Role Of Procalcitonin Research Articles

The Diagnostic Value of Procalcitonin in Patients with Severe Acute Pancreatitis: A Meta-Analysis.

The role of procalcitonin in diagnosing severe acute pancreatitis has not been clearly assessed. This meta-analysis aims to evaluate the overall diagnostic accuracy of procalcitonin as a biomarker for severe acute pancreatitis. Medline (via PubMed), Embase, Web of Science, Cochrane Library, China National Knowledge Infrastructure, and China WanFang Data were searched systematically for prospective studies reporting procalcitonin as a diagnostic marker of severe acute pancreatitis before August 31, 2021. Sensitivity, specificity, and other measures of the accuracy of procalcitonin in the diagnosis of severe acute pancreatitis were pooled by Stata 15.0 software. Heterogeneity was evaluated by I2 test, and the quality of included studies was evaluated by using the Quality Assessment of Diagnostic Accuracy Studies-2 system. Further, the sources of heterogeneity were verified using meta-regression and subgroup analysis, and the publication bias was evaluated by the Deeks’ funnel plot. A total of 18 studies meeting the inclusion criteria were included, containing 1764 patients. The pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic odds ratio, and area under the receiver operating characteristic curve of procalcitonin for diagnosing severe acute pancreatitis were as follows: 0.80 (95% CI: 0.73-0.86), 0.84 (95% CI: 0.78-0.88), 4.95 (95% CI: 3.46-7.09), 0.23 (95% CI: 0.16-0.34), 21.26 (95% CI: 11.09-40.74), 0.89 (95% CI: 0.86-0.92). Also, P > .05 suggested no significant publication bias. Current evidence indicates that procalcitonin has good sensitivity and diagnostic accuracy for severe acute pancreatitis. However, the findings should be carefully used as routine evidence in diagnosing patients with severe acute pancreatitis alone because of the limited number of included studies and high heterogeneity.

The role of procalcitonin and Clinical Pulmonary for Infection Score (CPIS) score to reduce inappropriate antibiotics use among moderate to severe coronavirus disease 2019 (COVID-19) pneumonia: A quasi-experimental multicenter study.

In this quasi-experimental study, implementing a procalcitonin and Clinical Pulmonary Infection Score (CPIS) successfully reduced inappropriate antibiotic use among severely-to-critically ill COVID-19 patients, multidrug-resistant organisms, and invasive fungal infections during the intervention period in 2 medical centers. However, this strategy did not improve inappropriate antibiotic use among mildly-to-moderately ill COVID-19 patients.

The role of procalcitonin as a biomarker for acute pulmonary exacerbation in subjects with cystic fibrosis and non-cystic fibrosis bronchiectasis

Objective: Patients with cystic fibrosis (CF) and non-CF bronchiectasis are prone to exacerbations of pulmonary infections. C-reactive protein (CRP) and procalcitonin (PCT) are inflammatory markers. The aim of this study is to evaluate the role of CRP and PCT on exacerbations of CF and non-CF bronchiectasis. Patients and Methods: The medical records of 18 CF (52 hospitalizations) and 20 non-CF bronchiectasis patients (51 hospitalizations) were reviewed retrospectively. CRP, PCT levels and, white blood cell (WBC) counts on admission and follow-up were evaluated. Results: C-reactive protein levels correlated with PCT levels on admission in all patients. Baseline PCT levels were markedly higher (>0.5µg/L) in 12% of CF and 10% of non-CF bronchiectasis patients, however, baseline CRP values were markedly higher (>5mg/L) in 96% of CF and non-CF bronchiectasis patients (p=0.760 and p=0.100, respectively). Baseline CRP and PCT levels were positively correlated with hospitalization length (r=0.501, p=0.001 and r=0.289, p=0.04, respectively) in CF patients, but not in non-CF bronchiectasis. Conclusion: Our study shows the potential utility of these biomarkers to determine the severity of the exacerbation particularly predicting hospitalization length in CF patients. Both biomarkers could be able to guide antibiotic treatment of infective exacerbations in CF and non-CF bronchiectasis patients

Role of Procalcitonin in Predicting Mortality and Organ Dysfunction at Intensive Care Admission.

