Procalcitonin Concentrations Research Articles

Procalcitonin for diagnosis of asymptomatic bacteriuria in kidney transplant recipients

Background and aim. Asymptomatic bacteriuria (ASB) is a frequent finding in allograft kidney transplant recipients and may be associated with a higher incidence of urinary tract infections in this population. We aimed to investigate the potential utility of serum procalcitonin (PCT) concentrations, an early marker of infection, for ASB diagnosis. We also compared its diagnostic performance with white blood cell (WBC) count, erythrocyte sedimentation rate (ESR), and highly sensitive C-reactive protein (hsCRP). Methods. In a single-center, cross-sectional study, 37 kidney transplant recipients with no clinical signs or symptoms of urinary tract infections were included. ASB was assessed by means of urine culture. Serum PCT concentrations were determined by the electrochemiluminescence immunoassay technique. Receiver operating characteristic (ROC) curve analysis was used to determine the diagnostic performance of PCT and other classifiers. Results. Seventeen patients (46%) had ASB. Serum PCT concentrations were significantly higher in ASB+ patients (0.14 vs. 0.08 ng/ml, p=0.009). PCT concentrations significantly correlated with serum creatinine (r=0.408, p=0.012) and ESR (r=0.466, p=0.004). Of the four tested classifiers (PCT, WBC count, ESR, and hsCRP), only PCT was able to significantly distinguish between ASB+ and ASB- patients [area under the curve: 0.74, (95% CI: 057-0.91) p=0.012]. Adjustment of the ROC model for serum creatinine showed that the ability of PCT in classifying patients by ASB status is not affected by creatinine concentrations (crude vs. adjusted area under the curve: 0.74 vs. 0.72, test of AUC difference: p=0.891). A cut-point of 0.10 ng/ml of PCT correctly classified ASB+ patients with a sensitivity and specificity of 64.7% and 80.0%, respectively. Conclusion. PCT might be a useful surrogate marker for ASB diagnosis among kidney transplant recipients. Diagnostic performance of PCT is superior to that of WBC count, ESR, and hsCRP. Further, diagnostic ability of PCT appears to be independent of renal function.

Cerebral Microbleeds Assessment and Quantification in COVID-19 Patients With Neurological Manifestations.

It is increasingly acknowledged that Coronavirus Disease 2019 (COVID-19) can have neurological manifestations, and cerebral microbleeds (CMBs) have been observed in this setting. The aim of this study was to characterize CMBs patterns on susceptibility-weighted imaging (SWI) in hospitalized patients with COVID-19 with neurological manifestations. CMBs volume was quantified and correlated with clinical and laboratory parameters. The study included patients who were hospitalized due to COVID-19, exhibited neurological manifestations, and underwent a brain MRI between March and May 2020. Neurological, clinical, and biochemical variables were reported. The MRI was acquired using a 3T scanner, with a standardized protocol including SWI. Patients were divided based on radiological evidence of CMBs or their absence. The CMBs burden was also assessed with a semi-automatic SWI processing procedure specifically developed for the purpose of this study. Odds ratios (OR) for CMBs were calculated using age, sex, clinical, and laboratory data by logistic regression analysis. Of the 1,760 patients with COVID-19 admitted to the ASST Papa Giovanni XXIII Hospital between 1 March and 31 May 2020, 116 exhibited neurological symptoms requiring neuroimaging evaluation. Of these, 63 patients underwent brain MRI and were therefore included in the study. A total of 14 patients had radiological evidence of CMBs (CMBs+ group). CMBs+ patients had a higher prevalence of CSF inflammation (p = 0.020), a higher white blood cell count (p = 0.020), and lower lymphocytes (p = 0.010); the D-dimer (p = 0.026), LDH (p = 0.004), procalcitonin (p = 0.002), and CRP concentration (p < 0.001) were higher than in the CMBs- group. In multivariable logistic regression analysis, CRP (OR = 1.16, p = 0.011) indicated an association with CMBs. Estimated CMBs volume was higher in females than in males and decreased with age (Rho = −0.38; p = 0.18); it was positively associated with CRP (Rho = 0.36; p = 0.22), and negatively associated with lymphocytes (Rho = −0.52; p = 0.07). CMBs are a frequent imaging finding in hospitalized patients with COVID-19 with neurological manifestations and seem to be related to pro-inflammatory status.

