of serum procalcitonin by high performance liquid chromatography, Il-6 by ELISA method and hs-CRP by nephelometry were done. Culture of vaginal bacteria was done for study group only. Results: Procalcitonin levels in the PRROM group were significantly higher than in healthy pregnant women (median 1.95 versus 0.39-Interquartile range 1.375 versus 0.213 ­ P0.001. A significant correlation was observed between PCT and hs-CRP (r=0.510; P0.031 and leucocytosis (r=0.544- P 0.013. Also IL-6 levels were significantly higher in cases of PPROM compared with control group (median 40.01 versus 5.55 ­ Interquartile range, 45.88 versus 4.22 P 0.001. No significant correlation was present between PCT and IL-6 Conclusion: Determination of PCT, hs-CRP and IL-6 in mother's blood sample can be useful for diagnostics of PPROM cases suspected of intrauterine infection. However PCT more valuable and specific.

  2. The relationship between serum procalcitonin (PCT) level and acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ ) score in septic patients%脓毒症患者降钙素原与APACHEⅡ评分的相关性探讨

    刘慧琳; 刘桂花

    2012-01-01

    Objective To investigate the relationships between serum procalcitonin (PCT) level and APACHE Ⅱ score as well the prognosis of septic patients.Methods Ninety patients with sepsis were collected from emergency and critical care department of Third Hospital,Peking University,Beijing.Within 24 hours after admission,the serum PCT,hypersensitive C-reactive protein (hs-CRP),leucocyte count (WBC) and lactic acid were examined,and APACHE Ⅱ score were calculated.According to APACHE Ⅱscore,the septic patients were divided into three groups of high,median and low scores.Based on the 28 -day outcomes of patients,the patients were divided into survival group and death group.The differences in PCT,APACHE score,WBC and lactic acid between the survival group and the death group were detected.Results The serum levels of PCT were significantly higher ( P < 0.01 ) in patients with high APACHE Ⅱ score ( > 20) than that in patients with median score (10-20) and low score ( < 10 ).There was significant correlation between PCT level and APACHE Ⅱscore ( r =0.58,P <0.01 ).Conclusions There is a good correlation between serum PCT level and APACHE Ⅱ score.The serum PCT and APACHE Ⅱ can be used for predicting the outcomes of septic patients.%目的 探讨脓毒症患者血清降钙素原(PCT)与急性生理学与慢性健康状况Ⅱ(APACHEⅡ)评分及预后的关系,进而了解PCT对脓毒症早期诊断和预后的影响.方法 采用前瞻性方法进行研究,将北京大学第三医院急诊重症监护病房(EICU)脓毒症90例患者按照APACHEⅡ评分分组,测定患者入院后24h内PCT、超敏C反应蛋白(hs-CRP)及乳酸的水平,比较PCT、白细胞和乳酸的差异.后再根据患者28 d结局不同(分为生存组和死亡组两组),比较PCT、APACHEⅡ评分、白细胞及乳酸的差异.结果 低危组患者PCT为(0.15±0.14) ng/ml,低于中危组(0.62±0.61) ng/ml和高危组(5.32±5.20) ng/ml,中危组PCT低于高危组,其差

  3. 肝衰竭患者血清降钙素原测定的应用价值%Study of procalcitonin in patients with hepatic failure

    张国栋

    2015-01-01

    Objective To explore the value of serum procalcitonin in patients with hepatic failure.Methods Totally 106 patients with hepatic failure from January 2009 to October 2014 were enrolled and divided into infection group (75 cases) and non-infection group (31 cases).After anti-infection treatment,75 cases in infection group weredivided into high procalcitonin group (33 cases) and low procalcitonin (42 cases) according to the level of serum procalcitonin.Twenty three cases of liver failure patients with calcitonin peptide < 0.5 μg/L underwent serum procalcitonin reexamination within 48 h and divided into procalcitonin increasing > 1 time group (10 cases) and procalcitonin increasing < 1 time group (13 cases).The value of procalcitonin for early diagnosis and prognosis prediction of bacterial infections were evaluated.Results In infection group,there were 72 cases with procalcitonin≥0.5 μg/L [96.0% (72/75)],significantly more than that in non-infection group [35.5% (11/31)] (x2 =47.28,P < 0.01).In high procalcitonin group,21 cases were dead [63.6% (21/33)],significantly more than that in low procalcitonin group[14.3% (6/42)] (x2 =19.53,P < 0.01).There were 6 cases in procalcitonin increasing > 1 time group and 2 cases in procalcitonin increasing < 1 time group were complicated with infection with significantly differece (P < 0.05).Conclusion Serum procalcitonin is important for early diagnosis and prediction of infection in hepatic failure patients;it is also important for prediction of hepatic failure complicated with infection.%目的 探讨血清降钙素原测定在肝衰竭患者中的应用价值.方法 回顾性分析2009年1月至2014年10月在平煤神马医疗集团总医院住院治疗的由病毒性肝炎导致的肝衰竭患者106例,测定细菌感染情况.依据是否发生感染把106例患者分为感染组(75例)和非感染组(31例).将合并细菌感染的75例肝衰竭患者按抗感染治疗后降钙素原的变

  4. Evaluation of diagnostic value of procalcitonin in pediatric acute pyelonephritis

    Simin Sadeghi-bojd

    2012-05-01

    Full Text Available Background and Aim: Urinary tract infection (UTI in children is among the prevalent infections of childhood, which occurs due to growth of bacteria in the urinary tract. The aim of this study was to evaluate the usefulness of procalcitonin (PCT as a reliable marker for distinguishing urinary tract infection (UTI with or without renal parenchyma (cystitis. Materials and Methods: Eighty children, who were suspicious of having UTI and had been referred to Ali Ibne Abitaleb hospital (in Zahedan or pediatric clinics (June 2007- Oct 2009 were included in the study after their urine culture revealed their infection. Besides, their clinical and lab symptoms including erythrocyte sedimentation rate (ESR, C– reactive protein (CRP, serum WBC, and serum procalcitonin (PCT were recorded. The patients were divided into two groups based on their lab clinical symptoms and radio-isotope scans, namely acute pyelonephritis and acute cystitis (lower UTI. Serum procalcitonin was measured in these cases in a semi-quantitative manner. Results: Fifty children with mean age of 4.89±3.50 years were compared with 30 children with mean age of 5.20±3.07 years. ESR, WBC, and PCT were significantly higher in patients with upper UTI (P<0.001 , but CRP was not significantly different in the two groups. PCT, which was semi-quantitatively measured, when lower than 0.5 had a relationship with sensitivity, specificity, positive predictive value, and negative value of 72%, 83.3%, 87.8%, and 64.1% respectively. When PCT was more than 2, the relationship with the mentioned features was 50%, 96.6%, 96.2%, and 53.7%, respectively. The relationships in these two domains can both be assistant in differentiating pyelonephritis from cystitis. Conclusion: PCT was more sensitive and specific for the diagnosis of upper versus lower UTI compared with CRP, and it can be a better marker than CRP for early prediction of febrile pyelonephritis in children.

  5. The methodological evaluation of detecting procalcitonin by immunoturbidimetric assay%免疫透射比浊法检测降钙素原的实验评价

    金强; 姚晓玲; 胡恩赑

    2012-01-01

    Objective To evaluate the method of procalcitonin detection by immunoturbidmetric assay. Methods Immunoturbidmetric assay was established to determine serum procalcitonin, and then its precision, linearity, recovery and interference test were evaluated. Results The method had a good linearity response ( y = 1. 152x -0.0452 ), and the linear correlation coefficient r =0. 999. The inter and intra CVs of the serum procalcitonin levels were lower than 5% and 10% , respectively. The average recovery was 97. 7% . Some degree of bilirubin, hemoglobin and triglycerides did not interfere with the procalcitonin results significantly. Conclusion Immunoturbidmetric assay is a simple, fast and automated detection method, which shows good performance in clinical use.%目的 对免疫透射比浊法定量测定降钙素原的方法进行实验评价.方法 实验评价包括精密度、线性、回收实验及干扰实验.结果 该方法测定降钙素原线性良好(y=1.152x-0.0452,r=0.999),批内CV<5%,批间CV<10%;回收率平均97.7%;对胆红素、血红蛋白及三酰甘油具有较好的干扰能力.结论 该方法简便、快速,便于自动化检测,适合临床使用.

  6. Serum Procalcitonin and Procalcitonin Clearance as a Prognostic Biomarker in Patients with Severe Sepsis and Septic Shock

    Min-Yi Huang; Chun-Yu Chen; Ju-Huei Chien; Kun-Hsi Wu; Yu-Jun Chang; Kang-Hsi Wu; Han-Ping Wu

    2016-01-01

    We evaluated the tendency of the plasma concentration and procalcitonin (PCT) clearance (PCTc) to act as biomarkers of prognosis in patients with severe sepsis and septic shock. From 2011 to 2013, we prospectively analyzed patients with sepsis admitted to the intensive care unit (ICU). The serum PCT was evaluated at the time of sepsis diagnosis and again after 48 h (day 3) and 96 h (day 5). PCTc after 48 h (PCTc-day 3) and 96 h (PCTc-day 5) was also calculated to evaluate the prognostic value...

  7. The Prognosis Value of Change Levels of Serum Procalcitonin in Early Stage on Patients with Severe Trauma%严重创伤患者早期血清降钙素原水平变化对预后评估的意义

    杨兴伟; 董士民

    2013-01-01

    Objective To explore levels of serum procalcitonin (PCT) in patients with severe trauma in evaluation of clinical significances of prognosis.Methods Levels of serum PCT in 93 patients with systemic inflammatory response syndrome (SIRS)after severe trauma were detected at 1 st d,2nd d and 3rd d before admission,and the division of groups was based on changes of the levels of serum PCT.Survival rates,times of mechanical ventilation,length of stay in ICU,and the correlation between PCT levels and scores of severe trauma levels at 28th d after admission were evaluated.Results Among 93 patients,83 patients survived (survival group) and 10 patients died (mortality group) at 28th d after admission.Levels of serum PCT at the 3 d before admission in mortality group were significantly higher than those in survival group (P < 0.05),and the trend rose higher and higher (P < 0.05) ;the differences in length of stay in ICU and times of mechanical ventilation between mortality group and survival group were statistically significant (P < 0.05).All the patients in normal group (n =10) and low level group (n =26) survived,1 patient (2.17%)died in middle level group (n =46),9 patients (81.82%) died in high level group (n =11),the mortality rate in high level group was significantly higher than those in other groups (P < 0.05).With PCT levels increased,times of mechanical ventilation,length of stay in ICU,and scores of severe trauma levels were significantly increased (P < 0.05).Spearman correlative analysis shows that PCT level was correlated with APACHE Ⅱ and ISS scores (P < 0.05).Conclusion As a marker to evaluate the prognosis the level of serum PCT is connected with prognosis of patients with severe trauma.%目的 探讨严重创伤患者中血清降钙素原(PCT)对患者预后评估的临床意义.方法 收集93例入院时存在全身炎症反应综合征的严重创伤,入院前3d每天检测血清PCT水平,并根据PCT水平

  8. Procalcitonin-guided antibiotic treatment of respiratory tract infections in a primary care setting

    Aabenhus, Rune; Jensen, Jens Ulrik Stæhr

    2011-01-01

    , could greatly improve patient care and limit excessive antibiotic prescriptions. Procalcitonin is a new marker of suspected bacterial infection that has shown promise in guiding antibiotic therapy in acute respiratory tract infections in hospitals without compromising patient safety. Procalcitonin......-of-care test for procalcitonin with acceptable precision, severely hampering its application in primary care. This article reviews the physiology of procalcitonin, describes the assays available for its measurement, evaluates the present evidence from primary care on its use to identify correctly patients who......Clinical signs of infection do not allow for correct identification of bacterial and viral aetiology in acute respiratory infections. A valid tool to assist the clinician in identifying patients who will benefit from antibiotic therapy, as well as patients with a potentially serious infection...

  9. Procalcitonin and community-acquired pneumonia (CAP) in children.

    Giulia, Bivona; Luisa, Agnello; Concetta, Scazzone; Bruna, Lo Sasso; Chiara, Bellia; Marcello, Ciaccio

    2015-12-01

    The role of procalcitonin (PCT) as a biomarker for sepsis in adults is well documented, while its role in infections affecting neonatal children remains controversial. Among these infections, Community-Acquired pneumonia (CAP) has been studied extensively, because it's the second cause of death in children in developing countries, and one of the most frequent causes of hospitalization in industrialized countries. The PubMed database and the Cochrane Library were used to search for the following keywords: CAP, procalcitonin, and children. Thirteen articles were studied to determine the role of PCT in CAP management, specifically its usefulness for distinguishing pneumococcal infections from viral and unknown infections, for predicting severity and the correct antibiotic treatment. This paper focuses on the studies performed to identify the best inflammatory biomarker for CAP management. Although there is an increase in studies confirming the usefulness of PCT in CAP management in children, further studies are needed to have better understanding of its role for pediatric CAP management. PMID:26434548

  10. Prognostic and diagnostic value of procalcitonin in the post-transplant setting after liver transplantation

    Perrakis, Aristotelis; Stirkat, Falk; Croner, Roland S; Vassos, Nikolaos; Raptis, Dimitrios; Yedibela, Süleyman; Hohenberger, Werner; Müller, Volker

    2016-01-01

    Introduction The aim of the study was to assess the diagnostic accuracy of procalcitonin (PCT) as a marker for complications and as a prognostic factor for mortality after liver transplantation. Material and methods Liver transplant patients between January 2007 and April 2011 were prospectively included in the study. Procalcitonin serum concentration was recorded before, 6 h after reperfusion and then daily. Postoperative clinical course was prospectively analyzed from admission to discharge...

  11. The Early Diagnostic Value of Serum Procalcitonin in Eldely Patients with Severe Pneumonia%降钙素原对老年性重症肺炎早期诊断的价值

    高萌萌; 崔丽

    2014-01-01

    目的评价血清降钙素原(procalcitonin,PCT)对老年性重症肺炎早期诊断的价值及临床意义。方法入院24 h内抽取30例老年性重症肺炎患者及30例轻症老年肺炎患者血液,检测PCT、C反应蛋白、白细胞计数、血沉,并对比。结果 PCT与其他指标相比,具有较高的灵敏性及特异性。结论 PCT对肺炎的诊断有一定的价值,对老年性重症肺炎早期诊断及病情评估价值更大,与肺炎的严重程度具有相关性。%Objective To investigate the early diagnostic value and clinical significanca of serum procalcitonin in eldely patients with severe pneumonia. Methods Drawed blood from 30 eldely patients with severe pneumonia and mild pneumonia respectively within 24h admission,simultaneously determined and compared procalcitonin,c-reactive protein levels,white blood cellcount,erythrocyte-sedimentation rate. Results Compared with other index, the procalcitonin has high sensitivity and specificity. Conclusion The procalcitonin has diagnosis value to roentgenodiagnosis of pneumonia.It has great value in diagnosis early and estimation prognosis diagnosis,and has positive correlation with the disease severity.