ObjectiveTo assess the prognostic utility of procalcitonin (PCT) in high-risk sepsis patients.MethodsA retrospective cohort study was conducted with the inclusion of all eligible intensive care unit patients with Sequential Organ Failure Assessment (SOFA) score of 2 or more.ResultsA total of 228 patients were acquired from January 2018 to December 2020, with male predominant (58.8%), mean age of 53.61 years old. The overall 28-day mortality was 57.5%. In the group with PCT ≥ 7 ng/mL, 28-day mortality was 68.5% (87 patients out of a total of 127). Cox regression showed that in this group, the risk of mortality occurring within 28 days from the day of ICU admission was 1.55 times higher (95% CI 1.074–2252, p value 0.02). Independent sample t-test showed that in this group, the mean SOFA score was higher by 2.279 (95% CI 1.497–3.060, p value <0.001).ConclusionProcalcitonin levels are associated with mortality and SOFA scores in sepsis patients. Further studies need to be carried out to provide more evidence so that it can help reduce the mortality and morbidity of sepsis.

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 role of procalcitonin in predicting risk of mechanical ventilation and mortality among moderate to severe COVID-19 patients

BackgroundSerum procalcitonin (PCT) has become an emerging prognostic biomarker of disease progression in patients with COVID-19. This study aims to determine the optimal cut-off value of PCT with regards to important clinical outcomes, especially for mechanical ventilation and all-cause mortality among moderate to severe COVID-19 patients in Malaysia.MethodsA total of 319 moderate to severe COVID-19 patients hospitalized at the National Referral Hospital in December 2020 were included in the study retrospectively. Demographics, comorbidities, the severity of COVID-19 infection, laboratory and imaging findings, and treatment given were collected from the hospital information system for analysis. The optimal cut-point values for PCT were estimated in two levels. The first level involved 276 patients who had their PCT measured within 5 days following their admission. The second level involved 237 patients who had their PCT measured within 3 days following their admission. Further, a propensity score matching analysis was performed to determine the adjusted relative risk of patients with regards to various clinical outcomes according to the selected cut-point among 237 patients who had their PCT measured within 3 days.ResultsThe results showed that a PCT level of 0.2 ng/mL was the optimal cut-point for prognosis especially for mortality outcome and the need for mechanical ventilation. Before matching, patients with PCT ≥ 0.2 ng/mL were associated with significantly higher odds in all investigated outcomes. After matching, patients with PCT > 0.2 ng/mL were associated with higher odds in all-cause mortality (OR: 4.629, 95% CI 1.387–15.449, p = 0.0127) and non-invasive ventilation (OR: 2.667, 95% CI 1.039–6.847, p = 0.0415). Furthermore, patients with higher PCT were associated with significantly longer days of mechanical ventilation (p = 0.0213). There was however no association between higher PCT level and the need for mechanical ventilation (OR: 2.010, 95% CI 0.828–4.878, p = 0.1229).ConclusionOur study indicates that a rise in PCT above 0.2 ng/mL is associated with an elevated risk in all-cause mortality, the need for non-invasive ventilation, and a longer duration of mechanical ventilation. The study offers concrete evidence for PCT to be used as a prognostication marker among moderate to severe COVID-19 patients.

Association of Procalcitonin to Albumin Ratio with the Presence and Severity of Sepsis in Neonates.