Optimal use of procalcitonin to rule out bacteremia in patients with possible viral infections.

ObjectiveDuring the winter, many patients present with suspected infection that could be a viral or a bacterial (co)infection. The aim of this study is to investigate whether the optimal use of procalcitonin (PCT) is different in patients with and without proven viral infections for the purpose of excluding bacteremia. We hypothesize that when a viral infection is confirmed, this lowers the probability of bacteremia and, therefore, influences the appropriate cutoff of procalcitonin.MethodsThis study was conducted in the emergency department of an academic medical center in The Netherlands in the winter seasons of 2019 and 2020. Adults (>18 years) with suspected infection, in whom a blood culture and a rapid polymerase chain reaction test for influenza was performed were included.ResultsA total of 546 patients were included of whom 47 (8.6%) had a positive blood culture. PCT had an area under the curve of 0.85, 95% confidence interval (95% CI) 0.80–0.91, for prediction of bacteremia. In patients with a proven viral infection (N = 212) PCT < 0.5 μg/L had a sensitivity of 100% (95% CI 63.1–100) and specificity of 81.2% (95% CI 75.1–86.3) to exclude bacteremia. In patients without a viral infection, the procalcitonin cutoff point of < 0.25 μg/L showed a sensitivity of 87.2% (95% CI 72.6–95.7) and specificity of 64.1 % (95% CI 58.3–69.6).ConclusionIn patients with a viral infection, our findings suggest that a PCT concentration of <0.50 μg/L makes bacteremia unlikely. However, this finding needs to be confirmed in a larger population of patients with viral infections, especially because the rate of coinfection in our cohort was low.

Air pollution might affect the clinical course of COVID-19 in pediatric patients

Air pollution, to which children are more susceptible than adults, can promote airway inflammation, potentially exaggerating the effects of respiratory viral infection. This study examined the association between the clinical manifestation of COVID-19 in unvaccinated pediatric patients hospitalized in Poland (n = 766) and levels of particulate matter 2.5 (PM2.5) and benzo(a)pyrene (B(a)P) within a week before hospitalization. Children aged ≤ 12 years exposed to mean and max 24 h B(a)P levels > 1 ng/m3 revealed higher odds of cough, dyspnea, fever, and increased concentrations of inflammatory markers (C-reactive protein, interleukin-6, procalcitonin, white blood cell count). In older patients (13–17 years), elevated mean 24 h B(a)P levels increased odds of dyspnea, fever, and diarrhea, and higher concentrations of C-reactive protein and procalcitonin. Exposure to max 24 h PM2.5 levels > 20 µg/m3 was associated with higher odds of cough, increased concentrations of C-reactive protein (group ≤12 years), and increased procalcitonin concentration (groups ≤12 years and 13–17 years). In both age groups, length of stay was extended in patients exposed to elevated levels of max 24 h PM2.5, mean and max 24 h B(a)P. This study suggests that worse air quality, particularly reflected in increased B(a)P levels, might affect the clinical course of COVID-19 in pediatric patients and adds to the disease burden during a pandemic.

Low Levels of Procalcitonin Are Related to Decreased Antibiotic Use in Children Hospitalized Due to Influenza.

Procalcitonin increases in bacterial infections, which are often suspected (though rarely confirmed) in paediatric influenza. We retrospectively verified procalcitonin’s usefulness in antibiotic guidance in children hospitalized due to laboratory-confirmed influenza. The ROC curve analysis evaluated procalcitonin’s performance in terms of antibiotic implementation or continuation in patients who were naive or had been receiving antibiotic treatment prior to hospital admission. We also assessed the procalcitonin’s usefulness to predict lower-respiratory-tract infections (LRTI), the presence of radiologically confirmed pneumonia, an intensive care unit transfer and a fatal outcome. Multiple regression models were built to verify the previously reported procalcitonin cut-off values. The study enrolled 371 children (median age 33 months). The AUC (area under the curve) for antibiotic implementation reached 0.66 (95%CI: 0.58–0.73) and 0.713 (95%CI: 0.6–0.83) for antibiotic continuation; optimal cut-offs (0.4 and 0.23 ng/mL, respectively) resulted in a negative predictive value (NPV) of 79.7% (95%CI: 76.2–82.9%) and 54.6% (95%CI: 45.8–63%), respectively. The use of 0.25 ng/mL as a reference decreased the odds of antibiotic treatment by 67% (95%CI: 43–81%) and 91% (95%CI: 56–98%), respectively. Procalcitonin showed lower AUC for the prediction of LRTI and pneumonia (0.6, 95%CI: 0.53–0.66, and 0.63, 95%CI: 0.56–0.7, respectively), with a moderately high NPV in the latter case (83%, 95%CI: 79.3–86.1%). Procalcitonin use may decrease the antibiotic frequency in hospitalized influenza cases both in terms of antibiotic administration and continuation. Procalcitonin concentrations may suggest bacterial suprainfections at lower concentrations than in adults, and a focus on its rule-out value is of special interest.