  12. Serum procalcitonin: Early detection of neonatal bacteremia and septicemia in a tertiary healthcare facility

    Ibeh Isaiah Nnanna

    2011-01-01

    Full Text Available Background: The benefits of procalcitonin measurement in neonatal bacteremia/septicemia with suspected nosocomial infection are unclear and unresearched. Aim: The aim of the study was to assess procalcitonin value as an early or first line diagnosis/prognosis for bacterial neonatal septicemic infection in selected critically ill neonates. Patients and Methods: An observational cohort study in a 10-bed intensive care unit was performed. Sixty neonates, with either proven or clinically suspected, but not confirmed, bacterial neonatal septicemic infection were included. Procalcitonin measurements were obtained on the day when the infection was suspected. Neonates with proven septicemic infection were compared to those without. The diagnostic value of procalcitonin was determined through the area under the corresponding receiver operating characteristic curve (AUROCC. In addition, the predictive value of procalcitonin variations preceding the clinical suspicion of infection was also assessed. Results: Procalcitonin was the best early predictor of proven infection in this population of neonates with a clinical suspicion of septicemia (AUROCC = 0.80; 91.6% CI, 0.68-0.91. In contrast, CRP elevation, leukocyte count and fever had a poor predictive value in our population. Conclusion: PCT monitoring could be helpful in the early diagnosis of neonatal septicemic infection in the intensive care unit. Both absolute values and variations should be considered and evaluated in further studies.

  13. Serum procalcitonin: Early detection of neonatal bacteremia and septicemia in a tertiary healthcare facility

    Ibeh Isaiah Nnanna

    2011-03-01

    Full Text Available Background: The benefits of procalcitonin measurement in neonatal bacteremia/septicemia with suspected nosocomial infection are unclear and unresearched. Aim: The aim of the study was to assess procalcitonin value as an early or first line diagnosis/prognosis for bacterial neonatal septicemic infection in selected critically ill neonates. Patients and Methods: An observational cohort study in a 10-bed intensive care unit was performed. Sixty neonates, with either proven or clinically suspected, but not confirmed, bacterial neonatal septicemic infection were included. Procalcitonin measurements were obtained on the day when the infection was suspected. Neonates with proven septicemic infection were compared to those without. The diagnostic value of procalcitonin was determined through the area under the corresponding receiver operating characteristic curve (AUROCC. In addition, the predictive value of procalcitonin variations preceding the clinical suspicion of infection was also assessed. Results: Procalcitonin was the best early predictor of proven infection in this population of neonates with a clinical suspicion of septicemia (AUROCC = 0.80; 91.6% CI, 0.68–0.91. In contrast, CRP elevation, leukocyte count and fever had a poor predictive value in our population. Conclusion: PCT monitoring could be helpful in the early diagnosis of neonatal septicemic infection in the intensive care unit. Both absolute values and variations should be considered and evaluated in further studies.

  14. Can procalcitonin measurement help in differentiating between bacterial infection and other kinds of inflammatory processes?

    Delevaux, I; Andre, M; Colombier, M; Albuisson, E; Meylheuc, F; Begue, R; Piette, J; Aumaitre, O

    2003-01-01

    Objective: To study the levels of procalcitonin (PCT) in various inflammatory states seen in an internal medicine department and to evaluate the possible discriminative role of PCT in differentiating bacterial infection from other inflammatory processes. Methods: PCT, C reactive protein (CRP), and white blood cell count (WBC) were measured in patients admitted to the department for fever or biological inflammatory syndrome, or both. The serum of 173 consecutive patients was analysed according to the aetiological diagnosis. The patients were divided into two groups: group I (n=60) with documented bacterial or fungal infection; group II (n=113) with abacterial inflammatory disease. Results: PCT levels were >0.5 ng/ml in 39/60 (65%) patients in group I. In group II, three patients with a viral infection had slightly increased PCT levels (0.7, 0.8, and 1.1 ng/ml) as did two others, one with crystal arthritis and the other with vasculitis (0.7 ng/ml in both cases). All other patients in group II had PCT levels 0.5 ng/ml was taken as the marker of bacterial infection (sensitivity 65%, specificity 96%). PCT values were more discriminative than WBC and CRP in distinguishing a bacterial infection from another inflammatory process. Conclusion: PCT levels only rose significantly during bacterial infections. In this study PCT levels >1.2 ng/ml were always evidence of bacterial infection and the cue for starting antibiotic treatment. PMID:12634233

  15. Value of serum procalcitonin in anti-tuberculosis therapeutic effect evaluation for tuberculosis%血清降钙素原在肺结核抗结核治疗疗效评估中的价值

    徐立; 金雪

    2013-01-01

    目的研究血清降钙素原在肺结核抗结核治疗疗效评估中的价值。方法选择2012年1月~2013年1月本科诊治的肺结核患者为研究对象(观察组),以同期未行抗结核治疗的肺结核患者为对照(对照组),比较两组患者治疗前后血清降钙素原的水平并分析不同水平降钙素原抗结核治疗疗效差异。结果观察组和对照组肺结核患者治疗前血清降钙素原差异无统计学意义,观察组患者治疗后1个月、3个月和6个月血清降钙素原显著降低( P<0.05),对照组治疗1个月、3个月和6个月血清降钙素原升高,观察组肺结核患者治疗1个月、3个月和6个月血清降钙素原均显著低于对照组(P<0.05)。治疗前降钙素原水平显著升高、轻度升高和正常患者治愈率依次降低(P<0.05)。结论肺结核患者血清降钙素原可作为其抗结核治疗疗效评估的标志物。%Objective To study the value of serum procalcitonin in anti-tuberculosis therapeutic effect evaluation for tuberculosis. Methods The patients with tuberculosis treated with anti-tuberculosis therapy in our department from January 2012 to January 2013 were selected as the observation group, while no anti-tuberculosis treatment patients with tuberculosis during the same period were selected as the control group. The level of serum procalcitonin in the two groups before and after the treatment were compared and the anti-tuberculosis therapeutic effect difference of different levels of procalcitonin were analyzed. Results There was not significant difference in the level of serum procalcitonin before the treatment between the observation group and the control group. The levels of serum procalcitonin in the observation group after the treatment of 1 month, 3 months and 6 months decreased significantly(P<0.05), while the levels of serum procalcitonin in the control group after the treatment of 1 month, 3 months and 6 months

  16. Variation in the levels of pregnancy-specific beta-1-glycoprotein in maternal serum from chromosomally abnormal pregnancies.

    Graham, G W; Crossley, J A; Aitken, D A; Connor, J M

    1992-06-01

    Human pregnancy-specific beta-1-glycoprotein (SP1) was assayed retrospectively in stored maternal serum (MS) samples from 82 chromosomally abnormal pregnancies and 377 matched controls. The median MSSP1 concentration in 48 Down's syndrome pregnancies was significantly elevated at 1.17 multiples of the control median (MOM), and significantly reduced (0.5 MOM) in a group of eight cases of unbalanced translocations. There was no significant difference in median SP1 concentrations in cases of trisomy 18, trisomy 13, balanced translocations, or sex chromosome abnormalities. A comparison with human chorionic gonadotrophin results in the same series of samples indicates that SP1 is a less sensitive predictor of Down's syndrome pregnancies. PMID:1387478

  17. The relationship between the procalcitonin level and liver function in pa-tients with hepatitis and liver cirrhosis%肝炎及肝硬化患者降钙素原水平与肝功能的关系探讨

    黄仲国

    2014-01-01

    Objective To explore the relationship between the serum procalcitonin(PCT) level and liver function in pa-tients with hepatitis and liver cirrhosis. Methods A retrospective analysis of 80 cases of hepatitis B virus in our hospi-tal from December 2012 to December 2013 admitted (hepatitis B virus, HBV) infection in patients with hepatitis and liver cirrhosis, included acute hepatitis B (acute hepatitis B, AHB) infection in 20 patients and hepatic cirrhosis (hep-atic cirrhosis, HC) infection in 60 patients. PCT in peripheral blood, white blood cell count, neutrophil count and liver function tests (ALT, AST, TBIL, PTA) levels before and after treatments in patients, and the relationship between PCT and liver function of patients were evaluated. Results PCT level, white blood cell count and neutrophil count in AHB patients and HC patients before treatment were significantly higher than that after treatment, there was statistically sig-nificant difference (t=11.411, 2.217, 3.567, P<0.05); After treatment, patients liver function was significantly improved than before treatment, the difference was statistically significant (t=14.465, 13.164, 14.563, 8.579, P<0.05);The level of PCT in serum and liver function of ALT, AST, TBIL were positively correlated, negatively correlated with the level of PTA (r=0.877, 0.964, 0.859, -0.744, P<0.05). Conclusion There is correlation between PCT level and each index in patients with hepatitis B virus infection and liver cirrhosis, which have significance in treatment patients with infection and liver function disorder.%目的:分析探讨肝炎及肝硬化患者血清中降钙素原(procalcitonin,PCT)水平与其肝功能的关系。方法回顾性分析我院2012年12月~2013年12月收治的80例乙型肝炎病毒(hepatitis B virus,HBV)感染的肝炎及肝硬化患者,其中急性乙型肝炎(acute hepatitis B,AHB)患者20例,肝硬化(hepatic cirrhosis,HC)患者60例,分别在治疗前后检测患者

  18. Elevated postoperative serum procalcitonin is not indicative of bacterial infection in cardiac surgical patients

    Murali Chakravarthy

    2015-01-01

    Full Text Available Background: Identifying infections early, commencing appropriate empiric antibiotic not only helps gain control early, but also reduces mortality and morbidity. Conventional cultures take about 5 days to identify infections. To identify the infections early biomarker like serum procalcitonin (SPC. Aims: We studied the correlation of an elevated level of SPC and positive culture in elective adult patients undergoing cardiac surgery. Methods: This prospective study was conducted from January to December 2013. SPC was checked in patients showing evidence of sepsis. Simultaneously, relevant culture was also undertaken. Correlation, specificity, and sensitivity of elevated SPC were checked. Results: A total of 819 adult patients were included in the study. 43 of them had signs of infection and SPC levels were checked. Based on the level of SPC criteria, 10 patients were diagnosed as "nil", out of them, 4 had culture-positive infections, 17 were suggested to have "mild infection," 3 out those had culture positivity. None among the eleven patients suggested to have "moderate infection," had a positive culture, and one among the five suggested to have a severe infection had a positive culture. The sensitivity was 50% and the specificity 17%. The positive predictive value was 12% and the negative predictive value 60%. Conclusions: We failed to elicit positive correlation between elevated SPC levels and postoperative infection in cardio surgical patients.

  19. Efficiency of Fetuin-A and Procalcitonin in the Diagnosis of Infection in Patients with Febrile Seizure

    Al-Hakeim Hussein Kadhem

    2016-03-01

    Full Text Available Fetuin-A is a negative acute phase reactant, while procalcitonin is an indicator of severe bacterial infection. Diagnosis of bacterial infection in febrile seizure (FS is important for choosing the most suitable treatment. In this study, serum fetuin-A was estimated, for the first time, in the inpatients with FS and compared with procalcitonin and blood culture tests.

  20. Efficiency of Fetuin-A and Procalcitonin in the Diagnosis of Infection in Patients with Febrile Seizure

    Al-Hakeim Hussein Kadhem; Al-Ankoshy Azhar Mohammed; Alsharifi Mohammed-R.

    2016-01-01

    Fetuin-A is a negative acute phase reactant, while procalcitonin is an indicator of severe bacterial infection. Diagnosis of bacterial infection in febrile seizure (FS) is important for choosing the most suitable treatment. In this study, serum fetuin-A was estimated, for the first time, in the inpatients with FS and compared with procalcitonin and blood culture tests.

  1. Age-specific percentile-based reference curve of serum procalcitonin concentrations in Japanese preterm infants.

    Fukuzumi, Noriko; Osawa, Kayo; Sato, Itsuko; Iwatani, Sota; Ishino, Ruri; Hayashi, Nobuhide; Iijima, Kazumoto; Saegusa, Jun; Morioka, Ichiro

    2016-01-01

    Procalcitonin (PCT) levels are elevated early after birth in newborn infants; however, the physiological features and reference of serum PCT concentrations have not been fully studied in preterm infants. The aims of the current study were to establish an age-specific percentile-based reference curve of serum PCT concentrations in preterm infants and determine the features. The PCT concentration peaked in infants at 1 day old and decreased thereafter. At 1 day old, serum PCT concentrations in preterm infants <34 weeks' gestational age were higher than those in late preterm infants between 34 and 36 weeks' gestational age or term infants ≥37 weeks' gestational age. Although the 50-percentile value in late preterm and term infants reached the adult normal level (0.1 ng/mL) at 5 days old, it did not in preterm infants. It took 9 weeks for preterm infants to reach it. Serum PCT concentrations at onset in late-onset infected preterm infants were over the 95-percentile value. We showed that the physiological feature in preterm infants was significantly different from that in late preterm infants, even in those <37 weeks' gestational age. To detect late-onset bacterial infection and sepsis, an age-specific percentile-based reference curve may be useful in preterm infants. PMID:27033746

  2. Abnormal auditory mismatch response in tinnitus sufferers with high-frequency hearing loss is associated with subjective distress level

    Berg Patrick

    2004-03-01

    Full Text Available Abstract Background Tinnitus is an auditory sensation frequently following hearing loss. After cochlear injury, deafferented neurons become sensitive to neighbouring intact edge-frequencies, guiding an enhanced central representation of these frequencies. As psychoacoustical data 123 indicate enhanced frequency discrimination ability for edge-frequencies that may be related to a reorganization within the auditory cortex, the aim of the present study was twofold: 1 to search for abnormal auditory mismatch responses in tinnitus sufferers and 2 relate these to subjective indicators of tinnitus. Results Using EEG-mismatch negativity, we demonstrate abnormalities (N = 15 in tinnitus sufferers that are specific to frequencies located at the audiometrically normal lesion-edge as compared to normal hearing controls (N = 15. Groups also differed with respect to the cortical locations of mismatch responsiveness. Sources in the 90–135 ms latency window were generated in more anterior brain regions in the tinnitus group. Both measures of abnormality correlated with emotional-cognitive distress related to tinnitus (r ~ .76. While these two physiological variables were uncorrelated in the control group, they were correlated in the tinnitus group (r = .72. Concerning relationships with parameters of hearing loss (depth and slope, slope turned out to be an important variable. Generally, the steeper the hearing loss is the less distress related to tinnitus was reported. The associations between slope and the relevant neurophysiological variables are in agreement with this finding. Conclusions The present study is the first to show near-to-complete separation of tinnitus sufferers from a normal hearing control group based on neurophysiological variables. The finding of lesion-edge specific effects and associations with slope of hearing loss corroborates the assumption that hearing loss is the basis for tinnitus development. It is likely that some central

  3. Microvascular abnormalities in capillaroscopy correlate with higher serum IL-18 and sE-selectin levels in patients with type 1 diabetes complicated by microangiopathy

    Maria Górska

    2011-04-01

    Full Text Available Microvascular abnormalities are one of the most important causes of persistent diabetic complications. The aim of this study was to compare microvascular changes examined by nailfold capillaroscopy with serum concentrations of soluble E-selectin (sE-selectin and IL-18 in type 1 diabetic patients with and without microangiopathy. Serum levels of sE-selectin and IL-18 were determined by an enzyme-linked immunosorbent assay in 106 patients with type 1 diabetes and in 40 healthy controls. All diabetic patients were evaluated by extensive clinical, laboratory and capillaroscopic studies. Morphological changes were observed by nailfold capillaroscopy in 86 out of 106 (81% diabetic patients. Severe capillaroscopic changes were seen in 32 out of 54 (59% patients with microangiopathy, but in only seven out of 52 (13% patients without microangiopathy. Higher serum levels of sE-selectin (p < 0.001 and IL-18 (p < 0.05 were demonstrated in diabetic patients compared to controls. Significant differences of sE-selectin (p < 0.001 and IL-18 (p < 0.01 serum concentrations were observed between diabetic patients with microangiopathy and controls. Moreover, comparison between patients with and without microangiopathic complications showed a significantly higher capillaroscopic score and sE-selectin serum concentration in the group with microangiopathy (p < 0.001. Furthermore, diabetic patients with severe microvascular changes in capillaroscopy showed significantly higher IL-18 (p < 0.001 and sE-selectin (p < 0.05 serum levels than subgroups without changes or with mild abnormalities. Our findings suggest that abnormalities in nailfold capillaroscopy may reflect the extent of microvascular involvement and are associated with higher sE-selectin and IL-18 serum levels, as well as with microangiopathic complications in diabetic patients. (Folia Histochemica et Cytobiologica 2011; Vol. 49, No. 1, pp. 104–110

  4. Congenital Abnormalities

    ... blood flow to the fetus impair fetal growth. Alcohol consumption and certain drugs during pregnancy significantly increase the risk that a baby will be born with abnormalities (e.g. fetal alcohol spectrum disorders ). Eating raw or uncooked foods during pregnancy can also be dangerous to health of the ...

