Role Of Procalcitonin Research Articles

Linking Inflammatory Biomarkers to COVID-19 Outcomes: The Role of Procalcitonin, IL, IFN-γ, and CRP.

Linking Inflammatory Biomarkers to COVID-19 Outcomes: The Role of Procalcitonin, IL, IFN-γ, and CRP.

The Role of Procalcitonin and Red Cell Distribution Width as Diagnostic and Prognostic Biomarkers in Patients with Sepsis and Septic Shock at Intensive Care Unit

Abstract Background Sepsis is defined as life-threatening organ dysfunction caused by a dysregulated host response to infection. Organ dysfunction can be identified as an acute change in total sequential organ failure assessment (SOFA). Septic shock is a subset of sepsis with circulatory and cellular/metabolic dysfunction associated with a higher risk of mortality. Biomarkers can be used in suspected sepsis for identifying or ruling out sepsis, evaluating the severity and assessing the prognosis and evaluating patients’ response to proper treatment. This study is on procalcitonin (PCT) and red cell distribution width (RDW) as diagnostic and prognostic biomarkers in patients with sepsis and septic shock. Objective This study aims to assess the feasibility of PCT and RDW as early diagnostic and prognostic biomarkers in patients with sepsis and septic shock. Methods This is a prospective observational study, in which 100 blood samples of clinically suspected sepsis and septic shock patients’ were included following a convenience sampling technique. PCT and RDW were recorded in day 0, 3, 6, 9 and 12. Results A rise in RDW and PCT levels could serve as early indicators of outcome including mortality. We found that baseline RDW cut-off point > 15.6 with sensitivity of 80.0%, specificity of 85.71% while in day 12 cut-off point > 17.3 with sensitivity of 60.0%, specificity of 100.0%. Accordingly PCT cut-off point > 4.1 with sensitivity of 80.0% and specificity of 94.29% in baseline values. While cut-off point in day 12 was > 0.7 with sensitivity of 80.0%, specificity of 97.0%. Conclusion A significant concurrence was seen between elevated serum PCT and RDW levels with severity and prognosis of sepsis. They were found to be a good predictor of sepsis and low levels rule out an infection.

The role of procalcitonin as a risk stratification tool of severity, prognosis, and need for surgery in patients with acute left-sided colonic diverticulitis

BackgroundImaging-based classifications do not always reflect the clinical severity and prognosis of acute left-sided colonic diverticulitis. This study aims to investigate the role of an early procalcitonin assessment in the emergency department as a risk stratification tool for severity, prognosis, and need for surgery in patients with acute left-sided colonic diverticulitis. MethodsIn this retrospective cohort study, all adult patients consecutively admitted from January 2015 to September 2020 for acute left-sided colonic diverticulitis and having a procalcitonin determination at admission were enrolled. The following data were collected: age, sex, comorbidities, laboratory parameters, level of urgency, clinical presentation, type of treatment, complications, and post-management outcomes. The association between the procalcitonin value at admission and the following endpoints was analyzed: type of treatment, classification of acute left-sided colonic diverticulitis, mortality, and type of surgery. ResultsA total of 503 consecutive patients were enrolled. Procalcitonin >0.5 ng/mL emerged as an independent risk factor for complicated acute left-sided colonic diverticulitis (P = .007). Procalcitonin >0.5 ng/mL (P = .033), together with a history of complicated acute left-sided colonic diverticulitis (P < .001), abdominal pain (P = .04), bowel perforation (P < .001), and peritonitis (P < .001), was a significant risk factor for surgery. Procalcitonin >0.5 ng/mL (P = .007) and peritonitis (P = .03) emerged as independent risk factors for sigmoidectomy without colorectal anastomosis. Procalcitonin >0.5 ng/mL (P = .004), a higher level of urgency at admission (P = .005), Hartmann’s procedure (P = .002), and the necessity of mechanical ventilation (P = .004) emerged as independent risk factors for mortality. ConclusionProcalcitonin >0.05 ng/mL at emergency department admission is a useful risk stratification tool for severity, prognosis, and need for surgical treatment in patients with acute left-sided colonic diverticulitis.