Elevated Serum Procalcitonin to Predict Severity and Prognosis of Extensive Burns

Purpose To analyze the factors affecting the elevation of serum procalcitonin (PCT) in patients with extensive burns, and explore its potential value in evaluating the severity and prognosis. Methods Clinical data of 139 patients with extensive burns admitted to our burn center from January 2014 to December 2019 were retrospectively analyzed. Spearman’s Rank correlation coefficient was used to analyze the factors influencing the elevated PCT levels. The predictive power of PCT for death was evaluated by receiver operating characteristic (ROC) and multiple logistic regression analysis. Results 72 cases exhibited elevated serum PCT concentrations during the shock phase, but none of them had obvious signs of infection. PCT level in the shock phase was positively correlated with burn area, depth, degree of inhalation injury, delay in fluid resuscitation, APACHE II, and SOFA scores. The peak values of PCT during shock and infection phases were significantly higher in the non-survivors than in the survivors. The areas under the ROC curve for predicting death were 0.788 and 0.926, respectively, and 5.4 ng/mL (OR = 5.33) and 8.5 ng/mL (OR = 14.49) were the high-risk thresholds for death prediction. Conclusions Serum PCT level in the shock phase is a potential indicator for evaluating the severity of burns, while the PCT level during the infection period can be used as an early warning indicator for severe systemic infection. High levels of PCT peaks during the shock and infection periods indicate an increased risk of poor prognosis, and targeted treatment is required accordingly.

Comparison of Presepsin (CD14), Procalcitonin (PCT) and C- reactive protein (CRP) at different SOFA and APACHE II scores in sepsis patients

Sepsis remains a major challenge in clinical practice with considerable morbidity and mortality despite modern treatments. Clinicians need good diagnostic and prognostic markers to identify infected patients who would rapidly benefit from prompt, empirical antibiotic therapy and other supportive treatment. to comparison of Presepsin (CD14), Procalcitonin (PCT) and C- reactive protein (CRP) at different SOFA and APACHE II scores in sepsis patients. A prospective cohort observational study was conducted in Critical Care Medicine Department, Faculty of medicine, Cairo University, Egypt recruiting admitted adult critically ill patients diagnosed. All subjects were recruited during the period from December 2013 to November 2015. All subjects were subjected to complete history taking, clinical examination, Complete blood count, Kidney and Liver function, Coagulation profiles, blood, urine, and sputum cultures ± wound or drain culture, presepsin, PCT and CRP plasma concentrations. Mean age of our study group was 49.8±16.05 years and mean APACHE II score 14±4.4 with mean length of ICU stay was 13.6±7.06 days.There was significantly higher frequency of DM and HTN in Non- survivors group than Survivors.SOFA score was significantly higher at all assessments in Non- survivors as compared to survivors on admission and at day 1, 3,7 and 15.

Assessment of Inflammatory Biomarkers as Predictor of Mortality in COVID-19 Patients