  5. Procalcitonin as diagnostic marker of infection in solid tumors patients with fever.

    Vincenzi, B; Fioroni, I; Pantano, F; Angeletti, S; Dicuonzo, G; Zoccoli, A; Santini, D; Tonini, G

    2016-01-01

    In oncologic patients fever is a non-specific clinical marker of different clinical settings. Procalcitonin (PCT) seems to be the most promising infection marker. We aimed to define the potential role of PCT as an earlier diagnostic marker in patients with fever and solid tumor. This retrospective study enrolled 431 patients. All of them performed hemoculture (HE) and basal PCT assessment (reference laboratory cut-off: ≤0.5 or >0.5 ng/dL) before starting antibiotic therapy. Gram positive (G+), negative (G-) or Fungi infection were detected. A statistically significant difference in PCT levels between patients with positive and negative HE was observed (P PCT values in patients with positive and negative HE, we obtain in the positive HE subpopulation an AUC of 0.7 and a cut-off of 1.52 ng/dL reached high sensitivity (61.6%) and specificity (70.1%). Using this last cut-off, instead of the normal reference value, we achieve a risk reduction to overestimate an infection status of 23.4%. We support the clinic usefulness of serum PCT dosage in febrile advanced solid tumor patients. A PCT cut-off of 1.52 ng/dL could be helpful in the management of the antibiotic therapy preventing delays of oncologic treatments. PMID:27312877

  6. Pleural fluid procalcitonin to distinguish infectious from noninfectious etiologies of pleural effusions.

    Khosla, Rahul; Khosla, Shikha G; Becker, Kenneth L; Nylen, Eric S

    2016-05-01

    In this study we investigate the diagnostic value of pleural fluid procalcitonin (PCT) in distinguishing infectious and noninfectious etiologies of pleural effusion. We reviewed the medical records of 75 hospitalized patients who underwent thoracentesis between 2011 and 2012. Data on pleural fluid lactate dehydrogenase (LDH), protein, albumin, cell count and differential, pH, Gram stain and culture, cytology, triglyceride, cholesterol, amylase, and PCT were collected. Data on serum LDH, protein, albumin, prothrombin time, normalized, and blood culture were also collected. Pleural effusions were classified into 2 groups, infectious and noninfectious. There were 18 infectious pleural effusions (IPE) and 57 noninfectious pleural effusions (NIPE). Median pleural fluid PCT was 1.088 ng/mL (0.312-2.940 ng/mL) in IPE and 0.123 ng/mL (0.05-0.263 ng/mL) in NIPE, with a P value 0.25 ng/mL had a sensitivity of 77.78% and specificity of 74.14% for diagnosing an IPE. A subgroup analysis of PCT in exudative infectious effusions versus exudative noninfectious malignant/paramalignant effusions showed higher levels in the former. PCT is a novel biomarker for diagnosing infectious pleural effusion, and it would be worthwhile to investigate the role of pleural PCT in assessing severity of illness, risk stratification, and antibiotic stewardship in hospitalized patients with pleural effusions. Journal of Hospital Medicine 2016;11:363-365. 2016 Society of Hospital Medicine. PMID:26821368

  7. Procalcitonin, MR-Proadrenomedullin, and Cytokines Measurement in Sepsis Diagnosis: Advantages from Test Combination

    Silvia Angeletti

    2015-01-01

    Full Text Available Background. Elevated cytokines levels correlate with sepsis severity and mortality but their role in the diagnosis is controversial, whereas Procalcitonin (PCT has been largely used. Recently, the mid-regional proadrenomedullin (MR-proADM has been combined with PCT for diagnosis optimization. In this study the combined measurement of PCT, MR-proADM, and cytokines in patients with sepsis was evaluated. Methods. One hundred and four septic patients and 101 controls were enrolled. Receiver operating characteristic (ROC analysis and multiple logistic regression were used to evaluate applicant markers for sepsis diagnosis. Markers with best Odds Ratio (OR were combined, and the posttest probability and a composite score were computed. Results. Based upon ROC curves analysis, PCT, MR-proADM, IL-6, IL-10, TNF-α, and MCP-1 were considered applicant for sepsis diagnosis. Among these PCT, MR-proADM , IL-6, and TNF-α showed the best OR. A better posttest probability was found with the combination of PCT with MR-proADM and PCT with IL-6 or TNF-α compared to the single marker. A composite score of PCT, MR-proADM, and TNF-α showed the best ROC curve in the early diagnosis of sepsis. Conclusion. The combination of PCT with other markers should expedite diagnosis and treatment of sepsis optimizing clinical management.

  8. Serum C-Reactive Protein and Procalcitonin Kinetics in Patients Undergoing Elective Total Hip Arthroplasty

    Sandra Battistelli

    2014-01-01

    Full Text Available Background. The sensitivity and the specificity of different methods to detect periprosthetic infection have been questioned. The current study aimed to investigate the kinetics of C-reactive protein (CRP and procalcitonin (PCT in patients undergoing uncomplicated elective total hip arthroplasty (THA, to provide a better interpretation of their levels in noninfectious inflammatory reaction. Methods. A total of 51 patients were included. Serum CRP and PCT concentrations were obtained before surgery, on the 1st, 3rd, and 7th postoperative days and after discharge on the 14th and 30th days and at 2 years. Results. Both markers were confirmed to increase after surgery. The serum CRP showed a marked increase on the 3rd postoperative day while the peak of serum PCT was earlier, even if much lower, on the first day. Then, they declined slowly approaching the baseline values by the second postoperative week. PCT mean values never exceed concentrations typically related to bacterial infections. Conclusions. CRP is very sensitive to inflammation. It could be the routine screening test in the follow-up of THA orthopaedic patients, but it should be complemented by PCT when there is the clinical suspicion of periprosthetic infection.

  9. Induction of procalcitonin in liver transplant patients treated with anti-thymocyte globulin

    Zazula, Roman; Prucha, Miroslav; Tyll, Tomas; Kieslichova, Eva

    2007-01-01

    Introduction The aim of this study was to compare the early postoperative kinetics of procalcitonin (PCT) and C-reactive protein (CRP) serum levels in patients undergoing orthotopic liver transplantation (OLTx) with different immunosuppressive regimens. Methods PCT and CRP serum concentrations were measured in a group of 28 OLTx recipients before induction of anesthesia, at 4 and 8 hours following graft reperfusion, and daily until postoperative day 4. The same parameters were determined in 12 patients undergoing liver resection without conjunctive immunosuppressive therapy. Summary data are expressed as medians and ranges. Two-tailed nonparametric tests were performed and considered significant at p values of less than 0.05. Results The highest serum levels of PCT (median 3.0 ng/mL, minimum 1.4 ng/mL, maximum 13.9 ng/mL) were found in patients after OLTx without ATG therapy, on postoperative day 1. In patients with ATG administration, PCT levels were highly increased on postoperative day 1 (median 53.0 ng/mL, minimum 7.9 ng/mL, maximum 249.1 ng/mL). Thereafter, PCT values continuously decreased independently of further ATG administration in both groups of patients. No evidence of infection was present in either group. In 12 patients undergoing liver resection, peak serum PCT levels did not exceed 3.6 ng/mL. CRP serum levels in a group of patients with and without ATG therapy increased significantly on postoperative day 1, followed by a decrease. The highest levels of CRP were found in patients after liver resection on postoperative day 2 and decreased thereafter. Conclusion ATG administration to patients with OLTx is associated with an increase in serum PCT levels, with peak values on postoperative day 1, and this was in the absence of any evidence of infection. The results of this study indicate that ATG immunosuppressive therapy is a stimulus for the synthesis of PCT. PMID:18088403

  10. 血清降钙素原在败血症早期诊断中的应用价值%The application value of serum procalcitonin in early diagnosis of sepsis

    张昌武

    2015-01-01

    目的:探讨血清降钙素原在败血症早期诊断中的应用价值. 方法:随机选取2012年11月至2014年2月就诊治疗的60例败血症患者作为观察组,并以同期的60例健康体检者作为对照组,检测并比较两组血清降钙素原水平. 结果:观察组患者的血清降钙素原水平为(4.57 ±1.32)ng/mL,对照组为(0.19 ±0.08)ng/mL,观察组患者的血清降钙素原水平高于对照组( P<0. 05). 结论:血清降钙素原水平检测对于败血症的早期诊断有很好的临床应用价值.%Objective:To explore and evaluate the application value of serum procalcitonin in early diagnosis of sepsis. Methods:60 patients with sepsis treated from November 2012 to February 2014 were randomly selected as the research objects of the observation group, and 60 patients examined healthy of the same period as the control group, with the level of serum procalcitonin detected and compared be-tween the two groups. Results:The average level of serum procalcitonin in the observation group was (4. 57 ± 1. 32) ng/mL, which was significantly higher than that of the control group (0. 19 ± 0. 08) ng/mL ( P <0. 05). Conclusion:The detection of serum procalcitonin level is of high value in clinical application for the early diagnosis of sepsis.

  11. The Clinical Application of Procalcitonin%降钙素原的临床应用

    左新; 赖晓东

    2015-01-01

    降钙素原20世纪90年代第一次在脓毒症的患者中被检测到,从此对降钙素原的研究越来越多。近年来,随着科学研究的增多,降钙素原在临床疾病诊治中的应用越来越多,降钙素原逐渐成为感染的判断以及抗生素合理应用的参考指标,同时还发现降钙素原对胰腺炎、术后感染、创伤、脑膜炎等疾病的诊治具有一定的参考价值。本文主要针对降钙素原的生化特点、临床检测及临床应用作一综述。%Procalcitonin was detected in the 1990s for the first time in the patients with sepsis,then the researches about procalcitonin were becoming more and more in recent years.With the increase of scientific research,procalcitonin has got more and more application in clinical diagnosis and treatment of diseases,the procalcitonin has become the reference index of the judgment of the infection and the reasonable use of antibiotics gradually, people also found the value of procalcitonin about diagnosis and treatment on the pancreatitis,postoperative infection,trauma,meningitis.This article mainly aims at the biochemical characteristics,clinical testing and clinical application of procalcitonin.

  12. Procalcitonin and Pentraxin-3: Current biomarkers in inflammation in white coat hypertension.

    Yavuzer, H; Cengiz, M; Yavuzer, S; Rıza Altıparmak, M; Korkmazer, B; Balci, H; Yaldıran, A L; Uzun, H

    2016-07-01

    An association has been described between inflammation and the progression of hypertension (HT) and is shown with several biochemical parameters. Our aim was to examine the distribution of the serum procalcitonin (PCT), pentraxin (PTX)-3 and interleukin (IL)-33 levels and their relationship with carotid intima-media thickness (CIMT) in subjects with white coat HT (WCH), HT and normotension (NT) groups. Thirty-three patients with HT, 33 patients with WCH and 33 healthy subjects were enrolled in this study. PCT, PTX-3 and C-reactive protein (CRP) levels significantly increased in the HT group compared with the NT group. In addition, PCT and CRP levels were significantly higher in the WCH group than in the NT group. CIMT measurements were significantly higher in the WCH and HT groups than in the NT group. In the HT and WCH groups, there were significant positive correlations between PTX-3, PCT and CRP. In the WCH group, PTX-3 and PCT levels were significantly positively correlated with CIMT. PCT had area under the curve value of 0.817 which demonstrates its sufficiency to distinguish WCH from NT individuals. Our results suggest that in subjects with WCH and HT, which are characterized by increased cardiovascular risk, PTX-3 and PCT levels in the HT group and PCT levels in the WCH group are significantly and consistently higher than normotensives. Systemic inflammation moderately occurs in the WCH and HT groups. PCT monitoring may be a useful biomarker in inflammation related to atherosclerosis and early stage HT. PMID:26040439

  13. 血清降钙素原对细菌性肺炎与肺结核鉴别的临床意义分析%Clinical significance analysis of serum procalcitonin for identification of bacterial pneumonia and ;pulmonary tuberculosis

    王雯

    2015-01-01

    Objective To explore the clinical significance of serum procalcitonin (PCT) for identifica-tion of bacterial pneumonia and pulmonary tuberculosis. Methods Serum samples of 21 patients with bacterial pneumonia (pneumonia group) and 22 patients with pulmonary tuberculosis (tuberculosis group) in the same pe-riod were collected. Their serum procalcitonin levels were detected by immumofluorescence method within 24 h after hospitalization for analysis and comparison. Results The pneumonia group had remarkably higher level of serum procalcitonin than the tuberculosis group, and the difference had statistical significance (P<0.05). Conclusion Detection of serum procalcitonin has important significance for identification of bacterial pneumonia and pulmonary tuberculosis.%目的:探讨血清降钙素原(PCT)测定对鉴别诊断细菌性肺炎与肺结核的临床意义。方法收集同期入院诊断为细菌性肺炎患者(肺炎组)21例及肺结核患者(结核组)22例的血清标本,入院24 h内采用免疫荧光法分别测定两组患者的血清降钙素原水平,进行分析比较。结果肺炎组血清降钙素原水平显著高于结核组,差异有统计学意义(P<0.05)。结论血清降钙素原测定对鉴别诊断细菌性肺炎和肺结核具有重要的临床意义。

  14. Value of procalcitonin, C-reactive protein, and neopterin in exacerbations of chronic obstructive pulmonary disease

    Alicia Lacoma

    2011-02-01

    Full Text Available Alicia Lacoma1,4, Cristina Prat1,4, Felipe Andreo2,4, Luis Lores3, Juan Ruiz-Manzano2,4, Vicente Ausina1,4, Jose Domínguez1,41Servei de Microbiologia, 2Servei de Pneumologia, Hospital Universitari Germans Trias i Pujol, Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Spain; 3Servei de Pneumologia, Hospital de Sant Boi, Sant Boi de Llobregat, Spain; 4CIBER Enfermedades Respiratorias (CIBERES, Instituto de Salud Carlos III, Madrid, SpainObjective: The identification of biological markers in order to assess different aspects of COPD is an area of growing interest. The objective of this study was to investigate whether levels of procalcitonin (PCT, C-reactive protein (CRP, and neopterin in COPD patients could be useful in identifying the etiological origin of the exacerbation and assessing its prognosis.Methods: We included 318 consecutive COPD patients: 46 in a stable phase, 217 undergoing an exacerbation, and 55 with pneumonia. A serum sample was collected from each patient at the time of being included in the study. A second sample was also collected 1 month later from 23 patients in the exacerbation group. We compared the characteristics, biomarker levels, microbiological findings, and prognosis in each patient group. PCT and CRP were measured using an immunofluorescence assay. Neopterin levels were measured using a competitive immunoassay.Results: PCT and CRP showed significant differences among the three patient groups, being higher in patients with pneumonia, followed by patients with exacerbation (P < 0.0001. For the 23 patients with paired samples, PCT and CRP levels decreased 1 month after the exacerbation episode, while neopterin increased. Neopterin showed significantly lower levels in exacerbations with isolation of pathogenic bacteria, but no differences were found for PCT and CRP. No significant differences were found when comparing biomarker levels

  15. Nanoimprinted nanopillar array chip for procalcitonin detection (Conference Presentation)

    Sun, Ling Ling; Zhou, Xiaodong

    2016-03-01

    Procalcitonin (PCT) is an early and highly specific biomarker in response to bacterial infection. The PCT-guided antibiotic therapy has demonstrated to be more efficient than standard therapy to reduce in antibiotic use without adverse outcome in mortality. The PCT detection in clinics is required to be highly sensitive with a sensitivity of 0.5 ng/ml. At present, the technologies for PCT detection are limited. This paper reported a highly sensitive nanoimprinted gold nanopillar array chip for PCT detection. To achieve high sensitivity for PCT detection, the gold nanopillar array sensing chip was designed by plasmonic simulation and fabricated by high fidelity nanoimprinting technology. The gold nanopillars of 140 nm were nanoimprinted on glass substrate. A robust sandwich bioassay of capture antibody /PCT / quantum dot (QD) conjugated detection antibody was established on the gold nanopillar array chip to detect PCT. The nanopillars serve as localized surface plasmon resonance (LSPR) generators to enhance the fluorescent emission from QD. A limit of detection (LOD) of 0.5 ng/ml was achieved for PCT detection. This is the first time that PCT is detected with such high sensitivity by LSPR enhanced QD emission. By considering the low-cost, high sensitivity of the bioassay, as well as the inexpensive mass fabrication of the high quality chips, this novel nanoimprinted gold nanopillar array chip is particularly useful for developing a point-of-care system for PCT detection.