PurposePrevious studies have demonstrated that procalcitonin and albumin have a close correlation with sepsis. However, the role of procalcitonin (PCT) to albumin (ALB) ratio (PAR) in sepsis was still unclear, especially in neonates. Thus, this study aimed to investigate the association between PAR and neonatal sepsis.Patients and MethodsA total of 1,196 neonates with suspected sepsis were included in this study. Neonates were divided into control group and sepsis group, according to whether they were diagnosed with sepsis. Neonates with sepsis were further divided into mild sepsis and severe sepsis group according to the severity of sepsis. PAR was calculated as serum PCT (ng/mL)/ALB (mg/mL). All statistical analyses were performed using the statistical package SPSS 24.0, as appropriate.ResultsCompared with the control group, neonates with sepsis had a higher PAR. PAR also showed a significant gradual increase in the control, mild sepsis, and severe sepsis groups (P<0.001). Correlation analysis showed that there was a strong positive correlation between PAR and hsCRP, neonatal sequential organ failure assessment score (nSOFA), and prolonged length of hospital stay (P<0.001). On multiple logistic regression, higher PAR was independently associated with the presence and severity of neonatal sepsis. According to the receiver operating characteristic curve analysis, a PAR ≥0.065 had 64% sensitivity and 72% specificity in predicting the presence of neonatal sepsis (area under curve (AUC)=0.72, 95% CI=0.69–0.75, P<0.001) and a PAR≥0.070 had 69% sensitivity and 63% specificity in predicting the presence of severe sepsis (AUC=0.71, 95% CI=0.68–0.74, P<0.001).ConclusionPAR is significantly higher in neonates with sepsis and correlated with the severity of the disease. Increased PAR is an independent predictor useful for identifying the presence and severity of neonatal sepsis.

Contested role of procalcitonin and C-reactive protein in the diagnosis of fascioliasis

Contested role of procalcitonin and C-reactive protein in the diagnosis of fascioliasis

Role of procalcitonin as a predictor of clinical outcomes in hospitalized patients with COVID-19

ObjectivesIn this study, we aimed to determine the correlation between procalcitonin (PCT) levels and clinical outcomes including in-hospital mortality, intensive care unit (ICU) length of stay, and hospital length of stay in patients hospitalized with COVID-19. MethodsClinical, laboratory, and demographic data of 223 patients who met inclusion criteria were analyzed. PCT measurements of 0.25 ng/mL and 0.50 ng/mL were used to stratify patients into 2 mutually exclusive groups. ResultsPatients with PCT above 0.25 ng/mL on admission had significantly elevated Acute Physiology and Chronic Health Evaluation II scores (9 vs 8; P = 0.042) and C-reactive proteins levels (111 μg/mL vs 79 μg/mL; P = 0.007). A multivariable binary logistic regression model demonstrated no relationship between PCT and mortality (OR = 1.00; 95% Cl: 0.97 to 1.02; P = 0.713). Kaplan-Meier analysis revealed no statistical evidence of a difference between PCT groups and hospital length of stay (P = 0.144 for 0.25 ng/mL, P = 0.368 for 0.50 ng/mL) or intensive care unit length of stay (P = 0.986 for 0.25 ng/mL, P = 0.771 for 0.50 ng/mL). ConclusionsElevated PCT levels were associated with severity of illness but did not correlate with in-hospital mortality, hospital length of stay, or ICU length of stay.

Role of Procalcitonin in Intracerebral Hemorrhage Stroke with COVID-19

Introduction: As COVID-19 has rapidly spread worldwide, it is an urgent health problem. Some evidence suggests that SARS-CoV-2 also affects the central nervous system. Stroke is the most common disease of the central nervous system. In contrast to ischemic stroke, which can occur due to the hypercoagulation effect of COVID-19, the study of Intracerebral Hemorrhage (ICH) associated with COVID-19 is still unclear. Objective: This paper investigated the characteristics of an inflammatory biomarker and compared the outcomes of ICH patients with COVID-19 and ICH patients without COVID-19. Methods: We conducted a retrospective, observational analysis case-control of patients (n = 42) admitted with ICH with positive COVID-19 and ICH with negative COVID-19 at the National Brain Center Hospital Prof.Dr.dr. Mahar Mardjono from March 2020 to August 2021. We took blood samples and COVID-19 swab PCR on the first day of admission, and GOS was measured when the patients were discharged. Results: There were 21 ICH patients with positive COVID-19 who had a significantly procalcitonin (p &lt; 0.05) compared to control patients. From Spearman’s correlational analysis, there is a significant value between early procalcitonin and the Barthel Index (rs = -0,374, p &lt; 0.05), early CRP and GOS (rs =- 0.329, p &lt; 0.05), which indicates weak-inverse correlation, and between early PCT and GOS (rs = -0.438, p &lt; 0.05) which indicates moderate-inverse correlation. Conclusion: The level of procalcitonin was increased in ICH patients with COVID-19. Maybe PCT could be a predictor of outcome in ICH patients with COVID-19.