Background: In individuals with coronavirus, a cytokine storm is an important cause of illness and demise. The purpose of the study was to assess whether pro-inflammatory cytokines had an impact on progression and risk of mortality in patients with COVID-19. Study Design: Retrospective study Place and Duration of Study: Intensive Care Unit (ICU) and Medical Wards, Bahria Town International Hospital from 21st August 2020 to 17th September 2021. Methodology: One hundred and thirty-six patients of confirmed cases of COVID-19 disease were enrolled. Their demographic, blood and biochemical parameters were collected within 48 hours after admission from the medical record of patients. Patients were divided into two groups according to the final outcome, the survivors and non survivors. The data were investigated to assess the prognostic importance of the blood marker and inflammatory variables for the prognostic importance. Results: The mean age and body mass index (BMI) were statistically higher in the non-survivors than in the survivors (p=0.017 and 0.03 respectively). For those with asthma and chronic obstructive pulmonary disease, the number was statistically higher in non-survivors (p = 0.002 and 0.04, respectively). The inflammatory markers concentrations of CPR, D. Dimer, serum ferritin, procalcitonin, and interleukin-6 were significantly higher within 48 hours of admission for non-survivors (p = 0.003, 0.007, &lt;0.001, 0.015, and &lt;0.001 respectively). Except ferritin levels, multi-variate logistic regression analysis exhibited that the CRP, D. Dimer, Procalcitonin and IL-6 were associated statistically significant higher risk of mortality (OR 1.235, p=0.007, 95% Cl 5.621-42.652, OR 1.906, p=0.003, 95% Cl 1.481-1.982, OR 3.967, p=&lt;0.001, 95% Cl 4.256-23.981, and OR 7.589, p=0.009, 95% Cl 4.561-113.852 respectively). Conclusion: The inflammatory markers have the prognostic importance in patients suffering from covid-19 infection as we found higher levels of these markers were related with the poor prognosis. Keywords: Inflammatory markers, Corona virus, Prognostic markers, Interleukin -6, Mortality

Role of procalcitonin in diagnosis of community acquired pneumonia in Children

BackgroundThe role of serum Procalcitonin (PCT) in adults in diagnosis of Community acquired pneumonia (CAP) is well established, however, role in pediatric CAP remains controversial.ObjectivesThe objective of this study was to investigate the utility of serum procalcitonin in differentiating bacterial community-acquired lower respiratory tract infection from non-bacterial respiratory infection in children; radiologically confirmed pneumonia was used as the reference. In addition, we assessed the utility of adding the PCT assay to the clinical criteria for diagnosis of pneumonia.Study designSubanalysis of a larger prospective,multicentriccohort study.ParticipantsChildren, 2 months to 59 months of age, attending paediatric OPD of 5 urban tertiary care hospitals, suffering from acute respiratory infection (ARI).InterventionDetailed clinical history and examination findings of enrolled children were recorded on predesigned case record form. Samples for PCT were obtained at admission and were measured centrally at the end of the study except for one site using VIDAS® B.R.A.H.M.S PCT kit (Biomerieux SA, France).OutcomesSensitivity and specificity of procalcitonin for diagnosis of radiologically confirmed pneumonia.ResultsSerum Procalcitonin was measured in 370 patients; median (IQR) age of these children being 12 (7, 22) months, 235 (63.5%) were boys. The median (IQR) serum procalcitonin concentration was 0.1(0.05, 0.4) ng/mL.Sensitivity and specificity of raised PCT (> 0.5 ng/mL) for pneumonia as per any CXR abnormalities were 29.7% and87.5%,(P < 0.001) respectively. Raised PCT was also significantly associated with consolidation (34.5%,79.2%,P < 0.02)and pleural effusion(54.6%,79%,P < 001). Adding PCT to the existing clinical criteria of WHO did not improve the sensitivity for diagnosis of pneumonia. PCT was significantly higher in children with severe pneumonia.ConclusionPositive PCT (> 0.5 ng/mL) is significantly associated with radiographic pneumonia but not with pneumonia based on WHO criteria.However, it can act as a surrogate marker for severe pneumonia.

The predictive value of procalcitonin combined with C-reactive protein and D dimer in moderately severe and severe acute pancreatitis.

ObjectiveThe objective of this study is to investigate the predictive value of a parametric model constructed by using procalcitonin, C-reactive protein (CRP) and D dimer within 48 h after admission in moderately severe and severe acute pancreatitis.MethodsA total of 238 patients were enrolled, of which 170 patients were moderately severe and severe acute pancreatitis (MSAP+SAP). The concentrations of procalcitonin, CRP and D dimer within 48 h after admission were obtained. The predictive value of the parametric model, modified computed tomography severity index (MCTSI), bedside index for severity in acute pancreatitis (BISAP), Ranson score, Acute Physiology and Chronic Health Evaluation II (APACHE II) score, modified Marshall score and systemic inflammatory response syndrome (SIRS) score of all patients was calculated and compared.ResultsThe area under receiver operator characteristic curve, sensitivity, specificity, Youden index and critical value of the parametric model for predicting MSAP+SAP were 0.853 (95% CI, 0.804–0.903), 84.71%, 70.59%, 55.30% and 0.2833, respectively. The sensitivity of the parametric model was higher than that of MCTSI (84.00%), Ranson score (73.53%), BISAP (56.47%), APACHE II score (27.65%), modified Marshall score (17.06%) and SIRS score (78.24%); the specificity of it were higher than that of MCTSI (52.94%) and Ranson score (67.65%), but lower than BISAP (73.53%), APACHE II score (76.47%), modified Marshall score (100%)and SIRS score (100.00%).ConclusionThe parametric model constructed by using procalcitonin 48 h, CRP 48 h and D dimer 48 h can be regarded as an evaluation model for predicting moderately severe and severe acute pancreatitis.