  16. Analysis of some sepsis markers: C-reactive protein, Procalcitonin, Osteopontin and suPAR

    Ilaria Crespi

    2010-09-01

    Full Text Available Sepsis appears to be due to an uncontrolled pro and anti-inflammatory response leading to organ dysfunction until shock and death.Accuracy of diagnosis and appropriate treatment affect the outcome. Aim of the study was to investigate if the levels of Osteopontin (OPN and Soluble Urokinase-type Plasminoge Activator Receptor (suPAR might be early markers of sepsis and if these markers play a role in predicting the progression to septic shock. Methods:The levels of OPN, suPAR, C-reactive protein (CRP and procalcitonin (PCT were measured in patients at higher risk of infection. The samples were collected from the day of admission for the following fifteenth day. During recovery Sistemic Inflammatory Response Syndrome (SIRS criteria, blood chemistry data, blood gas- analysis, lactate and diuresis were collected. Microbiological culture were performed according to the clinical condition. Results: 29 patients were enrolled in the study, including 14 subjects with positive blood cultures.The values of OPN, PCT, suPAR and CRP were significantly increased in patients with positive blood cultures than those with negative blood cultures.Analysing changes of the levels of OPN, suPAR, PCT and CRP in patients with septic shock, the values of OPN increased in advance to the clinical diagnosis of septic shock, while the values of suPAR and PCT slight delay compared to those OPN.The levels of CRP were independent from the onset of septic shock state. Conclusions: These preliminary data suggest that Osteopontin and suPAR can be used as early markers of sepsis and might be useful in monitoring of septic outcome to predict a possible evolution to septic shock.

  17. Behavioral Abnormalities in a Mouse Model of Chronic Toxoplasmosis Are Associated with MAG1 Antibody Levels and Cyst Burden.

    Xiao, Jianchun; Li, Ye; Prandovszky, Emese; Kannan, Geetha; Viscidi, Raphael P; Pletnikov, Mikhail V; Yolken, Robert H

    2016-04-01

    There is marked variation in the human response to Toxoplasma gondii infection. Epidemiological studies indicate associations between strain virulence and severity of toxoplasmosis. Animal studies on the pathogenic effect of chronic infection focused on relatively avirulent strains (e.g. type II) because they can easily establish latent infections in mice, defined by the presence of bradyzoite-containing cysts. To provide insight into virulent strain-related severity of human toxoplasmosis, we established a chronic model of the virulent type I strain using outbred mice. We found that type I-exposed mice displayed variable outcomes ranging from aborted to severe infections. According to antibody profiles, we found that most of mice generated antibodies against T. gondii organism but varied greatly in the production of antibodies against matrix antigen MAG1. There was a strong correlation between MAG1 antibody level and brain cyst burden in chronically infected mice (r = 0.82, p = 0.0021). We found that mice with high MAG1 antibody level displayed lower weight, behavioral changes, altered levels of gene expression and immune activation. The most striking change in behavior we discovered was a blunted response to amphetamine-trigged locomotor activity. The extent of most changes was directly correlated with levels of MAG1 antibody. These changes were not found in mice with less cyst burden or mice that were acutely but not chronically infected. Our finding highlights the critical role of cyst burden in a range of disease severity during chronic infection, the predictive value of MAG1 antibody level to brain cyst burden and to changes in behavior or other pathology in chronically infected mice. Our finding may have important implications for understanding the heterogeneous effects of T. gondii infections in human. PMID:27124472

  18. Thymidine kinase 2 deficiency-induced mitochondrial DNA depletion causes abnormal development of adipose tissues and adipokine levels in mice.

    Joan Villarroya

    Full Text Available Mammal adipose tissues require mitochondrial activity for proper development and differentiation. The components of the mitochondrial respiratory chain/oxidative phosphorylation system (OXPHOS are encoded by both mitochondrial and nuclear genomes. The maintenance of mitochondrial DNA (mtDNA is a key element for a functional mitochondrial oxidative activity in mammalian cells. To ascertain the role of mtDNA levels in adipose tissue, we have analyzed the alterations in white (WAT and brown (BAT adipose tissues in thymidine kinase 2 (Tk2 H126N knockin mice, a model of TK2 deficiency-induced mtDNA depletion. We observed respectively severe and moderate mtDNA depletion in TK2-deficient BAT and WAT, showing both tissues moderate hypotrophy and reduced fat accumulation. Electron microscopy revealed altered mitochondrial morphology in brown but not in white adipocytes from TK2-deficient mice. Although significant reduction in mtDNA-encoded transcripts was observed both in WAT and BAT, protein levels from distinct OXPHOS complexes were significantly reduced only in TK2-deficient BAT. Accordingly, the activity of cytochrome c oxidase was significantly lowered only in BAT from TK2-deficient mice. The analysis of transcripts encoding up to fourteen components of specific adipose tissue functions revealed that, in both TK2-deficient WAT and BAT, there was a consistent reduction of thermogenesis related gene expression and a severe reduction in leptin mRNA. Reduced levels of resistin mRNA were found in BAT from TK2-deficient mice. Analysis of serum indicated a dramatic reduction in circulating levels of leptin and resistin. In summary, our present study establishes that mtDNA depletion leads to a moderate impairment in mitochondrial respiratory function, especially in BAT, causes substantial alterations in WAT and BAT development, and has a profound impact in the endocrine properties of adipose tissues.

  19. Level of cytogenetic damage and morphological abnormalities in peripheral blood erythrocytes of fish from the Techa river

    Low-level radioactive waste had been releasing to the Techa River from 1949 to 1956. Now it is a suitable water system to study the potential effect of chronic low level exposure of radiation. During that period over 76 million m3 of waste water was released into the river with total activity of 1.1 *1017 Bq. In 2012 we examined the erythrocytes in peripheral blood of fish (roach, perch, pike), inhabiting different part of the Techa River (Russia, Chelyabinsk region). Sampling was conducted twice a year (in May during spawning, and in August during feeding) at three stations with various levels of radioactive contamination: Station RT1 in the upper reach of the Techa River, station RT2 in the middle reach and station RT3 in the lower reach of the river. Determination of radionuclide concentrations in water, bottom sediments and fish was performed. An average above-background content of 90Sr in the body of fish inhabiting the Techa River is given in the table. Fish from the nearby Miass River was used as a control group. Blood was taken from the tail vein of live fish for the preparation of smears for determination of cytogenetic damage levels. 3,000 erythrocytes were analyzed for each fish on microscope Axioskop 50 (Carl Zeiss). Regression analyses found out significant dependency of the frequency of erythrocytes with micronuclei in blood on the burden of 90Sr in the body of roach in the summer period (F1,32=4.6; p=0.04). The given data do not allow excluding the genotoxic influence of radiation on fish. Another important effect is an increase in the frequency of erythrocytes with cell division pathology: with an increase of the burden of 90Sr in the body, an increase in the frequency of amitoses and the sum of division pathologies are noted in the body. Regression analyses indicated a significant dependency of these parameters on the burden of 90Sr in the body of fish (for the frequency of amitoses F1,199=6.3, p=0.01; for the frequency of pathology division

  20. Role of Procalcitonin and Interleukin-6 in Predicting Cancer, and Its Progression Independent of Infection.

    Anne-Marie Chaftari

    Full Text Available Procalcitonin (PCT and Interleukin-6 (IL-6 have emerged as biomarkers for different inflammatory conditions. The purpose of the study was to evaluate the role of PCT and IL-6 as biomarkers of cancer and its progression in a large cohort of patients. This cross-sectional study included residual plasma samples collected from cancer patients, and control subjects without cancer. Levels of PCT and IL-6 were determined by Kryptor compact bioanalyzer. We identified 575 febrile cancer patients, 410 non-febrile cancer patients, and 79 non-cancer individuals. The median PCT level was lower in control subjects (0.029 ng/ml compared to cancer patients with stage I-III disease (0.127 ng/ml (p<0.0001 and stage IV disease (0.190 ng/ml (p<0.0001. It was also higher in febrile cancer patients (0.310 ng/ml compared to non-febrile cancer patients (0.1 ng/ml (p<0.0001. Median IL-6 level was significantly lower in the control group (0 pg/ml than in non-febrile cancer patients with stages I-III (7.376 pg/ml or stage IV (9.635 pg/ml (p<0.0001. Our results suggest a potential role for PCT and IL-6 in predicting cancer in non-febrile patients. In addition, PCT is useful in detecting progression of cancer and predicting bacteremia or sepsis in febrile cancer patients.

  1. The Diagnostic Value of D-dimer, Procalcitonin and CRP in Acute Appendicitis

    Bulent Kaya, Baris Sana, Cengiz Eris, Koray Karabulut, Orhan Bat, Riza Kutanis

    2012-01-01

    Full Text Available BACKGROUND: The early diagnosis of acute abdomen is of great importance. To date, several inflammatory markers have been used for the diagnosis of acute abdominal conditions, including acute appendicitis. The aim of this study was to evaluate the diagnostic utility of D-dimer, Procalcitonin (PCT and C-reactive protein (CRP measurements in the acute appendicitis.METHODS: This prospective study was conducted between March 1st, 2010 and July 1st, 2011. In this period, seventy-eight patients were operated with the diagnosis of acute appendicitis, and D-dimer, PCT and CRP levels of the patients were measured. The patients were grouped as phlegmonous appendicitis (Group 1, gangrenous appendicitis (Group 2, perforated appendicitis (Group 3 and negative appendectomy (Group 4 according to the surgical findings and histopathological results.RESULTS: Of 78 patients, 54 (69.2 % were male and 24 (30.8 % were female, and the mean age was 25.4 ± 11.1 years (range, 18 to 69 years. 66 (84.6 % patients had increased leukocyte count (white blood cell count. The PCT values were higher than the upper normal limit in 20 (25.6% patients, followed by D-dimer in 22 (28.2 % patients and CRP in 54 (69.2 % patients. The diagnostic value of leukocyte count and CRP in acute appendicitis was higher than that of the other markers, whereas leukocyte count showed very low specificity. CRP values were higher in perforated appendicitis when compared with the phlegmonous appendicitis (p<0.05. However, PCT and D-dimer showed lower diagnostic values (26% and 31%, respectively.CONCLUSION: An increase in CRP levels alone is not sufficient to make the diagnosis of acute appendicitis. However, CRP levels may differentiate between phlegmonous appendicitis and perforated appendicitis. Due to their low sensitivity and diagnostic value, PCT and D-dimer are not better markers than CRP for the diagnosis of acute appendicitis.

  2. Hepatic ischemia-reperfusion syndrome after partial liver resection (LR): hepatic venous oxygen saturation, enzyme pattern, reduced and oxidized glutathione, procalcitonin and interleukin-6.

    Kretzschmar, Michael; Krüger, Antie; Schirrmeister, Wulf

    2003-06-01

    The hepatic ischemia-reperfusion syndrome was investigated in 28 patients undergoing elective partial liver resection with intraoperative occlusion of hepatic inflow (Pringle maneuver) using the technique of liver vein catheterization. Hepatic venous oxygen saturation (ShvO2) was monitored continuously up to 24 hours after surgery. Aspartate aminotransferase, glutamate dehydrogenase, gamma-glutamyl transpeptidase, pseudocholinesterase, alpha-glutathione S-transferase, reduced and oxidized glutathione, procalcitonine, and interleukin-6 were serially measured both before and after Pringle maneuver during the resection and postoperatively in arterial and/or hepatic venous blood. ShvO2 measurement demonstrated that peri- and postoperative management was suitable to maintain an optimal hepatic oxygen supply. As expected, we were able to demonstrate a typical enzyme pattern of postischemic liver injury. There was a distinct decrease of reduced glutathione levels both in arterial and hepatic venous plasma after LR accompanied by a strong increase in oxidized glutathione concentration during the phase of reperfusion. We observed increases in procalcitonin and interleukin-6 levels both in arterial and hepatic venous blood after declamping. Our data support the view that liver resection in man under conditions of inflow occlusion resulted in ischemic lesion of the liver (loss of glutathione synthesizing capacity with disturbance of protection against oxidative stress) and an additional impairment during reperfusion (liberation of reactive oxygen species, local and systemic inflammation reaction with cytokine production). Additionally, we found some evidence for the assumption that the liver has an export function for reduced glutathione into plasma in man. PMID:12877355

  3. Level of cytogenetic damage and morphological abnormalities in peripheral blood erythrocytes of fish from the Techa river

    Tryapitsina, G. [Urals Research Center for Radiation Medicine - URCRM, Chelyabinsk State University (Russian Federation); Shaposhnikova, I. [Urals Research Center for Radiation Medicine - URCRM (Russian Federation); Rudolfsen, G. [Norwegian Radiation Protection Authority - NRPA, and University of Tromsoe (Norway); Obvintseva, N.; Pryakhin, E. [Urals Research Center for Radiation Medicine (Russian Federation); Akleyev, A. [Urals Research Center for Radiation Medicine and Chelyabinsk State University (Russian Federation)