The Role of Procalcitonin in Neonatal Sepsis-examining Facts and Misconceptions

Background: Neonatal sepsis has remained a major cause of neonatal morbidity and mortality. Despite advances in neonatal diagnostics, its diagnosis has remained challenging majorly because its symptoms are vague and blood culture which remains the gold standard for diagnosis is cumbersome and has poor yield and other forms of sepsis are usually not sought for (anaerobes, viral fungal). The search for newer diagnostic methods is still on going and procalcitonin has shown some promise. Aim/Objective: The aim of the study is to examine the role procalcitonin plays in neonatal sepsis. Materials and Methods: A total of 248 neonates with suspicion of sepsis were enrolled and had their samples taken for blood culture, full blood count, C-reactive and procalcitonin assay based on which the neonates were classified as proven, suspected and clinical sepsis. Result: The behaviour of procalcitonin in the different sepsis groups (more elevated in proven and suspected than clinical), ages (to accommodate the physiologic variation seen in the first 72hours of life) and according to isolates (more elevated in gram negative than gram positive sepsis). The diagnostic value of procalcitonin was also determined and found have sensitivity 74.5%, specificity 38.3%, positive predictive value 42.4% and negative predictive value 71.1%, which were better after &gt;72hours of life. Conclusion: For now, procalcitonin should continue to serve as a supportive marker for sepsis as its levels are affected by age of the neonate, sepsis mimics, and type of offending organism causing the infection.

Role of Procalcitonin as a Prognostic Marker in Patients with Diabetic Ketoacidosis

Role of Procalcitonin as a Prognostic Marker in Patients with Diabetic Ketoacidosis

Role of Procalcitonin in Pediatric Patients with Pneumonia

Role of Procalcitonin in Pediatric Patients with Pneumonia

Role of procalcitonin, interleukin-6 and interleukin-10 as a predictive marker for the use of perioperative steroid in maxillofacial trauma patients

Maxillofacial trauma often brings significant challenges for surgeons in terms of preoperative oedema. Steroids offer oedema reduction, yet potentially increase the risks of postoperative infection. This study explores procalcitonin (PCT), as a marker for bacterial infection risk, and interleukins IL-6 and IL-10, which respectively signify pro-inflammatory and anti-inflammatory responses, as potential indicators of infection and inflammation in these trauma cases and thereby aid in refining perioperative guidelines for the use of steroids. A prospective study was conducted at a tertiary public hospital in India from 2019 to 2022 on patients >18 years with facial trauma. After specific exclusions, patients were randomised into steroid (Group A) and non-steroid (Group B) groups. Various parameters including oedema, PCT, IL-6, and IL-10 levels were measured and analysed using SPSS software. Out of 80 patients, 44 were in Group A and 36 in Group B. Post-24 hours, Group A showed significant oedema reduction, with 25 patients displaying a decline to mild oedema, versus 10 patients in Group B (p = 0.034). However, Group A witnessed a higher infection risk, with 20 patients showing positive wound cultures versus three in Group B. Subgroup analysis revealed a link between higher PCT levels and infections (p = 0.039). Additionally, Group A showed less intraoperative bleeding and reduced operating time. While perioperative steroids mitigate swelling, they might increase postoperative infection risk. Elevated PCT levels indicate potential wound infections, suggesting those patients should avoid perioperative steroids. IL-6 and IL-10 trends during perioperative phases can predict pronounced oedema outcomes.

Role of procalcitonin in guiding antibiotic usage in acute pancreatitis - a randomized controlled trial

Role of procalcitonin in guiding antibiotic usage in acute pancreatitis - a randomized controlled trial

The Role of Procalcitonin and C-Reactive Protein in Prediction of Etiology of Bloodstream Infections

The Role of Procalcitonin and C-Reactive Protein in Prediction of Etiology of Bloodstream Infections

859. The Role of Procalcitonin in Antimicrobial De-escalation and Stewardship Program in Febrile Neutropenic Cancer Patients