Improving the immunoassay for procalcitonin detection using an aeroelastic agitator: A feasibility study

Procalcitonin (PCT) is an important biomarker of bacterial infections. Detection of serum PCT is of great significance in diagnosis and therapy of a variety of diseases. In this work it is measured through immunoassay using antibody-conjugated fluorescent microspheres. To improve the binding efficiency of PCT antigen and antibody, an aeroelastic agitator is designed. Through alternate perturbations, it produces chaotic advection to enhance the fluid mixing. The influences of key design and operating factors are analyzed, including the geometrical parameters, the driving pressure, and the alternating period. Then the agitator is applied for PCT detection and its performance is compared with an ultrasonic mixer. Results show that the chaotic mixing significantly improves the capturing efficiency of PCT antigen, leading to a better detection consistency and reliability. The fluorescence intensity correlates fairly well with the serum PCT concentration in the range of 0.02 ng/ml–49.56 ng/ml.

Candidate High-Resolution Mass Spectrometry-Based Reference Method for the Quantification of Procalcitonin in Human Serum Using a Characterized Recombinant Protein as a Primary Calibrator.

Procalcitonin (PCT) is a widely used biomarker for rapid sepsis diagnosis and antibiotic stewardship. Variability of results in commercial assays has highlighted the need for standardization of PCT measurements. An antibody-free candidate reference measurement procedure (RMP) based on the isotope dilution mass spectrometry and protein calibration approach was developed and validated to quantify PCT in human serum. The method allows quantification of PCT from 0.25 to 13.74 μg/L (R > 0.998) with extension up to 132 μg/L after dilution of samples with PCT concentration above 13.74 μg/L. Intraday bias was between −3.3 and +5.7%, and interday bias was between −3.0 and −0.7%. Intraday precision was below 5.1%, and interday precision was below 4.0%. The candidate RMP was successfully applied to the absolute quantification of PCT in five frozen human serum pools. A recombinant PCT used as a primary calibrator was characterized by high-resolution mass spectrometry and amino acid analysis to establish traceability of the results to the SI units. This candidate RMP is fit to assign target values to secondary certified reference materials (CRMs) for further use in external quality assessment schemes to monitor the accuracy and comparability of the commercially available immunoassay results and to confirm the need for improving the harmonization of PCT assays. The candidate RMP will also be used to evaluate whether the correlation between the candidate RMP and immunoassays is sufficiently high. Overall, this candidate RMP will support reliable sepsis diagnosis and guide treatment decisions, patient monitoring, and outcomes.

Baseline Procalcitonin as a Predictor of Bacterial Infection and Clinical Outcomes in Covid-19

Objective: The purpose of our study is to determine either bacterial infection or poor outcomes among patients with Covid-19 caused by increased level of procalcitonin. Study Design: Retrospective/ observational study Place and Duration: THQ Hospital Khairpur Tamewali. Jan 2021-Jun 2021 Methods: In this research, there were a total of 190 patients of both sexes. Patients ranged in age from 20 to 85. Detailed demographics, including age, sex, BMI, residence, and literacy, were obtained from all patients. Association of comorbidities among cases was determined. All the patients diagnosed Covid-19 by nasopharyngeal PCR. Baseline level of procalcitonin was measured among all cases before hospitalization and patients were separated either had bacterial infection or not. Outcomes among all the patients were measured in terms of mortality and survivors. Complete data was examined using the SPSS 23.0 version for statistical purposes alone. Results: Among 190 cases, most of the patients were males 110 (57.9%) and 80 (42.1%) patients were females. Mean age of the patients were 52.13±13.44 years with mean BMI 26.14±11.54 kg/m2. 85 (44.7%) patients were from rural areas and 115 (55.3%) had urban residency. 100 (52.6%) patients were educated. Hypertension was the most common comorbidity found in 120 (63.2%), followed by diabetes 95 (50%), kidney disease found in 40 (21.1%) patients and asthma in 25 (13.2%) patients. Mean PCT among all cases was 1.4±6.13 ng/mL. Bacterial infection (positive blood culture) was found among 130 (68.4%) cases with procalcitonin. Severity of pneumonia was found among 123 cases of bacterial infection. Mortality among all cases were 102 (53.4%) with positive blood culture for bacterial infection. Mean PCT of died patients was 1.1±4.6 ng/mL significantly higher than that of survived patients 2.13±4.45. Blood urea nitrogen and aspartate aminotransferase (AST) were also found a predictive value among died patients. Conclusion: According to our findings, procalcitonin was the only biomarker strongly associated with patient mortality and satisfaction in the intensive care unit. With increasing procalcitonin concentrations, death rates increased as quartiles of procalcitonin levels rose. This study shows that intensivists may use procalcitonin to guide the management of COVID-19 and the utilization of ICU resources.