    2014-07-01

    Low-level radioactive waste had been releasing to the Techa River from 1949 to 1956. Now it is a suitable water system to study the potential effect of chronic low level exposure of radiation. During that period over 76 million m{sup 3} of waste water was released into the river with total activity of 1.1 *10{sup 17} Bq. In 2012 we examined the erythrocytes in peripheral blood of fish (roach, perch, pike), inhabiting different part of the Techa River (Russia, Chelyabinsk region). Sampling was conducted twice a year (in May during spawning, and in August during feeding) at three stations with various levels of radioactive contamination: Station RT1 in the upper reach of the Techa River, station RT2 in the middle reach and station RT3 in the lower reach of the river. Determination of radionuclide concentrations in water, bottom sediments and fish was performed. An average above-background content of {sup 90}Sr in the body of fish inhabiting the Techa River is given in the table. Fish from the nearby Miass River was used as a control group. Blood was taken from the tail vein of live fish for the preparation of smears for determination of cytogenetic damage levels. 3,000 erythrocytes were analyzed for each fish on microscope Axioskop 50 (Carl Zeiss). Regression analyses found out significant dependency of the frequency of erythrocytes with micronuclei in blood on the burden of {sup 90}Sr in the body of roach in the summer period (F{sub 1,32}=4.6; p=0.04). The given data do not allow excluding the genotoxic influence of radiation on fish. Another important effect is an increase in the frequency of erythrocytes with cell division pathology: with an increase of the burden of {sup 90}Sr in the body, an increase in the frequency of amitoses and the sum of division pathologies are noted in the body. Regression analyses indicated a significant dependency of these parameters on the burden of {sup 90}Sr in the body of fish (for the frequency of amitoses F{sub 1,199}=6.3, p=0

  4. 腹水及血浆降钙素原在肝硬化合并自发性细菌性腹膜炎诊断中的价值%Values of ascites and plasma procalcitonin in diagnosis of liver cirrhosis with spontaneous bacterial peritonitis

    党燕; 张立丽; 娄金丽; 陈铭

    2015-01-01

    Objective To explore the clinical value of ascites and plasma procalcitonin examination in early diagnosis of liver cirrhosis with spontaneous bacterial peritonitis( SBP) . Methods Totally 69 cirrhotic patients with ascites including 28 patients with spontaneous bacterial peritonitis and 41 patients without spontaneous bacterial peritonitis seen in Beijing Youan Hospital from August, 2014 to January, 2015 were studied. The levels of ascites and plasma procalcitonin of these patients were analyzed. Results The levels of procalcitonin, white blood cell counts in plasma and procalcitonin, white blood cell, polymorphonuclear leucocytes counts in ascites in SBP group were significantly higher than those in the non-SBP group(P<0. 01). The procalcitonin levels in ascites and plasma were positively correlated(r=0. 877, P<0. 01). ROC curve analysis showed that the areas under curve of ascites and plasma procalcitonin were 0. 919 and 0. 820;meanwhile the best thresholds were 0. 415 and 0. 746 ng/mL respectively. Conclusion Detections of ascites and plasma procalcitonin have significant value for the early diagnosis of liver cirrhosis patients with spontaneous bacterial peritonitis, it has high sensitivity and specificity, and the diagnostic value of plasma procalcitonin is superior to ascites procalcitonin.%目的:探讨腹水及血浆降钙素原在肝硬化合并自发性细菌性腹膜炎( spontaneous bacterial peritonitis,SBP)诊断中的价值,为其早期诊断提供依据。方法选取首都医科大学附属北京佑安医院2014年8月至2015年1月肝硬化腹水患者69例,其中确诊合并自发性细菌性腹膜炎的28例,未合并自发性细菌性腹膜炎的41例,进行腹水及血浆降钙素原水平检测,并进行相关统计分析。结果与非SBP组相比,SBP组腹水降钙素原( procalcitonin,PCT)、腹水白细胞( white blood cell,WBC)、腹水多形核细胞(polymorphonuclear,PMN)和血浆PCT、全血WBC检测结果均显著升

  5. Pro/Con debate: Is procalcitonin useful for guiding antibiotic decision making in critically ill patients?

    Shehabi, Yahya; Seppelt, Ian

    2008-01-01

    You are concerned about the escalating use of antibiotics in your intensive care unit (ICU). This has put a strain on the ICU budget and is possibly resulting in the emergence of resistant bacteria. You review the situation with your team and one suggestion is to consider using biomarkers such as procalcitonin to better guide appropriate antibiotic decision making. PMID:18466649

  6. Guiding of serum procalcitonin-guided antibiotic in elderly early-onset stroke-associated pneumonia

    龙威

    2013-01-01

    Objective To evaluate the effects of serum procalcitonin (PCT) -guided antibiotic therapy in elderly patients with early-onset stroke-associated pneumonia (EOP) .Methods Totally 179 eligible elderly patients with EOP were randomly devided into 2 groups:standard therapy

  7. Procalcitonin and C-reactive protein as markers of bacterial infection in patients with solid tumours

    Diness, Laura V; Maraldo, Maja V; Mortensen, Christiane E;

    2014-01-01

    infection. In this prospective study, we wanted to investigate the value of procalcitonin (PCT) compared with C-reactive protein (CRP) as an indicator of bacterial infection in adult patients with solid tumours. METHODS: A total of 41 patients with solid tumours admitted to hospital due to fever or clinical...

  8. Additional value of procalcitonin for diagnosis of infection in patients with fever at the emergency department

    M.D. de Kruif; M. Limper; H. Gerritsen; C.A. Spek; D.P.M. Brandjes; H. ten Cate; P.M. Bossuyt; P.H. Reitsma; E.C.M. van Gorp

    2010-01-01

    Objective: First, to determine whether procalcitonin (PCT) significanty adds diagnostic value in terms of sensitivity and specificity to a common set of markers of infection, including C-reactive protein (CRP), at the Emergency Department. Second, to create a simple scoring rule implementing PCT val

  9. Procalcitonin behaves as a fast responding acute phase protein in vivo and in vitro

    Nijsten, MWN; Olinga, P; The, TH; de Vries, EGE; Groothuis, GMM; Limburg, PC; ten Duis, HJ; Moshage, H; Hoekstra, HJ; Bijzet, J; Zwaveling, JH; Schraffordt Koops, H.

    2000-01-01

    Objectives: Procalcitonin (PCT) is a 13 kD protein of which plasma concentrations are strongly increased in inflammatory states, PCT concentrations are claimed to have a more powerful discriminatory value for bacterial infection than the acute phase proteins serum amyloid A (SAA) or C-reactive prote

  10. The correlation study of procalcitonin and C- reactive protein with children's bloodstream infections%降钙素原、C-反应蛋白与儿童血流感染的相关性研究

    余烈中; 彭伟媛; 何静文; 赖挺方

    2016-01-01

    Objective To study the correlation of procalcitonin with children's bloodstream infections. Methods 300 cases of suspected bloodstream infections children in author hospital were selected,where simultaneous blood cultures and procalcitonin detected as research subjects.Comparison of two groups of children of serum procalcitonin levels,C- reactive protein levels,serum procalcitonin levels Gram bacteria cases between yin and yang. Results Children with blood culture-negative serum procalcitonin group,C- reactive protein and blood mean level culture positive infants compared, they had significant differences(P 0.05). Conclusion The serum procalcitonin level cloud be used as an early auxiliary diagnosis in bacterial infection, which may be conducive to implement antibiotic therapy.Meanwhile,the serum procalcitonin level cloud provide evidence for antibiotic therapy to avoid abuse of antibiotics.%目的:分析血清降钙素原与儿童血流感染之间的相关性。方法选择笔者所在医院同时进行血培养和降钙素原检测的300例疑似血流感染患儿为研究对象。比较两组患儿的血清降钙素原水平、C-反应蛋白水平及革兰阴阳菌病例间的血清降钙素原水平。结果血培养阴性组患儿的血清降钙素原、C-反应蛋白的均值水平与血培养阳性组患儿相比,差异有统计学意义(P<0.05)。革兰阳性菌49株(74.24%),革兰阴性菌17株(25.76%);革兰阳性菌组患者血清降钙素原均值水平显著低于格兰阴性菌组。两组菌株、血清降钙素原水平比较差异有统计学意义(P<0.05);C-反应蛋白比较差异不显著,差异无统计学意义(P>0.05)。结论血清血降钙素原水平可作为临床早期诊断细菌感染的辅助指标,从而及时有效地实施抗菌药物治疗。同时,血清降钙素原水平还可为抗菌药物应用提供有效的参照标准,对避免抗菌药物滥用具有重要的现实意义。

  11. Procalcitonin versus C-reactive protein for predicting pneumonia in adults with lower respiratory tract infection in primary care

    Holm, Anette; Pedersen, Svend S; Nexoe, Joergen;

    2007-01-01

    BACKGROUND: The role of procalcitonin in diagnosing bacterial infection has mainly been studied in patients with severe infections. There is no study on the value of procalcitonin measurements in adults with lower respiratory tract infection (LRTI) treated in primary care. AIM: To evaluate the...... accuracy of plasma procalcitonin in predicting radiographic pneumonia, bacterial infection, and adverse outcome in a population of adults with LRTI treated in primary care. DESIGN OF STUDY: Prospective, observational study. SETTING: Forty-two general practices and an outpatient clinic at the Department of...... Infectious Diseases, Odense University Hospital, Denmark. METHOD: A total of 364 patients with LRTI were prospectively enrolled from 42 general practices. Patients were examined with chest radiography, microbiological analyses, and measurements of C-reactive protein (CRP) and procalcitonin. The outcome...

  12. Procalcitonin-guided antibiotic treatment of respiratory tract infections in a primary care setting: are we there yet?

    Aabenhus, R.; Jensen, J.U.

    2011-01-01

    , could greatly improve patient care and limit excessive antibiotic prescriptions. Procalcitonin is a new marker of suspected bacterial infection that has shown promise in guiding antibiotic therapy in acute respiratory tract infections in hospitals without compromising patient safety. Procalcitonin......-of-care test for procalcitonin with acceptable precision, severely hampering its application in primary care. This article reviews the physiology of procalcitonin, describes the assays available for its measurement, evaluates the present evidence from primary care on its use to identify correctly patients who......Clinical signs of infection do not allow for correct identification of bacterial and viral aetiology in acute respiratory infections. A valid tool to assist the clinician in identifying patients who will benefit from antibiotic therapy, as well as patients with a potentially serious infection...

  13. Clinical Applications of Procalcitonin in Pediatrics: An Advanced Biomarker for Inflammation and Infection—Can It Also Be Used in Trauma?

    Koutroulis, Ioannis; Loscalzo, Steven M.; Kratimenos, Panagiotis; Singh, Sabina; Weiner, Evan; Syriopoulou, Vassiliki; Theocharis, Stamatios; Chrousos, Georgios

    2014-01-01

    Background. Procalcitonin is a small molecular peptide that has gained increased support as an adjunct diagnostic marker of infection in the adult population; the concordant body of evidence for the use of procalcitonin in pediatric populations is far less complete. Objectives. Our objective is to review the current evidence supporting the utilization of procalcitonin in children in a variety of clinical scenarios including SIRS, sepsis, burns, and trauma and to identify existing knowledge ga...

  14. Correlation between Procalcitonin and the Degree of Atherosclerotic Lesions%降钙素原与冠状动脉粥样硬化病变程度相关性分析

    莫艳霞; 万翔

    2015-01-01

    目的:探讨降钙素原与冠状动脉粥样硬化( CAS)病变程度间的相关性。方法选择2012年1月至2014年1月仙桃市第一人民医院心血管内科收治的CAS患者100例为病例组,均行临床冠状动脉造影检查,并选择同期疑似CAS且经冠状动脉造影检查正常者100例为对照组,两组患者均在冠状动脉造影检查同时抽取静脉血进行降钙素原和高敏 C 反应蛋白(hs-CRP)水平检测;根据冠状动脉造影结果对病例进行分级,比较各疾病亚组之间的降钙素原和 hs-CRP水平。结果与对照组比较,病例组降钙素原 hs-CRP 水平均显著升高[(360±69)μg/L 比(50±10)μg/L,(45.59±11.25) mg/L比(1.33±0.11) mg/L,P<0.05]。随着CAS的加重,降钙素原逐渐升高;各疾病亚组间比较差异有统计学意义( P<0.05)。结论降钙素原可作为 CAS分级较理想的指标,与 hs-CRP联合诊断,有更高的临床应用价值。%Objective To investigate the relationship between procalcitonin and atherosclerotic lesions . Methods A total of 100 cases with coronary heart disease in Xiantao First People′s Hospital from Jan.2012 to Jan.2014 were chosen as the experimental group, and 100 cases with suspected coronary heart disease but normal coronary angiography, were chosen as control group.The serum procalcitonin and high sensitivity C reactive protein( hs-CRP) level were detected.According to coronary angiography result, the patients were graded into different levels( subgroups) ,and the procalcitonin and hs-CRP level of different subgroups were compared.Results The serum procalcitonin and hs-CRP level of the observation group were significantly higher than those in the control group[(360 ±69)μg/L vs (50 ±10) μg/L,(45.59 ±11.25) mg/L vs (1.33 ±0.11) mg/L,P<0.05].The procalcitonin and hs-CRP level increased with the severity of CAS (P<0.05).And the differences between the different

  15. Diagnostic accuracy of procalcitonin in critically ill immunocompromised patients

    Legriel Stéphane

    2011-08-01

    Full Text Available Abstract Background Recognizing infection is crucial in immunocompromised patients with organ dysfunction. Our objective was to assess the diagnostic accuracy of procalcitonin (PCT in critically ill immunocompromised patients. Methods This prospective, observational study included patients with suspected sepsis. Patients were classified into one of three diagnostic groups: no infection, bacterial sepsis, and nonbacterial sepsis. Results We included 119 patients with a median age of 54 years (interquartile range [IQR], 42-68 years. The general severity (SAPSII and organ dysfunction (LOD scores on day 1 were 45 (35-62.7 and 4 (2-6, respectively, and overall hospital mortality was 32.8%. Causes of immunodepression were hematological disorders (64 patients, 53.8%, HIV infection (31 patients, 26%, and solid cancers (26 patients, 21.8%. Bacterial sepsis was diagnosed in 58 patients and nonbacterial infections in nine patients (7.6%; 52 patients (43.7% had no infection. PCT concentrations on the first ICU day were higher in the group with bacterial sepsis (4.42 [1.60-22.14] vs. 0.26 [0.09-1.26] ng/ml in patients without bacterial infection, P 0.5 ng/ml had 100% sensitivity but only 63% specificity for diagnosing bacterial sepsis. The area under the receiver operating characteristic (ROC curve was 0.851 (0.78-0.92. In multivariate analyses, PCT concentrations > 0.5 ng/ml on day 1 independently predicted bacterial sepsis (odds ratio, 8.6; 95% confidence interval, 2.53-29.3; P = 0.0006. PCT concentrations were not significantly correlated with hospital mortality. Conclusion Despite limited specificity in critically ill immunocompromised patients, PCT concentrations may help to rule out bacterial infection.

  16. Useulness of B Natriuretic Peptides and Procalcitonin in Emergency Medicine

    P. Ray

    2008-01-01

    Full Text Available Congestive heart failure (CHF is the main cause of acute dyspnea in patients presented to an emergency department (ED, and it is associated with high morbidity and mortality. B-type natriuretic peptide (BNP is a polypeptide, released by ventricular myocytes directly proportional to wall tension, for lowering renin-angiotensin-aldosterone activation. For diagnosing CHF, both BNP and the biologically inactive NT-proBNP have similar accuracy. Threshold values are higher in elderly population, and in patients with renal dysfunction. They might have also a prognostic value. Studies demonstrated that the use of BNP or NT-proBNP in dyspneic patients early in the ED reduced the time to discharge, total treatment cost. BNP and NT-proBNP should be available in every ED 24 hours a day, because literature strongly suggests the beneficial impact of an early appropriate diagnosis and treatment in dyspneic patients. Etiologic diagnosis of febrile patients who present to an ED is complex and sometimes difficult. However, new evidence showed that there are interventions (including early appropriate antibiotics, which could reduce mortality rate in patients with sepsis. For diagnosing sepsis, procalcitonin (PCT is more accurate than C-reactive protein. Thus, because of its excellent specificity and positive predictive value, an elevated PCT concentration (higher than 0.5 ng/mL indicates ongoing and potentially severe systemic infection, which needs early antibiotics (e.g. meningitis. In lower respiratory tract infections, CAP or COPD exacerbation, PCT guidance reduced total antibiotic exposure and/or antibiotic treatment duration.