Abstract Background Serial procalcitonin (PCT) measurement has been adopted as an adjunct to clinical judgement to guide antibiotic therapy, prevent antibiotics overuse and endorse antimicrobial stewardship programs. PCT peaks at 24 to 48 hours, and declines with infection resolution. In this prospective study we explored the role of PCT used as a biomarker in adjunct to the clinical judgment to guide antibiotic course. Methods We prospectively enrolled cancer patients with febrile neutropenia (FN) to receive empiric intravenous broad-spectrum antibiotics (IV-BSA) for at least 48 hours. PCT was measured at baseline and 48-72 hours after initiation of study drug. A PCT drop at 48-72 hours after study drug initiation was defined as a drop by ≥30 % from baseline (start of therapy) or a level of &amp;lt; 0.25 ng/ml. De-escalation was defined as a switch of IV-BSA to oral or simplified once a day IV therapy. Results A total of 80 patients were enrolled between October 2021 and April 2023, of whom 74 had serial PCT measurements. Median age was 59 years, 57% were male, and 66% had hematological malignancies. A PCT drop at 48-72 hours was observed in 68% of patients who de-escalated to oral or IV therapy. In this PCT guided study, the median time to de-escalation was 62 hours (&amp;lt; 3 days). Furthermore, 64% of these patients de-escalated within 3 days after initiation of therapy, 79% de-escalated by day 4, 85% by day 5 and 92% by day 7. Patients with PCT drop had a shorter median duration of antibiotic compared to those without PCT drop (54.8 hours vs 106.4 hours; p=0.003). Furthermore, the antibiotic therapy de-escalation occurred sooner in patients with PCT drop (75% occurred prior or at 72 hours in the PCT drop group vs 41% in the non-PCT drop group; p=0.017). Patients who had a documented bacteremia had a significantly higher median PCT level at baseline than those without bacteremia (3.92 ng/ml vs 0.37 ng/ml; p=0.001). Conclusion In this PCT guided study, the median time to de-escalation of IV-BSA was &amp;lt; 3 days and most of the cancer patients with FN who de-escalated had a PCT drop within 3 days of initiating therapy. Patients with a PCT drop had an earlier de-escalation and a shorter course of antibiotic therapy. Disclosures Natalie J Dailey Garnes, MD, MPH, AlloVir: Grant/Research Support Issam I. Raad, Distinguished Professor, Novel Anti-Infective Technologies, LLC: Technology License

Role of procalcitonin in predicting newborn hospital-acquired sepsis: a case–control study

BackgroundNeonatal sepsis is a leading cause of newborn mortality in the developing world. Most of the newborn babies admitted to a neonatal ICU for different reasons acquire hospital-acquired infections. Early and optimal management is pivotal for successful outcomes. However, most of the places lack advanced automated culture facilities. Procalcitonin could potentially be used for early diagnosis of such infection.ObjectiveTo study the diagnostic role of serum procalcitonin in newborn hospital-acquired sepsis.Materials and methodsA case–control study was conducted in a tertiary care hospital in northern India.ResultsCulture-positive nosocomial sepsis group consisted of 59 patients and the control group of 41 patients. Gram-negative organisms were the most commonly isolated organisms (91.5%). The baseline median and interquartile range (IQR) serum PCT of the study population was 0.3 (0.18–.44) ng/ml. The median (IQR) serum PCT values at the time of clinical deterioration in the nosocomial sepsis and the sepsis-like illness groups are 4 (6.5) ng/ml and 1.2 (1.6) ng/ml, respectively (p = 000). The area under the ROC curve for the prediction of bacterial infection for PCT was 0.864. On the ROC curve, the PCT level that combined the greatest sensitivity and comparatively good specificity was 1.95 ng/ml, with a sensitivity of 88%, and specificity of 79%.ConclusionWe conclude that serum procalcitonin is a reliable marker for the diagnosis of neonatal nosocomial sepsis.

"A Brief Overeview: The Role of Procalcitonin in the Emergency Medicine"

"A Brief Overeview: The Role of Procalcitonin in the Emergency Medicine"

Management of Intra-Abdominal Infections: The Role of Procalcitonin.