The Role of Procalcitonin in Predicting Necessity of Antivenom Administration and Clinical Severity in Snake Bites.

One of the most important steps for preventing deaths due to snake bites is to administer snake antivenom to the eligible patients in a swift manner. In our study, we aimed to investigate whether procalcitonin is useful for predicting the clinical severity and the necessity of antivenom therapy at the early stages in patients presenting with snake bite. A total of 78 patients over the age of 18 who applied to the emergency department within the first 24 hours were included in this retrospective cross-sectional study. Age and sex of patients, severity of snake bites, total antivenom vials administered, observation periods and outcomes were recorded. Patients were graded according to their clinical severity after the snake bite. Procalcitonin, complete blood count and biochemical parameters of the patients were recorded. According to their clinical severity, the patients' grades were as follows: 21 (26.9%) patients were grade 0; 21 patients (26.9%) were grade 1; 16 patients (20.5%) were grade 2; and 20 patients (25.6%) were grade 3. Snake antivenom was administered to 57 (73.1%) patients. There was a statistically significant difference between procalcitonin levels of patients in respect to their grade (P < 0.001). Sensitivity and specificity of procalcitonin levels of 13.45 and above were 100% and 100% respectively, both for the need of antivenom administration and for the blister formation in the patients. According to our study, we believe that elevated procalcitonin levels should alert the clinicians for possible blister formation, higher clinical severity, and increased requirement for antivenom administration.

Low-Level Elevations of Procalcitonin Are Associated with Increased Mortality in Acute Heart Failure Patients, Independent of Concomitant Infection.

We aimed to evaluate the prognostic value of procalcitonin (PCT) in acute heart failure (AHF) patients, especially in those without underlying infection. We enrolled patients presenting with acute dyspnea to the emergency department (ED) of Heidelberg University Hospital and studied the prognostic role of PCT on all-cause death. Of 312 patients, AHF was diagnosed in 139 patients. Of these, 125 patients had AHF without signs of infection, and 14 had AHF complicated by respiratory or other infection. The optimal prognostic PCT cutoff value for mortality prediction was calculated by a receiver operating characteristics curve. In patients with AHF, the prognostic PCT cutoff value was 0.08 ng/mL. The Kaplan–Meier survival analysis showed that AHF patients with PCT values > 0.08 ng/mL had a higher all-cause mortality at 120 days than those with PCT values ≤ 0.08 ng/mL (log-rank p = 0.0123). Similar results could be obtained after subdivision into AHF patients with and without signs of overt infection. In both cases, mortality was higher in patients with PCT levels above the prognostic PCT cutoff than in those with values ranging below this threshold. Moreover, we show that the prognostic PCT cutoff values for mortality prediction ranged below the established PCT cutoff for the guidance of antibiotic therapy. In conclusion, the data of our study revealed that low-level elevations of PCT were associated with an increased mortality in patients with AHF, irrespective of concomitant respiratory or other infection. PCT should thus be further used as a marker in the risk stratification of AHF.

The role of procalcitonin and lactate at single determination in the intensive care unit in the diagnosis and prognosis of hypovolemic and distributive (septic) shock