  17. The clinical application of procalcitonin in diagnosis of pneuminia in children%降钙素原在小儿肺炎诊断中的应用

    蔡美珠; 何凤琼; 曹永东

    2008-01-01

    Objective To analyze the serum level of procalcitonin (PCT) in children with bacte-rial or viral pneumonia, explore its diagnostic value in diagnosis of bacterial pneuminia in children, and so as to provide evidence for clinical use of antibiotics. Methods A total of 42 children with pneumonia(mean age was 5.6 yrs, including 24 boys and 18 girls) were divided into viral neumonia group (n=25) and bacterial neumonia group (n=17). Semi-quantitative solid-phase immunoassay was applied to measuring serum procalcitonin. There were four PCT grades:/0.5 ng/mL、≥2 ng/mL和≥10 ng/mL4个等级,进行x2检验.结果 细菌性肺炎组患儿血清PCT水平高于病毒性肺炎组,差异有显著性意义(P<0.01).结论 血清PCT是小儿细菌性肺炎的敏感标志物之一,血清PCT检测有助于小儿肺炎的诊断及鉴别诊断,可作为临床抗生素的使用依据.

  18. Procalcitonin: A New Biomarker for Medullary Thyroid Cancer? A Systematic Review.

    Karagiannis, Apostolos K A; Girio-Fragkoulakis, Constantine; Nakouti, Theodora

    2016-08-01

    Medullary thyroid cancer (MTC) is a rare but aggressive thyroid malignancy. The gold-standard biomarker for its diagnosis and follow-up is calcitonin (CT); however, it has a variable half-life dependent on its circadian variability. It has been suggested that a more stable hormone, procalcitonin (PCT), may overcome these problems and its introduction to routine practice may give more accurate results in the diagnosis and follow-up of MTC. We systematically reviewed Pubmed, Scopus, Biosis Previews and Embase databases up to March 2016. A total of 15 out of 184 articles were retrieved and analyzed. Of these 15 studies, 3 were case reports. In these 15 studies, the values of CT and PCT were assessed in both patients with MTC and patients that were either healthy volunteers or with benign/malignant thyroid nodular disease or with bacterial infection. Our search suggests that PCT seems to be a useful biomarker for the diagnosis and follow-up of MTC when used in conjunction with CT, particularly in a small proportion of tumors that are CT-negative or secrete low levels of CT. So far, there has not been enough data to suggest a specific threshold for normal PCT. However, most studies indicate a value of 0.1 ng/ml as an acceptable cut-off in everyday clinical practice. At present, CT should continue to be the primary biomarker in MTC with the addition of PCT in some patient groups. Nevertheless, larger patient series need to be conducted in order to provide safer and more accurate results. PMID:27466480

  19. PROCALCITONIN AS A BIOMARKER OF BACTERIAL INFECTION IN SICKLE CELL VASO-OCCLUSIVE CRISIS.

    Dilip Kumar Patel

    2014-02-01

    Full Text Available Bacterial infection is an important trigger of vaso-occlusive crisis (VOC in sickle cell anaemia (SCA. SCA Patients with VOC have signs of inflammation and it is difficult to diagnose bacterial infection in them. This study was undertaken to evaluate serum procalcitonin (PCT as a biomarker of bacterial infection in acute sickle cell vaso-occlusive crisis. Hundred SCA patients were studied at Sickle Cell Clinic and Molecular Biology Laboratory, V.S.S. Medical College, Burla, Odisha, India. SCA was diagnosed by haemoglobin electrophoresis, HPLC and molecular analysis. Patients were divided into 3categories namely Category-A (VOC/ACS with fever but without evidence of bacterial infection-66 patients; Category-B (VOC with fever and documentedbacterial infection-24 patients; and Category-C (Patients in steady statewithout VOC/ACS or fever-10 patients. Investigations like complete blood count, C-reactive protein estimation and PCT measurement was done in all the cases. There was no significant difference in total leucocytes count and C-reactiveprotein values between category A and B. In category A the PCT level was 0.5ng/mL with 87.5% of cases having >2ng/mL. In category C, PCT value was 2ng/mL is indicative of bacterial infection necessitating antimicrobial therapy. Patients with indeterminate PCT value of0.5-2ng/mL, need a repeat PCT estimation or an empirical antibiotic therapyawaiting the availability of microbiological report as deemed necessary.

  20. Test of Serum Procalcitonin Applied to Neonatal Infectious Diseases%降钙素原检测在新生儿感染性疾病中的应用

    杨继英

    2015-01-01

    Objective To investigate the value of serum procalcitonin (PCT) applied to neonatal infectious diseases. Methods 288 neonates hospitalized in Department of Pediatrics of our hospital from December 2013 to December 2014 were divided into severe infection group (64 cases), general infection group (132 cases), non-infected group (92 cases). Electrochemical luminescence method was used to test the level of serum PCT in the neonates. Results Of the 132 cases in the general infection group, 46 cases had positive procalcitonin with the positive rate of 34.85%, 86 cases had negative procalcitonin. Of the 64 cases in the severe in-fection group, 40 cases had positive procalcitonin with the positive rate of 62.5%, 24 cases had negative procalcitonin. Of the 92 cases in the non-infected group, 9 cases had positive procalcitonin with the positive rate of 9.78%, 83 cases had negative procal-citonin. The severe infection group had the highest positive rate of PCT, followed by the general infection group, and the non-in-fected group had the lowest positive rate of PCT with statistically significant difference (P<0.05). The level of PCT in all the neonates decreased as the disease improved with statistically significant difference (P<0.05). Conclusion ①The infection of the neonates and bacterial infection can be effectively identified by testing the level of serum PCT in 288 neonates. ②Many reasons including bacterial infection can cause neonatal pneumonia. PCT testing can be used as the identification index of neonatal infec-tious pneumonia, which provides a theoretical basis for the clinical rational use of antibiotics.%目的 探讨血清降钙素原(PCT)在新生儿感染性疾病应用价值. 方法 将该院儿科2013年12月—2014年12月收治的288例住院新生儿分别归入重症感染组(64例)、一般感染组(132例)、非感染组(92例),采用电化学发光法检测患儿血清降钙素原(PCT)水平变化.结果 一般感染组132例,降钙素原阳性46

  1. The Association between N-terminal Pro-Brain Natriuretic Peptide Levels in the Umbilical Vein and Amniotic Fluid Volume Abnormalities.

    Ersoy, Ali Ozgur; Ozler, Sibel; Oztas, Efser; Ersoy, Ebru; Ergin, Merve; Erkaya, Salim; Uygur, Dilek

    2016-04-01

    Purpose The amniotic fluid volume (AFV) is known as a predictor for the wellness of a fetus. We aimed to investigate whether N-terminal pro-brain natriuretic peptide (NTproBNP) levels reflect AFV abnormalities in otherwise normal fetuses. Methods We recruited 24 women with isolated oligohydramnios, 23 women with isolated polyhydramnios, and 36 women with normal AFV at a tertiary referral center. NT-proBNP levels in umbilical venous samples and the individual characteristics of the three groups were compared. One-way ANOVA and Kruskal-Wallis analysis of variance were used for multi-group comparisons of continuous variables. When a significant difference was detected, the Scheffe test was performed as a post-hoc analysis. Proportions were compared using the Chi-square (χ2) test. Results Maternal age, body mass indices, weight gained in pregnancy and NT-proBNP levels were similar among the three groups. Apgar scores at 1 and 5 minutes significantly correlated with NT-proBNP levels in all newborns (Spearman's r = 0.23; p = 0.03 and Spearman's r = 0.24; p = 0.02, respectively). The umbilical venous NT-proBNP levels did not differ between newborns who needed mechanical ventilation and those who didn't (p = 0.595). Conclusions NT-proBNP is a biomolecule that may provide insights into the pathogenesis of fetal circulatory problems and subsequent renal failure. Further investigations are warranted. PMID:27096950

  2. Using the Procalcitonin and C-reactive Protein in the Diagnosis of Infectious Diseases%血清降钙素原与C反应蛋白对感染性疾病的诊断价值

    苏巧云; 杨凤啸

    2013-01-01

    目的:探讨血清降钙素原(PCT)与c反应蛋白(CRP)对感染性疾病的诊断价值.方法:回顾性分析我院2012年1月至2012年8月间102例确诊为感染性疾病的患者的临床资料,探讨164例患者血清降钙素原及C反应蛋白的水平及其与感染性疾病之间的联系.以上病例均经我院实验室病原学检查及血清学检查等临床实验确诊.结果:血清降钙素原和C反应蛋白与感染的严重程度相关,感染源及疾病程度不同时,血清降钙素原及C反应蛋白水平不同.细菌性感染组与正常对照组的降钙素原相比差异有统计学意义(P<0.05);细菌感染组与病毒感染组降钙素原相比较时,差异有统计学意义(P<0.05);病毒感染组与正常对照组降钙素原比较无统计学差异(P>0.05).三组之间的C反应蛋白相比,均有统计学差异(P<0.05).结论:利用血清降钙素原和C反应蛋白的检测对临床感染进行诊断,可以提高感染性疾病诊断的准确率,且可根据实验结果判断感染性疾病的严重程度,值得临床推广.%Objective:To investigate the serum procalcitonin (PCT) and C-reactive protein (CRP) in the diagnosis of infectious diseases.Method:A retrospective analysis was designed to explore the relationship of procalcitonin and C-reactive protein levels and Infectious disease.All the cases were confirmed by clinical trials of pathogenic examination in our hospital clinical laboratory.Result:The level of procalcitonin and C-reactive protein in serum is related to the severity of the infection disease.The concentration of procalcitonin between bacterial infection group and normal control group was different statistically significant (P <0.05) ; the concentration of procalcitonin in the bacterial infection group compared to the original with the viral infection group,the difference was statistically significant (P <0.05) ; the concentration of procalcitonin in the infection group and normal control group

  3. Research of the clinical application of serum procalcitonin test for sepsis%某市临床医生对降钙素原在脓毒症中临床应用的研究∗

    刘慧恒; 张民伟; 叶剑鸿; 李娟; 陈美君; 刘晓楣; 郭久冰

    2015-01-01

    Objective To evaluate the clinical application of serum procalcitonin test for diagnosis of sepsis in Xiamen,aimed at observing the application level for serum procalcitonin by different professional clinicians.Methods Retrospectively analyzed the data from 552 specimens collected at three integrated teaching hospitals in Xiamen from July 2012 to October 2013.Patients of sep-sis with positive culture blood were enrolled in the study.All specimens were divided into four groups according to specimen sources,including ICU group,non-ICU group,medicine systems group and surgery systems group.The blood submission rates for procalcitonin detection by different professional clinicians were compared.Results As compared with the non-ICU group,the ICU group had higher submission rate for procalcitonin detection(P < 0.05 ).Medicine systems group had higher submission rate for procalcitonin detection than surgery systems group(P <0.05).Conclusion There is significant difference between professional cli-nicians in procalcitonin application.Surgery clinicians are poor in accepting procalcitonin for diagnosis of sepsis in Xiamen.%目的:通过对552例次血培养阳性标本及病例资料的回顾性研究,观察不同专业临床医生对血样降钙素原(PCT)送检率的差异,评价不同专业临床医师对 PCT 临床应用的认知程度。方法选取厦门市3家教学医院,对2012年7月至2013年10月临床及血培养确诊为脓毒症的患者资料进行回顾性分析,按照血样科室来源分为重症监护室(ICU)组、非 ICU 组,内科组和外科组,比较不同组别间血样 PCT 送检率。结果ICU 组医师的血样 PCT 送检率明显高于非 ICU 组(P <0.05),内科组对脓毒症患者血样 PCT 的送检率明显高于外科组(P <0.05),但仍明显低于 ICU 组的血样 PCT 送检率(P <0.05)。结论厦门市不同专业临床医生在诊断脓毒症时的血样 PCT 送检率存在明显差别,ICU 医生送检率最高,其次是内

  4. Use of procalcitonin and C-reactive protein to evaluate vaccine efficacy against pneumonia.

    Shabir A Madhi

    2005-02-01

    Full Text Available BACKGROUND: Pneumonia remains the leading cause of death in young children. The poor specificity of chest radiographs (CXRs to diagnose pneumococcal pneumonia may underestimate the efficacy of pneumococcal conjugate vaccine in preventing pneumococcal pneumonia. METHODS AND FINDINGS: The efficacy of nine-valent pneumococcal conjugate vaccine among children not infected with HIV (21%; 95% confidence interval, 1%-37% increased when CXR-confirmed pneumonia was associated with serum C-reactive protein of 120 mg/l (12 mg/dl or more and procalcitonin of 5.0 ng/ml or more (64%; 95% confidence interval, 23%-83%. Similar results were observed in children infected with HIV. CONCLUSION: C-reactive protein and procalcitonin improve the specificity of CXR to diagnose pneumococcal pneumonia and may be useful for the future evaluation of the effectiveness of pneumococcal conjugate vaccine in preventing pneumococcal pneumonia.

  5. The effect of non-infectious diseases on serum procalcitonin concentrations in premature neonates%非感染因素对早产新生儿血清降钙素原浓度的影响

    吴志新; 郭婕; 许靖; 武荣; 花少栋; 封志纯

    2015-01-01

    Objective To study the effect of non-infectious factors on serum procalcitonin(PCT) in preterm neonates.MethodThe premature infants of neonatal intensive care unit(NICU) in our hospital were chosen from gestational age ranged from 33 to 36 weeks, birth time less than 12 hours without premature rupture and hospitalization period from January 2012 to December 2012. All of the premature infants were drawn blood immediately admitted to hospital and C-reactive protein (CRP), blood cultures and procalcitonin were tested. The types of premature infants non-infectious diseases included intracranial hemorrhage (ICH), neonatal respiratory distress syndrome (NRDS), neonatal asphyxia and the control group (preterm infants) without disease. The blood routine , C-reactive protein, blood culture, procalcitonin and other infections indicators in each group were monitored dynamicly in order to study the impact of these non-infectious diseases on serum procalcitonin concentrations by statistical analysis.Results ① Compared with the current literature recommended serum procalcitonin concentrations (<0.5ng / ml), procalcitonin concentrations in preterm neonates singniifcantly increase (1.07± 0.76) ng / ml.②Compared with control group (1.07±0.76) ng/ml,the procalcitonin levels in intracranial hemorrhage group (2.12± 0.99) ng/ml, neonatal respiratory distress syndrome group (2.28±1.09) ng/ml and asphyxia group (3.64± 3.17) ng / ml signiifcantly increased (F= 10.462,P <0.05).There were no signiifcant differences (F= 0.173,P= 0.950) among the different levels of intracranial hemorrhage group; Compared with the ifrst grade NRDS , the procalcitonin leves in second grade and third grade NRDS groups were significantly increased (F=5.475,P= 0.010); The procalciton level in severe asphyxia group was signiifcantly higher than in mild asphyxia group (t= 5.245,P= 0.003). Conclusions The procalcitonin concentration physiologically increased after preterm neonates were born. Many factors

  6. Procalcitonin and C-reactive protein during systemic inflammatory response syndrome, sepsis and organ dysfunction

    Castelli, Gian Paolo; Pognani, Claudio; Meisner, Michael; Stuani, Antonio; Bellomi, Daniela; Sgarbi, Laura

    2004-01-01

    Introduction Both C-reactive protein (CRP) and procalcitonin (PCT) are accepted sepsis markers. However, there is still some debate concerning the correlation between their serum concentrations and sepsis severity. We hypothesised that PCT and CRP concentrations are different in patients with infection or with no infection at a similar severity of organ dysfunction or of systemic inflammatory response. Patients and methods One hundred and fifty adult intensive care unit patients were observed...