Patients with intra-abdominal sepsis suffer from significant mortality and morbidity. The main pillars of treatment for intra-abdominal infections are (1) source control and (2) early delivery of antibiotics. Antibiotic therapy should be started as soon as possible. However, the duration of antibiotics remains a matter of debate. Prolonged antibiotic delivery can lead to increased microbial resistance and the development of nosocomial infections. There has been much research on biomarkers and their ability to aid the decision on when to stop antibiotics. Some of these biomarkers include interleukins, C-reactive protein (CRP) and procalcitonin (PCT). PCT's value as a biomarker has been a focus area of research in recent years. Most studies use either a cut-off value of 0.50 ng/mL or an >80% reduction in PCT levels to determine when to stop antibiotics. This paper performs a literature review and provides a synthesized up-to-date global overview on the value of PCT in managing intra-abdominal infections.

Role of Procalcitonin, C-reactive Protein and Total Leucocyte Count in Suspected Cases of Sepsis

Background: Sepsis is a life-threatening infection, responsible for tremendous morbidity, mortality and healthcare expenditure worldwide. Sepsis is characterized by non-specific symptoms and clinical diagnosis remains difficult. C Reactive protein (CRP) and procalcitonin (PCT) are now days used as surrogate markers of sepsis. Aim: To determine PCT levels in patients with suspected sepsis and its correlation with CRP and total leucocyte count (TLC). Material &amp; Methods: The retrospective study was conducted in tertiary care hospital in India. Adults patients (&gt; 18 years) admitted to Intensive care unit in the hospital during study period, fulfilling the ACCP criterion for the diagnosis of sepsis were included in the study. Data was collected using laboratory software maintaining confidentiality. Results: The study comprised of 190 patients. Patients were divided into four groups based on PCT values and severity of sepsis. Out of 190 patients, PCT was positive in 135 patients. The CRP and TLC levels were distributed into the four PCT groups and their correlation with PCT was studied. For PCT values between 2-10ng/ml, &gt;10ng/ml CRP showed statistically significant correlation with p value &lt;0.05, whereas correlation of TLC with PCT was poor. Conclusion Procalcitonin along with CRP is a better diagnostic tool for sepsis but their correlation in context to TLC was poor. Due to lack of an ideal isolated marker, our study mandates multidisciplinary approach for diagnosis of sepsis. Keywords: Sepsis, Procalcitonin, C reactive protein, Total leucocyte count, Culture

The Role of Procalcitonin as an Antimicrobial Stewardship Tool in Patients Hospitalized with Seasonal Influenza

Up to 60% of the antibiotics prescribed to patients hospitalized with seasonal influenza are unnecessary. Procalcitonin (PCT) has the potential as an antimicrobial stewardship program (ASP) tool because it can differentiate between viral and bacterial etiology. We aimed to explore the role of PCT as an ASP tool in hospitalized seasonal influenza patients. We prospectively included 116 adults with seasonal influenza from two influenza seasons, 2018-2020. All data was obtained from a single clinical setting and analyzed by descriptive statistics and regression models. In regression analyses, we found a positive association of PCT with 30 days mortality and the amount of antibiotics used. Influenza diagnosis was associated with less antibiotic use if the PCT value was low. Patients with a low initial PCT (<0.25 µg/L) had fewer hospital and intensive care unit (ICU) days and fewer positive chest X-rays. PCT had a negative predictive value of 94% for ICU care stay, 98% for 30 days mortality, and 88% for bacterial coinfection. PCT can be a safe rule-out test for bacterial coinfection. Routine PCT use in seasonal influenza patients with an uncertain clinical picture, and rapid influenza PCR testing, may be efficient as ASP tools.

The role of procalcitonin in the follow-up of medullary thyroid cancer.