Specific Combinations of Inflammatory, Angiogenesis and Vascular Integrity Biomarkers Are Associated with Clinical Severity, Coma and Mortality in Beninese Children with Plasmodium Falciparum Malaria.

Malaria-related deaths could be prevented if powerful diagnostic and reliable prognostic biomarkers were available to allow rapid prediction of the clinical severity allowing adequate treatment. Using quantitative ELISA, we assessed the plasma concentrations of Procalcitonin, Pentraxine-3, Ang-2, sTie-2, suPAR, sEPCR and sICAM-1 in a cohort of Beninese children with malaria to investigate their potential association with clinical manifestations of malaria. We found that all molecules showed higher levels in children with severe or cerebral malaria compared to those with uncomplicated malaria (p-value < 0.005). Plasma concentrations of Pentraxine-3, Procalcitonin, Ang-2 and the soluble receptors were significantly higher in children with coma as defined by a Blantyre Coma Score < 3 (p < 0.001 for Pentraxine-3, suPAR, and sTie-2, p = 0.004 for PCT, p = 0.005 for sICAM-1, p = 0.04 for Ang-2). Moreover, except for the PCT level, the concentrations of Pentraxine-3, suPAR, sEPCR, sICAM-1, sTie-2 and Ang-2 were higher among children who died from severe malaria compared to those who survived (p = 0.037, p = 0.035, p < 0.0001, p= 0.0008, p = 0.01 and p = 0.02, respectively). These findings indicate the ability of these molecules to accurately discriminate among clinical manifestations of malaria, thus, they might be potentially useful for the early prognostic of severe and fatal malaria, and to improve management of severe cases.

Diagnostic value of different interleukins and procalcitonin in critically ill patients admitted with suspected sepsis.

: Many biomarkers have now been studied such as C-reactive Protein (CRP), procalcitonin (PCT), etc., and are widely used for the diagnosis of sepsis in clinical practice which may determine the appropriate antibiotic treatment. A flowcytometric cytokine bead array (CBA) assay has now been used to determine multiple interleukins (IL), simultaneously. The aim of this study was to determine the cytokine (IL2, IL4, IL6, IL10, TNFα, INFγ, and IL17) profiles of interleukins in plasma of sepsis patients by using multiplex Flowcytometric CBA array assay. s: A total of 99 consecutive patients admitted with the suspected sepsis were studied. PCT concentrations were measured by using the enzyme-linked fluorescent immunoassay (ELFA) technique and flow cytometry-based BD™ CBA Cytokine Kit was used to evaluate levels of 7 cytokines [IL-2, IL-4, IL-6, IL-10, Tumour Necrosis Factor (TNF), Interferon- γ (IFN-γ), and IL-17A]. Microbiologically defined infection (MDI) demonstrated a positive culture report in 79/99 (79.7%) of patients. The IL6 [1873.7 (4-5000)] and IL10 [(154.7 (0-1764)] levels were significantly higher in septic patients than those in the negative MDI IL6 [901 (4-5000)] and IL10 [110.4 (4-1372)] levels. The AUROC value of IL6 [0.66 (0.53-0.79)] was found to be the highest among all followed by IL10 [0.65 (0.51-0.79)], IFNγ [0.63 (0.51-0.77)], PCT [0.61 (0.48-0.75)], and TNFα [0.55 (0.42-0.69)]. Our study suggests that that IL6 is substantially more economical and can reduce the investigation cost to half as compared with the procalcitonin assay.