  7. Diagnostic value of procalcitonin, CRP, leukocytes and BAL neutrophils for pulmonary complications in the immunocompromised host

    Daiana Stolz

    2006-12-01

    Full Text Available We evaluated the diagnostic accuracy of laboratory biomarkers and BAL differential cell count for the diagnosis of bacterial infection in severe immunosuppressed patients. One-hundred and seven consecutive patients undergoing bronchoscopy for suspected pulmonary infection were included in this study. Assessment included history, clinical examination, chest image studies, CRP, procalcitonin (ProCT, leukocyte counts, and BAL results. Patients were classified as having proven, possible, and non-bacterial infection.

  8. Procalcitonin as a biomarker of bacterial infection in pediatric patients after congenital heart surgery

    Chakravarti, Sujata B; Diane A Reformina; Lee, Timothy M; Malhotra, Sunil P; Mosca, Ralph S; Puneet Bhatla

    2016-01-01

    Background: Bacterial infection (BI) after congenital heart surgery (CHS) is associated with increased morbidity and is difficult to differentiate from systemic inflammatory response syndrome caused by cardiopulmonary bypass (CPB). Procalcitonin (PCT) has emerged as a reliable biomarker of BI in various populations. Aim: To determine the optimal PCT threshold to identify BI among children suspected of having infection following CPB. Setting and Design: Single-center retrospective observationa...

  9. Diagnostic value of lipopolysaccharide-binding protein and procalcitonin for sepsis diagnosis in forensic pathology

    Augsburger, Marc; Iglesias, Katia; Bardy, Daniel; Mangin, Patrice; Palmiere, Cristian

    2016-01-01

    The aims of this study were twofold. The first was to investigate the diagnostic performance of two biochemical markers, procalcitonin (PCT) and lipopolysaccharide-binding protein (LBP), considering each individually and then combined, for the postmortem diagnosis of sepsis. We also tested the usefulness of pericardial fluid for postmortem LBP determination. Two study groups were formed, a sepsis-related fatalities group of 12 cases and a control group of 30 cases. Postmortem native CT scans,...

  10. Is Procalcitonin a usefull biomarker for the risk stratification of facial cellulitis?

    Bertolus, Chloé; Schouman, Thomas; Aubry, Adeline; Hausfater, Pierre

    2016-01-01

    International audience Backgroundfacial cellulitis is an infectious disease that may require emergency surgical drainage based on clinical assessment. To date, no biological marker has been reported to be useful for risk stratification. Procalcitonin (PCT) is a diagnostic and prognostic sepsis biomarker. We aimed to study the usefulness of PCT dosage for the risk-stratification of facial cellulitis.Patients and methodsThis was a monocentric prospective study conducted in a referral center ...

  11. Prognostic value of procalcitonin in hospitalized patients with lower respiratory tract infections

    NOBRE Vandack; Borges, Isabela

    2016-01-01

    Lower respiratory tract infections are common and potentially lethal conditions and are a major cause of inadequate antibiotic prescriptions. Characterization of disease severity and prognostic prediction in affected patients can aid disease management and can increase accuracy in determining the need for and place of hospitalization. The inclusion of biomarkers, particularly procalcitonin, in the decision taken process is a promising strategy. This study aims to present a narrative review of...

  12. Hubungan Antara Neutrophil – Lymphocyte Count Ratio Dengan Kadar Procalcitonin Pada Pasien Sepsis

    Silalahi, Bratasena

    2016-01-01

    Background: Sepsis is a major worldwide problem which is associated with the high incidence of death annually. It takes rapid, and accurate diagnose to prevent death and worst outcomes of sepsis. The neutrophil-lymphocyte count ratio (NLCR) has been shown a simple promising method to predict sepsis. Purpose: To investigate the difference of NLCR value between sepsis patients and in infection non-sepsis patients and its relationship to procalcitonin Method : A cross sectional...

  13. Dual-Quantum-Dots-Labeled Lateral Flow Strip Rapidly Quantifies Procalcitonin and C-reactive Protein

    Qi, Xiaoping; Huang, YunYe; Lin, ZhongShi; Xu, Liang; Yu, Hao

    2016-01-01

    In the article, a dual-quantum-dots-labeled (dual-QDs-labeled) lateral flow strip (LFS) method was developed for the simultaneous and rapid quantitative detection of procalcitonin (PCT) and C-reactive protein (CRP) in the blood. Two QD-antibody conjugates with different fluorescence emission spectra were produced and sprayed on the LFS to capture PCT and CRP in the blood. Furthermore, a double antibody sandwich method for PCT and, meanwhile, a competitive inhibition method for CRP were employ...

  14. Plasma Procalcitonin Concentration in Healthy Horses and Horses Affected by Systemic Inflammatory Response Syndrome

    Bonelli, F.; Meucci, V.; Divers, T.J.; Jose‐Cunilleras, E.; Corazza, M; Tognetti, R; Guidi, G.; Intorre, L.; Sgorbini, M.

    2015-01-01

    Background The diseases most frequent associated with SIRS in adult horses are those involving the gastrointestinal tract. An early diagnosis should be the goal in the management of horses with SIRS. Objective The objective of this study was to evaluate the plasma procalcitonin (PCT) concentration in healthy and SIRS horses to assess differences between the two groups. Animals Seventy‐eight horses (30 healthy and 48 SIRS). Methods Prospective in vivo multicentric study. Horses were classified...

  15. Prognostic Value of Procalcitonin in Adult Patients with Sepsis: A Systematic Review and Meta-Analysis.

    Dan Liu

    Full Text Available Procalcitonin (PCT has been widely investigated for its prognostic value in septic patients. However, studies have produced conflicting results. The purpose of the present meta-analysis is to explore the diagnostic accuracy of a single PCT concentration and PCT non-clearance in predicting all-cause sepsis mortality. We searched PubMed, Embase, Web of Knowledge and the Cochrane Library. Articles written in English were included. A 2 × 2 contingency table was constructed based on all-cause mortality and PCT level or PCT non-clearance in septic patients. Two authors independently evaluated study eligibility and extracted data. The diagnostic value of PCT in predicting prognosis was determined using a bivariate meta-analysis model. We used the Q-test and I2 index to test heterogeneity. Twenty-three studies with 3,994 patients were included. An elevated PCT level was associated with a higher risk of death. The pooled relative risk (RR was 2.60 (95% confidence interval (CI, 2.05-3.30 using a random-effects model (I(2 = 63.5%. The overall area under the summary receiver operator characteristic (SROC curve was 0.77 (95% CI, 0.73-0.80, with a sensitivity and specificity of 0.76 (95% CI, 0.67-0.82 and 0.64 (95% CI, 0.52-0.74, respectively. There was significant evidence of heterogeneity for the PCT testing time (P = 0.020. Initial PCT values were of limited prognostic value in patients with sepsis. PCT non-clearance was a prognostic factor of death in patients with sepsis. The pooled RR was 3.05 (95% CI, 2.35-3.95 using a fixed-effects model (I(2 = 37.9%. The overall area under the SROC curve was 0.79 (95% CI, 0.75-0.83, with a sensitivity and specificity of 0.72 (95% CI, 0.58-0.82 and 0.77 (95% CI, 0.55-0.90, respectively. Elevated PCT concentrations and PCT non-clearance are strongly associated with all-cause mortality in septic patients. Further studies are needed to define the optimal cut-off point and the optimal definition of PCT non-clearance for

  16. Serum procalcitonin elevation in critically ill patients at the onset of bacteremia caused by either gram negative or gram positive bacteria

    Prin Sébastien

    2008-03-01

    Full Text Available Abstract Background In the ICU, bacteremia is a life-threatening infection whose prognosis is highly dependent on early recognition and treatment with appropriate antibiotics. Procalcitonin levels have been shown to distinguish between bacteremia and noninfectious inflammatory states accurately and quickly in critically ill patients. However, we still do not know to what extent the magnitude of PCT elevation at the onset of bacteremia varies according to the Gram stain result. Methods Review of the medical records of every patient treated between May, 2004 and December, 2006 who had bacteremia caused by either Gram positive (GP or Gram negative (GN bacteria, and whose PCT dosage at the onset of infection was available. Results 97 episodes of either GN bacteremia (n = 52 or GP bacteremia (n = 45 were included. Procalcitonin levels were found to be markedly higher in patients with GN bacteremia than in those with GP bacteremia, whereas the SOFA score value in the two groups was similar. Moreover, in the study population, a high PCT value was found to be independently associated with GN bacteremia. A PCT level of 16.0 ng/mL yielded an 83.0% positive predictive value and a 74.0% negative predictive value for GN-related bacteremia in the study cohort (AUROCC = 0.79; 95% CI, 0.71–0.88. Conclusion In a critically ill patient with clinical sepsis, GN bacteremia could be associated with higher PCT values than those found in GP bacteremia, regardless of the severity of the disease.

  17. Study on the Relationship Between Plasma Procalcitonin and Kawasaki Dis-ease Related with Bacterial Infection%血浆前降钙素与细菌性川崎病的关系研究

    徐小桥

    2014-01-01

    Objective To study the relationship between the level of plasma procalcitonin and kawasaki disease related with bacte-rial infection and its clinical value. Methods 86 cases of kawasaki disease diagnosed and treated in our hospital from June, 2011 to December, 2013 were selected as the object of the study by sampling and analyzed professionally and retrospectively. Results The plasma procalcitonin level of group with positive pathogens was significantly higher than that of group with negative pathogens. And plasma procalcitonin level of patients with bacterial infection was also significantly higher than that of patients with non-bac-terial infection, and the difference was statistically significant (P<0.05). Conclusion Plasma procalcitonin level is one of the main indicators for the diagnosis of kawasaki disease caused by bacterial infection or non-bacterial infection. It provides important refer-ence for the scientific diagnosis and treatment of the patients.%目的:研究血浆前降钙素水平与细菌感染相关川崎病的关系及临床价值。方法从该院2011年6月-2013年12月诊治的川崎病病例中,抽样选取86例作为该研究的对象,进行专业的回顾性分析。结果病原体阳性组的血浆前降钙素水平明显高于病原体阴性组,且细菌感染患者的血浆前降钙素水平也明显高于非细菌感染患者,差异有统计学意义(P<0.05)。结论血浆前降钙素水平是诊断细菌感染相关川崎病与非细菌感染相关川崎病的主要指标之一,为患者的科学诊治提供了重要的参考依据。

  18. 血清降钙素原和C-反应蛋白在评价老年肺炎病情严重程度及预后中的价值探讨%Value of serum procalcitonin and c-reactive protein for elderly pneumonia severity and prognosis

    阿丽娅·艾依提; 白婷迪娜

    2013-01-01

    Objective To explore the value of serum procalcitonin and c-reactive protein for elderly pneumonia severity and prognosis. Methods 60 patients with community-acquired pneumonia treated in respiratory department clinics and wards were collected in our hospital from May 2010 to May 2012. Its severity divided into three group. 20 healthy cases were randomly selected from the same period in our hospital, as the control group. To compare serum procalcitonin and c -reactive protein of each groups. Results The serum procalcitonin and C -reactive protein of Group A, Group B, Group C was significantly higher than the control group and the group C serum procalcitonin and C-reactive protein levels was higher than group A, group B, the difference was statistically significant (P < 0.05). Conclusion Patients with pneumonia more severe the disease, the higher the concentration of serum procalcitonin and C-reactive protein. Detection of serum procalcitonin and c-reactive protein can contribute to the clinical judgment of severity of pneumonia.%目的 探讨血清降钙素原和C-反应蛋白在老年肺炎病情严重程度及预后的临床价值.方法 收集2010年5月~2012年5月在新疆维吾尔自治区人民医院接受治疗的社区获得性老年肺炎患者60例,按其严重程度分为A、B、C、三组.同时随机选取同一时期在新疆维吾尔自治区人民医院体检健康者20例作为对照组.比较各组患者血清血清降钙素原和C-反应蛋白水平的变化.结果 A、B、C组患者血清降钙素原水平和血清C-反应蛋白水平明显高于正常组,且C组血清降钙素原、C-反应蛋白水平均高于A、B组,比较差异均具有统计学意义(P < 0.05).结论 肺炎病情越重的患者,其血清降钙素原和C-反应蛋白浓度越高,检测血清降钙素原、C-反应蛋白可有助于临床判断肺炎的严重程度.

  19. 血液灌流对急性重度有机磷中毒的疗效观察%Values of serum procalcitonin in predicting severity and prognosis of community-acquired pneumonia in-patients

    朱小生; 方长太; 白兆青

    2011-01-01

    目的 探讨血液灌流对重度急性有机磷农药中毒(AOPP)的临床疗效,促进其推广及应用.方法 回顾性分析重症有机磷中毒患者的临床资料,将其分为血液灌流(HP)治疗组和对照组.所有病例均予以积极的内科治疗(洗胃、氯磷定、阿托品和机械通气等).对治疗组及对照组病人进行回顾性对照分析.结果 行HP组清醒时间,CHE活性恢复时间,住院时间均明显短于对照组,阿托品及氯磷定用药总量明显小于对照组,治愈率明显高于对照组.结论 HP能迅速清除体内毒物,明显缩短病程,提高重度AOPP抢救的成功率,应加强宣教及推广.%Aim To investigate the relationship of serum procalcitonin to severity and prognosis of community acquired pneumonia in-patients. Methods Retrospective analysis was made of community-acquired pneumonia in-patients admitted to hospital from July 2009 to July 2010. Results Among 324 cases of community-acquired pneumonia admitted,248 cases were included for analysis. The mean levels of serum procalcitonin,neutrophil number,average duration of intravenous antibiotic therapy, average hospital stay,PSI scale and CURB 65 score were(0.22±0.34) μg· L -1,(8.92±2.47)x109 ·L -1,(8.7 ±2.6)days,(9.2±2.4)days,67.8 ±33.5,2.12 ±0.45.The correlation indices of serum procalcitonin to PSI and CURB-65 score and duration of intravenous antibiotic therapy, average hospital stay were 0. 845,0.22,0. 404 and 0. 443,respectively. The mean procalcitonin levels of severe CAP and deaths were( 5.87 ± 2.83 ) μg · L -1 and( 2.42 ± 1.28 ) μg · L -1, respectively. The sensitivity and specificity of serum procalcitonin more than 0.5 μg · L -1 on admission were 0.714 and 0. 844 in predicting death. Conclusion The serum level of procalcitonin on admission is correlated with severity of community-acquired pneumonia in patients,and PCT≥0. 335 μg · L -1 may indicate poorer prognosis.

  20. Procalcitonin and C-reactive protein-based decision tree model for distinguishing PFAPA flares from acute infections.

