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Gómez NFP, Del Pilar Sanz Martín M, Chong MAS, Cruz NDZ, Hernández RM, Molina IG, Sanz IG, Tejerina AF, Rueda FR. Usefulness of Procalcitonin Levels for Predicting the Microbiological Orientation in Patients with Sepsis. J Pers Med 2024; 14:208. [PMID: 38392641 PMCID: PMC10890570 DOI: 10.3390/jpm14020208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 02/07/2024] [Accepted: 02/11/2024] [Indexed: 02/24/2024] Open
Abstract
The main objective of the study was to verify whether levels of procalcitonin (PCT) could guide us toward determining the type of bacteria causing the sepsis and to identify the discriminatory cut-off point in the first urgent laboratory test. This study is a single center retrospective analysis that includes 371 patients with a mean age of 71.7 ± 15.6 years who were diagnosed with sepsis or septic shock. The yield of blood cultures in demonstrating the causative microbiological agent was 24.3% (90), and it was 57, 1% (212) when evaluating all types of cultures. Statistically significant positive differences were observed in the mean value of the PCT between the group that obtained positive cultures and the group that did not (p < 0.0001). The AUC-ROC of PCT values as a guide to the causal bacteria type was 0.68 (95%CI: 0.57-0.78, p < 0.0021). The PCT value that showed the best diagnostic characteristics for identifying Gram-negative rods (GNR) as the causative agent in blood cultures was 2.1 ng/mL. The positive predictive value (PPV) was 78, 9% (66.3-88.1%). The AUC-ROC of the PCT values for sepsis diagnosis, with any positive culture that could be assessed, was 0.67 (95%CI: 0.63-0.73, p < 0.0001). The PCT value that showed the best diagnostic characteristic for predicting sepsis was 3.6 ng/mL.
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Affiliation(s)
- Natalia Fernanda Pascual Gómez
- Department of Clinical Analysis, La Princesa University Hospital, Diego de León 62, 28006 Madrid, Spain
- Physiology and Pathophysiology Teaching Unit, Faculty of Pharmacy, Complutense University of Madrid, 28040 Madrid, Spain
| | | | | | | | - Rosa Méndez Hernández
- Department of Anesthesiology and Surgical Intensive Care, La Princesa University Hospital, Diego de León 62, 28006 Madrid, Spain
| | - Iñigo Guerra Molina
- Department of Emergency, La Princesa University Hospital, Diego de León 62, 28006 Madrid, Spain
| | - Iñigo García Sanz
- Department of Digestive and General Surgical, La Princesa University Hospital, Autónoma University of Madrid, Diego de León 62, 28006 Madrid, Spain
| | - Angels Figuerola Tejerina
- Department of Preventive Medicine and Public Health, La Princesa University Hospital, Diego de León 62, 28006 Madrid, Spain
| | - Fernando Ramasco Rueda
- Department of Anesthesiology and Surgical Intensive Care, La Princesa University Hospital, Diego de León 62, 28006 Madrid, Spain
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Song W, Tian F, Wang Y, Sun Q, Guo F, Zhao G, Lin Y, Wang J, Yang L, Ma X. Predictive value of C-reactive protein, procalcitonin, and interleukin-6 on 30-day mortality in patients with bloodstream infections. Med Clin (Barc) 2023:S0025-7753(23)00091-X. [DOI: 10.1016/j.medcli.2023.01.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 01/17/2023] [Accepted: 01/18/2023] [Indexed: 04/03/2023]
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Xu HG, Tian M, Pan SY. Clinical utility of procalcitonin and its association with pathogenic microorganisms. Crit Rev Clin Lab Sci 2021; 59:93-111. [PMID: 34663176 DOI: 10.1080/10408363.2021.1988047] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
In this review, we summarize the relationship of PCT with pathogens, evaluate the clinical utility of PCT in the diagnosis of clinical diseases, condition monitoring and evaluation, and guiding medical decision-making, and explore current knowledge on the mechanisms by which pathogens cause changes in PCT levels. The lipopolysaccharides of the microorganisms stimulate cytokine production in host cells, which in turn stimulates production of serum PCT. Pathogens have different virulence mechanisms that lead to variable host inflammatory responses, and differences in the specific signal transduction pathways result in variable serum PCT concentrations. The mechanisms of signal transduction have not been fully elucidated. Further studies are necessary to ascertain the PCT fluctuation range of each pathogen. PCT levels are helpful in distinguishing between certain pathogens, in deciding if antibiotics are indicated, and in monitoring response to antibiotics.
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Affiliation(s)
- Hua-Guo Xu
- Department of Laboratory Medicine, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Meng Tian
- Department of Laboratory Medicine, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Shi-Yang Pan
- Department of Laboratory Medicine, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China
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Waris A, Din M, Iqbal N, Yar L, Khalid A, Nawaz M, Baset A, Ali M. Evaluation of serum procalcitonin level as a biomarker for disease severity in COVID-19 patients. New Microbes New Infect 2021; 43:100922. [PMID: 34336223 PMCID: PMC8302477 DOI: 10.1016/j.nmni.2021.100922] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
The pandemic of coronavirus disease 2019 (COVID-19) has infected millions of individuals around the globe. Forecasting the COVID-19 severity is essential, and various biomarkers could be used to evaluate it. The current study was therefore aimed to evaluate the serum pro-calcitonin (PCT) level as a biomarker for bacterial co-infection and disease severity in COVID-19 patients. A total of 430 COVID-19 positive individuals were examined, in which 332 (77.2%) were male individuals while 98 (22.8%) were female individuals. Among the examined samples, 281 were classified as moderate (PCT value 0.07 ± 0.06 ng/mL), 95 were severe (PCT value 0.5 ± 0.4 ng/mL), and 54 were classified as critical (PCT value > 1 ng/mL) individuals. The increase in the total serum level of PCT was observed with the severity of the disease (p < 0.05). The statistical analysis represented no association of PCT value with gender (p 0.9650) while revealed a significant association (p < 0.001) with the age and PCT value in COVID-19 patients. It can be concluded that the serial PCT measurement could determine the prognosis of the disease and the presence of bacterial co-infection in COVID-19 patients. Further exploration of the topic is needed to evaluate the effect of different therapies on the PCT level and to prescribe specific treatment options for coinfection.
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Affiliation(s)
- A. Waris
- Department of Biotechnology, Quaid-i-Azam University, Islamabad, Pakistan
| | - M. Din
- Department of Biotechnology, Quaid-i-Azam University, Islamabad, Pakistan
| | - N. Iqbal
- Department of Statistics, Quaid-i-Azam University, Islamabad, Pakistan
| | - L. Yar
- Department of Biotechnology, Quaid-i-Azam University, Islamabad, Pakistan
| | - A. Khalid
- Sahiwal Medical College, University of Health Sciences, Lahore, Pakistan
| | - M. Nawaz
- Department of Biotechnology, Quaid-i-Azam University, Islamabad, Pakistan
| | - A. Baset
- Department of Zoology, Bacha Khan University, Charsadda, Pakistan
| | - M. Ali
- Department of Biotechnology, Quaid-i-Azam University, Islamabad, Pakistan
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