Introduction. The greatest difficulties arise in the differential diagnosis of hypovolemic or distributive (septic) shock. The aim of this study was to critically analyze the information value of the blood plasma content of lactate and procalcitonin (PCT) in patients with septic and hypovolemic shock.Materials and methods. The diagnosis of «Sepsis» and «Septic shock» in the study was established according to the criteria of «Sepsis-3». 143 IRCs were filled, 34 of them with septic shock, 44 IRCs with hypovolemic, 65 IRCs with sepsis and organ dysfunction (OD).Results. When determining the content of PCT in the blood plasma in patients with septic and hypovolemic shock, we found a statistically significant difference. The level of PKT in infectious shock —33.3 (95% CI 7.9 — 58.0) ng / ml was higher than hypovolemic-0.9 (95% CI 0.43 — 6.45) ng/ml on average more than 30 times. In contrast to PCT, the content of lactate in the blood plasma did not carry a differential diagnostic value. Once measured at admission to the ICU, the level of PCT has no informational significance and does not indicate a likely outcome of the disease, complicated by the development of septic and hemorrhagic shock. Together with the low predictive ability of the nature of shock, lactate was highly informative in relation to the outcome of the disease, complicated by the development of shock syndrome.Discussion. In our analysis, it is obvious that there were observations when the PCT level during hypovolemia was noticeably higher than normal, reaching a maximum of 6.4 ng / ml. Apparently, there was a combination of factors with an obvious activation of a trigger that affects its libration or the presence of endotoxinemia in hypovolemic shock in these specific patients. The informational value of PCT is not absolute and, according to meta-analyzes, is about 80%.Conclusion. The blood content of procalcitonin in shock of an infectious nature was more than 30 times higher than the hypovolemic level on average. The informational value of procalcitonin in terms of predicting the course of the disease in septic and hypovolemic shock is absent. In the absence of predicting the nature of the shock, lactate is informative about the outcome of the shock. The possibility of increasing the blood lactate content in severe hemorrhagic shock with renal damage was noted.

356. The Role of Procalcitonin in Antimicrobial Stewardship Among Cancer Patients Admitted with COVID-19

BackgroundProcalcitonin (PCT) has been used to guide antimicrobial therapy in bacterial infections. With the wide spread use of empiric use of antibiotics in cancer patients admitted with COVID-19 disease, we aimed to evaluate the role of PCT in decreasing the duration of empiric antimicrobial therapy among cancer patients admitted with COVID-19. MethodsWe conducted a retrospective study of cancer patients admitted to MD Anderson Cancer Center who had a PCT test done within 72 hours of admission following their COVID-19 diagnosis between March 1, 2020 and June 6, 2021. Patients were divided into 2 groups of PCT < 0.25 ng/mL and PCT >=0.25 ng/mL. We assessed pertinent cultures including blood and respiratory, as well as antibacterial use and duration of empiric antibacterial therapy.ResultsWe identified 544 patients with a median age of 62 years (range, 14-93). There were 312 (57%) patients that had at least one culture obtained from a sterile or infected site within 7 days following admission. None of the patients who had PCT< 0.25 had a positive culture whereas 41/111 (37%) patients with PCT >= 0.25 had at least one positive culture [P< 0.0001]. Among the 373 patients who had a PCT < 0.25, 129 (35%) patients received more than 72 hours of IV antibiotics compared to 87/171 (51%) among patients with PCT >=0.25 [P= 0.0003].ConclusionThese results confirm the correlation between a PCT level greater than 0.25 and a documented bacterial infection. Furthermore, procalcitonin could be useful in enhancing antimicrobial stewardship in cancer patients with COVID-19 by reducing the duration of antimicrobial therapy beyond the initial empiric 72 hours until PCT results become available.Disclosures Natalie J Dailey Garnes, MD, MPH, AlloVir (Other Financial or Material Support, collaborator on research protocol)

The role of procalcitonin in identifying high-risk cancer patients with febrile neutropenia: A useful alternative to the multinational association for supportive care in cancer score.

BackgroundThe Multinational Association for Supportive Care in Cancer (MASCC) risk index has been utilized to determine the risk for poor clinical outcomes in patients with febrile neutropenia (FN) in an emergency center (EC). However, this index comprises subjective elements and elaborated metrics limiting its use in ECs. We sought to determine whether procalcitonin (PCT) level (biomarker of bacterial infection) with or without lactate level (marker of inadequate tissue perfusion) offers a potential alternative to MASSC score in predicting the outcomes of patients with FN presenting to an EC.MethodsWe retrospectively identified 550 cancer patients with FN who presented to our EC between April 2018, and April 2019, and had serum PCT and lactate levels measured.ResultsCompared with patients with PCT levels <0.25 ng/ml, those with levels ≥0.25 ng/ml had a significantly higher 14‐day mortality rate (5.2% vs. 0.7%; p = 0.002), a higher bloodstream infection (BSI) rate, and a longer hospital length of stay (LOS). Logistic regression analysis showed that patients with PCT levels ≥0.25 ng/ml and lactate levels >2.2 mmol/L were more likely to be admitted and have an LOS >7 days, BSI, and 14‐day mortality than patients with lower levels. PCT level was a significantly better predictor of BSI than MASSC score (p = 0.003) or lactate level (p < 0.0001).ConclusionsProcalcitonin level is superior to MASCC index in predicting BSI. The combination of PCT and lactate levels is a good predictor of BSI, hospital admission, and 14‐day mortality and could be useful in identifying high‐risk FN patients who require hospital admission.