    Kraszewska-Głomba, Barbara; Szymańska-Toczek, Zofia; Szenborn, Leszek

    2016-01-01

    As no specific laboratory test has been identified, PFAPA (periodic fever, aphthous stomatitis, pharyngitis and cervical adenitis) remains a diagnosis of exclusion. We searched for a practical use of procalcitonin (PCT) and C-reactive protein (CRP) in distinguishing PFAPA attacks from acute bacterial and viral infections. Levels of PCT and CRP were measured in 38 patients with PFAPA and 81 children diagnosed with an acute bacterial (n=42) or viral (n=39) infection. Statistical analysis with the use of the C4.5 algorithm resulted in the following decision tree: viral infection if CRP≤19.1 mg/L; otherwise for cases with CRP>19.1 mg/L: bacterial infection if PCT>0.65ng/mL, PFAPA if PCT≤0.65 ng/mL. The model was tested using a 10-fold cross validation and in an independent test cohort (n=30), the rule's overall accuracy was 76.4% and 90% respectively. Although limited by a small sample size, the obtained decision tree might present a potential diagnostic tool for distinguishing PFAPA flares from acute infections when interpreted cautiously and with reference to the clinical context. PMID:27131024

  1. The Comparison of Procalcitonin Guidance Administer Antibiotics with Empiric Antibiotic Therapy in Critically Ill Patients Admitted in Intensive Care Unit

    Atabak Najafi

    2015-10-01

    Full Text Available The empiric antibiotic therapy can result in antibiotic overuse, development of bacterial resistance and increasing costs in critically ill patients. The aim of the present study was to evaluate the effect of procalcitonin (PCT guide treatment on antibiotic use and clinical outcomes of patients admitted to intensive care unit (ICU with systemic inflammatory response syndrome (SIRS.  A total of 60 patients were enrolled in this study and randomly divided into two groups, cases that underwent antibiotic treatment based on serum level of PCT as PCT group (n=30 and patients who undergoing antibiotic empiric therapy as control group (n=30. Our primary endpoint was the use of antibiotic treatment. Additional endpoints were changed in clinical status and early mortality. Antibiotics use was lower in PCT group compared to control group (P=0.03. Current data showed that difference in SOFA score from the first day to the second day after admitting patients in ICU did not significantly differ (P=0.88. Patients in PCT group had a significantly shorter median ICU stay, four days versus six days (P=0.01. However, hospital stay was not statistically significant different between two groups, 20 days versus 22 days (P=0.23.  Early mortality was similar between two groups. PCT guidance administers antibiotics reduce antibiotics exposure and length of ICU stay, and we found no differences in clinical outcomes and early mortality rates between the two studied groups.

  2. Procalcitonin and C-reactive protein-based decision tree model for distinguishing PFAPA flares from acute infections

    Kraszewska-Głomba, Barbara; Szymańska-Toczek, Zofia; Szenborn, Leszek

    2016-01-01

    As no specific laboratory test has been identified, PFAPA (periodic fever, aphthous stomatitis, pharyngitis and cervical adenitis) remains a diagnosis of exclusion. We searched for a practical use of procalcitonin (PCT) and C-reactive protein (CRP) in distinguishing PFAPA attacks from acute bacterial and viral infections. Levels of PCT and CRP were measured in 38 patients with PFAPA and 81 children diagnosed with an acute bacterial (n=42) or viral (n=39) infection. Statistical analysis with the use of the C4.5 algorithm resulted in the following decision tree: viral infection if CRP≤19.1 mg/L; otherwise for cases with CRP>19.1 mg/L: bacterial infection if PCT>0.65ng/mL, PFAPA if PCT≤0.65 ng/mL. The model was tested using a 10-fold cross validation and in an independent test cohort (n=30), the rule’s overall accuracy was 76.4% and 90% respectively. Although limited by a small sample size, the obtained decision tree might present a potential diagnostic tool for distinguishing PFAPA flares from acute infections when interpreted cautiously and with reference to the clinical context. PMID:27131024

  3. Procalcitonin: Is it a predictor of noninvasive positive pressure ventilation necessity in acute chronic obstructive pulmonary disease exacerbation?

    Ahmet Cemal Pazarli

    2012-01-01

    Full Text Available Background: Acute exacerbations of chronic obstructive pulmonary disease (AeCOPD are important causes of morbidity and mortality. In this study, we analyzed procalcitonin (PCT levels in AeCOPD and stable period of COPD in order to evaluate usage of PCT in the prediction of the severity of AeCOPD, and its value on the planing of noninvasive positive pressure ventilation (NPPV. Materials and Methods: In this cross sectional study (2009-2010 118 COPD patients were enrolled, 68 of them (58% were in acute exacerbations (case group. The others had stabile COPD and they were defined as control group. Results: In case group the mean levels of PCT (0.19 ± 0.02 C-Reactive Protein (44.7 ± 5.92, erythrocyte sedimentation rate (28.4 ± 2.65, white blood cell (9.4 ± 0.43 and %neutrophils (69.9 ± 1.22 were significantly higher than controls (P = 0.0001. There was no difference between PCT levels based on stages of COPD. There were significiant differences in mean PCT levels according to type and severity of AeCOPD. Mean PCT level in hospitalized patients receiving NPPV was 0.36 ng/ml, while it was 0.15 ng/ml for those treated without NPPV (P = 0.0001. PCT cut-off value for NPPV indication was determined to be 0.10 ng/ml. Conclusions: PCT levels were found to be higher in AeCOPD patients than in stable COPD patients, as expected. Also mean PCT levels increased especially in cases with severe AeCOPD and those receiving NPPV among them. In the present study, we determined a cut off value of PCT as 0.10 ng/ml as a predictor of necessity of NPPV in AeCOPD.

  4. Prediction of high-grade vesicoureteral reflux after pediatric urinary tract infection: external validation study of procalcitonin-based decision rule.

    Sandrine Leroy

    Full Text Available BACKGROUND: Predicting vesico-ureteral reflux (VUR ≥3 at the time of the first urinary tract infection (UTI would make it possible to restrict cystography to high-risk children. We previously derived the following clinical decision rule for that purpose: cystography should be performed in cases with ureteral dilation and a serum procalcitonin level ≥0.17 ng/mL, or without ureteral dilatation when the serum procalcitonin level ≥0.63 ng/mL. The rule yielded a 86% sensitivity with a 46% specificity. We aimed to test its reproducibility. STUDY DESIGN: A secondary analysis of prospective series of children with a first UTI. The rule was applied, and predictive ability was calculated. RESULTS: The study included 413 patients (157 boys, VUR ≥3 in 11% from eight centers in five countries. The rule offered a 46% specificity (95% CI, 41-52, not different from the one in the derivation study. However, the sensitivity significantly decreased to 64% (95%CI, 50-76, leading to a difference of 20% (95%CI, 17-36. In all, 16 (34% patients among the 47 with VUR ≥3 were misdiagnosed by the rule. This lack of reproducibility might result primarily from a difference between derivation and validation populations regarding inflammatory parameters (CRP, PCT; the validation set samples may have been collected earlier than for the derivation one. CONCLUSIONS: The rule built to predict VUR ≥3 had a stable specificity (ie. 46%, but a decreased sensitivity (ie. 64% because of the time variability of PCT measurement. Some refinement may be warranted.

  5. Diagnostic Value of Serum Procalcitonin in Children Respiratory Tract Infection%儿童呼吸道医院感染诊断中血清降钙素原检测的价值观察

    杨丽; 赵东赤

    2016-01-01

    Objective To evaluate the diagnostic value of serum procalcitonin in children respiratory tract infection.Methods In 50 cases between January 1, 2015 to January 1,2016 in my hospital for treatment of respiratory tract infection in children hospital as the research object(observation group)to the same period in the hospital healthy 50 healthy children as a reference object(control group),serum procalcitonin levels two children.Results The survey results showed that serum procalcitonin levels in the observation group is significantly higher,the diference was statisticaly significant(P<0.05).ConclusionThe diagnosis of nosocomial infection in children with respiratory tract can be measured when serum procalcitonin levels the most important basis for the determination.%目的:探讨血清降钙素原检测对儿童呼吸道医院感染的诊断价值。方法以2015年1月1日~2016年1月1日在我院诊治的呼吸道医院感染患儿50例为研究对象(观察组),以同期在医院健康体检的50例健康儿童为参照对象(对照组),检测两组儿童的血清降钙素原水平。结果调查结果显示,在血清降钙素原水平上观察组高于对照组,差异具有统计学意义(P<0.05)。结论在诊断儿童呼吸道医院感染的时候可以将测得的血清降钙素原水平最为重要的判定依据。

  6. Significance of serum procalcitonin and blood gas analysis in the risk anticipation of patients with acute exacerbation of COPD%血清降钙素原联合血气分析检测对AECOPD患者临床风险预测的意义

    曹友红

    2013-01-01

    Objective To estimate the prognostic value of serum procalcitonin and blood gas analysis in the risk anticipation of patients with acute exacerbation of chronic obstructive pulmonary disease ( AECOPD ). Methods The study selected 65 patients with AECOPD as the test group and 50 healthy people as the control group. Their PCT level and arterial blood gas analysis indexes were tested and dynamically monitored 5 days after the treatment. Results Serum procalcitonin and blood gas analysis had a high sensitivity, and the differences showed a statistical significance before and after the treatment (P 0.05).结论 联合检测血清降钙素原及血气分析对AECOPD患者的风险预测具有较重要的临床意义.

  7. Value research of procalcitonin in the identification between bacterial pneumonia and pulmonary tuberculosis%降钙素原在细菌性肺炎及肺结核中的鉴别研究

    尹义平; 胡苏萍; 杨澄清; 李雪英

    2013-01-01

    目的 通过测定细菌性肺炎及肺结核患者血清降钙素原水平进一步探讨降钙素原对这两种疾病的鉴别诊断价值.方法 收集细菌性肺炎患者(20例)及肺结核患者(21例)血清标本,两组患者病情严重程度达到系统性炎症反应综合征(SIRS)水平,采用免疫荧光法分别检测两组患者血清降钙素原水平,并进行比较,绘制ROC曲线,根据曲线下面积评价降钙素原对上述两种疾病的鉴别诊断价值.结果 细菌性肺炎患者血清降钙素原水平明显高于肺结核患者(P<0.05),绘制ROC曲线后,曲线下面积(AUC)为0.923,95%可信区间为(0.844,1.000),在临界值为0.20 ng/ml时,其灵敏度为85%,特异度为86%.结论 降钙素原在临界值为0.20 ng/ml时,对达到SIRS水平的细菌性肺炎及肺结核患者具有良好的鉴别诊断价值.%Objective To explore the differential value of procalcitonin between bacterial pneumonia and pulmonary tuberculosis. Methods The serum procalcitonin of patients with bacterial pneumonia ( 20 cases ) and pulmonary tuberculosis (21 cases ) was detected by immunofluorescence and then compared. All patients were suffering from systemic inflammatory response syndrome ( SIRS ). HOC curves were described and the differential value of procalcitonin was evaluated according to AUG. Results The level of serum procalcitonin was significantly higher in patients with bacterial pneumonia than in patients with pulmonary tuberculosis ( P < 0. 05 ). The AUC of ROC curve was 0.923, 95% Cl ( 0. 844, 1.000 ). At the cut-off value of 0.20 ng/ml, the sensitivity was 85% , and the specificity was 86 % . Conclusion When the level of procalcitonin reaches the cut-off value of 0. 20 ng/ml, procalcitonin can be used as a valuable clinical inflammatory marker to differentiate bacterial pneumonia and pulmonary tuberculosis with SIRS.

  8. 血清降钙素原和内毒素在肝硬化患者腹水感染中的诊断价值%The values of serum procalcitonin and endotoxin in diagnosis of the ascitic infection in patients with cirrhosis

    党燕; 于艳华; 刘新; 张立丽; 陈铭; 娄金丽

    2014-01-01

    Objective To investigate the clinical value of serum procalcitonin and endotoxin in diagnosis of the ascitic infection in patients with liver cirrhosis .Methods Retrospective study on 61 cirrhotic patients with ascitic infection and 67 cirrhotic patients with sterile ascites in Beijing Youan Hospital from August 2012 to December 2013 .The levels of procalcitonin and endotoxin in serum of these patients were analyzed .Results The common pathogens were Enterococcus faecium, Staphylococcus haemolyticus, Escherichia coli, Staphylococcus epidermidis and so on.Mean values of procalcitonin and endotoxin in the ascitic infection group were significantly higher than those in the non-ascitic infection group(P<0.01).ROC curve analysis showed that the areas under the curve of procalcitonin and endotoxin were 0.983 and 0.919, respectively.The sensitivities of procalcitonin and endotoxin were 93.5% and 83.6% respectively, while the specificities were 88.1% and 97.0% respectively in diagnosis of the ascitic infection .Conclusion The serum levels of procalcitonin and endotoxin in cirrhotic patients with ascitic infection both rose and had high sensitivities and specificities .Detections of procalcitonin and endotoxin could be applied in diagnosis of ascitic infection in patients with cirrhosis as fast and accurate auxiliary indicators.The value of procalcitonin was higher especially .%目的:探讨血清降钙素原和内毒素浓度在肝硬化患者腹水感染诊断中的应用价值。方法回顾性研究首都医科大学附属北京佑安医院2012年8月至2013年12月的61例肝硬化腹水感染患者和67例肝硬化腹水无感染患者的血清降钙素原和内毒素的质量浓度并进行统计分析。结果腹水培养阳性的病原菌最常见的依次为屎肠球菌、溶血葡萄球菌、大肠埃希菌、表皮葡萄球菌等。与非腹水感染组相比,腹水感染组的血清降钙素原、内毒素检测结果均显著升高,差

  9. Research of Procalcitonin in Early Diagnosis of Infection in Breast Cancer Patients with Neutropenia after Chemotherapy%降钙素原早期诊断乳腺癌化疗后粒细胞减少伴感染的研究

    郭满; 张浩; 李伟汉; 刘平贤; 杜新峰; 翟晓健

    2014-01-01

    目的:探讨降钙素原在乳腺癌化疗后粒细胞减少伴发热患者中的临床应用价值。方法:回顾性分析2008年3月-2012年9月本院收治的118例乳腺癌化疗后中性粒细胞减少伴发热患者临床资料,根据患者临床症状、体征、病原及影像学资料,将患者分为感染组和发热原因不详组,分析两组血清降钙素原水平差异及血清降钙素原水平与患者年龄、化疗方案、发热程度和粒细胞缺乏的关系。结果:感染组血清降钙素原水平明显高于发热原因不详组(P0.05)。结论:血清降钙素原水平对于乳腺癌化疗后中性粒细胞减少伴感染的早期诊断具有重要意义,且不受患者的年龄、化疗方案、发热程度和粒细胞水平影响。%Objective:To explore clinical value of procalcitonin in breast cancer patients with neutropenia associated with fever after chemotherapy. Method:The clinical data of 118 hospitalized patients with breast cancer associated with fever after chemotherapy from March 2008 to September 2012 were analyzed. The patients were divided into the infected group and the fever reasons unknown group according to clinical symptoms,signs,etiology. The relationship of serum procalcitonin levels were comparative analyzed between the two groups. The relationship of serum procalcitonin levels with age,chemotherapy scheme,heating degree and agranulocytosis levels were analyzed. Result:Serum procalcitonin levels in the infected group was significantly higher than the fever reasons unknown group(P0.05). Conclusion:Serum procalcitonin levels has a great significance for early diagnosis of infection in breast cancer patients with neutropenia associated with fever after chemotherapy,and it did not infected by patients age,chemotherapy scheme, heating degree and agranulocytosis levels.

  10. Taux de la procalcitonine durant la grossesse, l'accouchement et le post-partum

    Paccolat, Céline

    2013-01-01

    Les complications infectieuses durant la grossesse constituent le problème médical le plus fréquemment rencontré chez la femme enceinte. Il est actuellement bien démontré que les marqueurs couramment utilisés dans le diagnostic des infections, tels que la leucocytose et la protéine C réactive (CRP), doivent être utilisés prudemment durant la grossesse, en raison de la modification physiologique de leurs valeurs de normalité durant cette période. La procalcitonine (PCT) est, depuis plusieurs a...