Can Procalcitonin Be Dosed in Bovine Milk Using a Commercial ELISA Kit?

Simple SummaryMastitis is one of the major economic and animal welfare problems on dairy farms. The gold standard test for mastitis diagnosis is milk culture, but bacteria are not always isolated (only in 11–44% of milk samples from clinical cases of mastitis) and sometimes a positive culture can result from a contamination of the milk. Procalcitonin is a new biomarker which may lead to an early detection of inflammation due to bacterial infection. In humans, procalcitonin concentration has also been evaluated in milk in addition to plasma. The authors aimed to evaluate the possible application of a commercially available ELISA kit for bovine procalcitonin for the assessing of procalcitonin in bovine milk samples. Plasma and milk samples from cows with mastitis were collected to measure procalcitonin concentrations by using a bovine procalcitonin ELISA kit. Our results showed that the ELISA kit tested can be employed to assess bovine procalcitonin in plasma but not for analyzing milk samples.The aim was to evaluate the use of a bovine procalcitonin (PCT) ELISA kit (Cusabio, China) for assessing PCT in bovine milk samples. Validation was performed by using 10 plasma and corresponding milk samples from mastitic cows. The limit of detection (LOD) was calculated. The coefficient of variation (CV%) of the readings of five plasma samples measured five times in the same plate (intra-assay) and the CV% of the same five samples read five times in three separate plates was evaluated. Parallelism was determined by serial twofold dilutions of five plasma and corresponding milk samples. Milk samples were analyzed with and without centrifugation. Regarding plasma PCT, the method presented an inter- and intra-CV < 23.7% and parallelism had very good recovery values. The ELISA kit studied can measure bovine plasma PCT concentrations. The kit antibodies fail in binding PCT in milk samples because all centrifuged milk samples showed a lower LOD than blank samples. Only three uncentrifuged milk samples showed measurable PCT concentrations. Due to these results, the commercial ELISA kit investigated could not be employed for the detection of PCT in milk samples.

Investigation of procalcitonin and beta-defensin2 in the serum and feces of dogs with acute diarrhea.

Acute diarrhea is a common clinical condition where clinical parameters are used to assess disease severity, course, and prognosis. The aim of this study was to investigate procalcitonin (PCT) and beta-defensin2 (Bdef2) as biomarkers for disease severity, course, and prognosis of dogs with acute diarrhea. Dogs with acute diarrhea (enteritis group [EG], n=35) were compared with 30 healthy controls. The dogs in the EG were scored using the Canine Acute Diarrhea Severity (CADS) index and grouped by bacterial fecal culture results. Procalcitonin and Bdef2 were analyzed in serum and feces. Dogs with acute diarrhea showed higher serum PCT concentrations (P<0.0001) and lower fecal Bdef2 concentrations (P=0.0001) than unaffected dogs. Serum PCT was moderately and positively related to the extent of disease classified by the CADS score. Dogs with Clostridium perfringens or hemolyzing Escherichia coli as predominant pathogen had increased serum Bdef2 concentrations (P<0.01). Differentiation between uncomplicated (≤3days) and complicated (>3days) disease courses, determined by receiver operating characteristic (ROC) curves, resulted in a sensitivity of 0.74 and a specificity of 0.69 for serum PCT at a cutoff of 3.9ng/mL. The serum PCT and fecal Bdef2 quotient resulted in a sensitivity of 0.80 and a specificity of 0.92, with a cutoff of 80.5. The results of the present study indicate that PCT and Bdef2 are potential biomarkers that can provide information on the severity, course, and prognosis of acute diarrhea in dogs.

AN OBSERVATIONAL STUDY TO EVALUATE THE USEFULNESS OF PROCALCITONIN AS A BIOMARKER OF SEPSIS IN THE EARLY STRATIFICATION OF ADULT PATIENTS ADMITTED TO THE INTENSIVE CARE UNIT WITH SUSPECTED INFECTION.