Calcitonin (Ct) represents the most important biochemical marker of medullary thyroid cancer (MTC), but has certain limits. We analyzed the performance of procalcitonin (ProCt) in follow-up MTC patients. In this monocentric and retrospective study, we consecutively obtained ProCt and Ct values from all MTC patients that we visited during the period from April 2021 to May 2022. Patients were defined as having structural evidence of disease (29/90, 32.2%) irrespective of Ct values or, in its absence, as not evident disease (NED) if Ct was ≤10 ng/L (47/90, 52.2%), or minimal residual disease if Ct was >10 ng/L (14/90, 15.6%). Ct and ProCt values were highly correlated (r = 0.883, P < 0.01). Median ProCt values differed between NED, minimal residual disease, and structural disease, being 0.04 ng/mL, 0.26 ng/mL, and 1.98 ng/mL, respectively (P < 0.01). ProCt was undetectable (<0.04 ng/mL) in 40/47 (85.1%) of NED patients, in 3/14 (21.4%) patients with minimal residual disease and in none of the patients with a structural disease (P < 0.01). Among the 11 patients with detectable but ≤10 ng/L Ct and undetectable ProCt values, none had a structural disease. The most accurate cut-off of ProCt to distinguish between the presence or absence of a structural disease was >0.12 ng/mL (P < 0.01, area under the curve: 0.963), with the following sensitivity, specificity, positive predictive value, and negative predictive value (NPV): 100%, 83.61%, 74.4%, and 100.0%. ProCt and Ct have a high correlation in MTC follow-up. ProCt may be useful as an adjunct to Ct, especially for its NPV concerning the structural disease.

The Role of Procalcitonin and Serum Amyloid a As a Laboratory Biomarker in COVID-19

The Role of Procalcitonin and Serum Amyloid a As a Laboratory Biomarker in COVID-19

Role of Procalcitonin and C-reactive Protein as Predictors of Sepsis and in Managing Sepsis in Postoperative Patients: A Systematic Review.

Systemic inflammatory response syndrome (SIRS) and sepsis are inflammatory responsesto infection or trauma, causing symptoms and adverse outcomes such as organ shutdown and death. Different scoring systems can help in the diagnosis of SIRS and sepsis. Several biomarkers such as C-reactive protein (CRP), procalcitonin (PCT), and white blood cells (WBCs) can serve as predictors of sepsis. Surgery, trauma, and burns are the non-inflammatory causes of SIRS and sepsis. In postoperative patients, both inflammatory and non-inflammatory causes of immune response may co-exist. The role of inflammatory biomarkers in identifying sepsis development, deciding to use antibiotics, and discharging patients needs further exploration and clarity. We searched medical databases such as PubMed/Medline, PMC, ScienceDirect, Cochrane Library, and Google Scholar for relevant medical literature. The identified papers were screened, eligibility criteria were applied, and 15 research papers were identified. The finalized papers explored the roles of CRP and PCT in postoperative patients. Both CRP and PCT are raised in a postoperative patient, and then, gradually, the levels decrease. However, in case of an infection, these levels continue to rise and signify an infection, which may progress to sepsis. The cut-off values can guide decision-making about when to start antibiotics and discharge the patient. PCT was found to be more reliable in identifying the infection and preventing the development of sepsis. Further research is needed to identify the exact cut-off values that can help in decision-making.

Role of procalcitonin in predicting occurrence of bacteraemia: About 109 cases

The aim of this study was to evaluate procalcitonin (PCT) levels in the predicting of bloodstream infections in a large population of patients with positive blood cultures (BC) in the unit care of Avicenna military hospital of Marrakech. Material and Methods: This prospective study was carried out using clinical and routine laboratory data collected at the Clinical Microbiology and biochemistry from laboratory of Avicenna military hospital – Marrakech, Morocco, between January 2019 and December 2021. Results: 109 cases were collected from laboratory data of Avicenna military hospital in Marrakech. Most of patient were male with 79 cases (72.5%), blood cultures were positive in all cases. Procalcitonin were positive in the majority of patients with a 105 cases (96%). Klebsiella sp. was the most frequent germ in gram negative bacilli with a rate of 25 cases (23%) Coagulase-negative Staphylococcus was the most frequent germ in gram-positive cocci with a rate of 23 cases (21%).

Role of procalcitonin in predicting occurrence of bacteraemia: About 109 cases

Role of procalcitonin in predicting occurrence of bacteraemia: About 109 cases