Serum Procalcitonin(PCT) has become useful as a biomarker to assist in the diagnosis of sepsis, as well as related infectious or inammatory conditions. It is a soluble protein liberated into the circulation of patients in response to severe systemic inammation, in particular by bacterial infection. The aim of this study was to evaluate the usefulness of Procalcitonin as a biomarker of sepsis in the early stratication of adult patients admitted to the intensive care unit with suspected infection.Patients are randomly divided into two groups , Group-1: comprising those patients with a bacterial infection (SIRS with Sepsis) and Group -2: comprising patients without a bacterial infection (SIRS without Sepsis). we found that elevated PCT concentrations (&gt; 0.5ng/ml) were detected in a signicantly higher proportion of patients with SIRS with sepsis compared to those with SIRS without sepsis so we concluded that PCT is an excellent marker providing the additive effect to improve the predictive power for diagnosing sepsis, for assessing severity of sepsis, and also for predicting the outcome/prognosis.

Evaluation of Procalcitonin and Interleukin-6 as a Marker of Bacterial Urinary Tract Infection.

Urinary tract infection (UTI) is a major clinical problem in a wide age range that is associated with a high morbidity rate. Due to issues such as low specificity and the inability to differentiate between different types of infection in current diagnostic methods, there is a need to introduce novel UTI markers. The present study was conducted to evaluate the utility of Procalcitonin (PCT) and interleukin-6 (IL-6) as a marker of bacterial urinary tract infection. For this purpose, a cross-sectional study was conducted between November 2020 and February 2021 among 125 patients and 60 healthy volunteers (control) in Erbil Teaching Hospital. The concentration of PCT and IL-6 was quantified using the ELISA cloud immunoassay test. Between-group comparisons were assessed for the variables with analysis of variance. The results revealed that there was a significant difference between PCT levels in UTI patients (104.6±6.07) and control groups (54±2.24) (p <0.0001). The differences in IL-6 concentration in UTI patients (55.74±4.2) and control groups (24.56±2.4) were also significant (p <0.0001), implying that the level of both PCT and IL-6 increased due to bacterial infection in the urinary tract. As a whole, the findings of this study provide.

The Effects of Different Blood Sample Types on Quantitative Detection of Procalcitonin.

Procalcitonin (PCT) has been recommended and widely used for the prognosis, diagnosis, and monitoring of sepsis. Currently, a majority of PCT detection products are limited to using serum samples, which requires the tedious pre-treatment process, as well as a large sample volume for analysis. Hence, there is an increasing need to replace serum with plasma or whole blood samples. In this work, we evaluated the effects of different blood sample types on PCT quantitative detection by measuring PCT levels in clinically homogenous whole blood, plasma, and serum samples, in hope of extending the application of PCT detection in more sample types. Ninety patients from Tong Ren Hospital of Shanghai Jiao Tong University, School of Medicine with different PCT levels volunteered for this study. Clinically homogenous samples, including EDTA- K2 anticoagulant whole blood, centrifuged serum and procoagulant plasma, were collected and analyzed using i-Reader S automatic immunoanalyzer and its supporting reagent kits. Passing and Bablok regression analysis, Bland-Altman plotting, and Kappa test were used for consistency analysis and the determination of consistency intensity, respectively. Correlation analysis showed that PCT concentrations measured from EDTA-K2 anticoagulated plasma samples had a good linear regression relationship with PCT from serum samples, with a slope of 0.8741, r = 0.958, p < 0.05. A similar correlation was observed between whole blood and serum, with a slope of 0.9234, r = 0.965, p < 0.05. A good correlation was found from the quantitative results of different sample types obtained from the same patient. In detail, PCT levels in EDTA-K2 anticoagulant whole blood and plasma are well correlated with that in the serum (r = 0.831, p < 0.05; r = 0.814, p < 0.05). There was no significant difference among different sample types (p > 0.05). Variation in PCT quantification induced by different sample types has no statistical influence on positive/negative decision (p > 0.05). Bland-Altman analysis for assessing PCT concentration agreement showed there was no outlier ratio between whole blood and plasma within the range of the detection system, as well as no outlier between serum and plasma. Kappa coefficient of PCT concentration between serum and homologous EDTA-K2 anticoagulated plasma was 0.8942 (p < 0.001), and for serum and homologous whole blood it was 0.6954 (p < 0.001). We concluded that quantitative PCT detection can be conducted in different sample types with good correlation and consistency, which means that it is feasible to replace serum samples with whole blood and/or plasma samples for PCT detection in clinical use. These findings reduce the sample volume and turnover time of PCT detection in clinical labs, greatly improving the process of PCT detection and promoting the application of PCT as an important inflammatory biomarker for disease diagnosis.