The Role of Procalcitonin as a Prognostic Variable in Ovarian Cancer Patients at Dr. Soetomo General Hospital Surabaya

Background: Procalcitonin (PCT) is a pro-hormone calcitonin that is strongly associated with bacterial infections, especially bacteremia. High serum PCT levels have been correlated with Lung cancer, colorectal cancer, thyroid cancer, and tumors of neuroendocrine. Studies on the role of PCT in ovarian tumors are still limited. This study aims to evaluate the role of PCT as a prognostic variable to determine the effectiveness of diagnostics in predicting ovarian cancer progression and metastasis.Methods: This was a descriptive analytic study with a cross sectional design, conducted in Dr. Soetomo General Hospital Surabaya from July until October 2019. The subject selection used total quota sampling with inclusion criteria of female aged &gt;12 or already menstruating, undergoing surgical removal of ovarian tumors either cystic or solid, with risk malignancy index (RMI) of &gt;200, and with imaging results of suggestive ovarian malignancy. The data were analyzed descriptively using Chi-square test (α &lt;0.05) and receiver operating characteristic (ROC) curve analysis.Results: There were 36 study subjects; 38.9% of them are 40-49 years old; 77.8% have malignant tumors; and 22.2% of them have benign tumors with epithelial histopathology of 78.5% and nonepithelial of 21.4%. The optimal cut-off for PCT levels in ovarian tumors is 0.07 ng/ml with a 57.1% sensitivity and 87.5% specificity. There was a significant correlation between levels of PCT and ovarian tumors based on tumor types, postoperative tumor residues, and stages (p &lt;0.05). There was no significant correlation between PCT levels and histopathological types and tumor grade.Conclusions: Procalcitonin can be used as a prognostic variable to determine disease progression in ovarian tumors, especially in ovarian cancer.

Role of procalcitonine, hsCRP and 16SrRNA in diagnosis of culture negative endocarditis

Infective endocarditis infects the heart's inner surface, mostly the valves. It is a lethal disease with a high rate of morbidity and fatality. It mostly caused by bacteria, but fungi can also cause it. Microbiological diagnosis relies on blood culture. Molecular and biochemical indicators add to diagnosis, particularly in culture-negative patients. This study aimed to decide the role of 16s rRNA, procalcitonin, and high sensitivity C reactive protein (hsCRP) in the diagnosis of culture negative infective endocarditis (CNIE) in Assiut university hospitals. This cross-sectional study included 60 patients who were admitted to cardiac hospitals with suspected infective endocarditis according to modified DUKE criteria. A group of 20 apparently healthy subjects served as a control group for investigation of inflammatory biomarkers. We performed blood culture, biochemical markers and molecular investigations. Of the 60 patients, there were 46 (76.7%) culture positives and 14 (23.3%) culture negatives. Staphylococcus aureus was the most prevalent pathogen in culture positive patients, followed by enterococcus and klebsiella. Linezolid and imipenem were the most sensitive antibiotics for Gram-positive and Gram-negative bacteria, respectively. Amplification of bacterial 16S rRNA gene, after DNA extraction from whole blood samples, was positive in 11/14 cases (78.5%) of culture negative patients and in 42/46 cases (91.3%) of culture positive patients. The range of procalcitonin in culture positive patients was (0.32- 89) ng/ml, significantly higher than in culture negative patients (0.02- 8.8) ng/ml, and in the control group (0.01-0.08) ng/ml. hsCRP showed the same pattern. In conclusion, our data suggest that PCR was the most accurate diagnostic tool for diagnosing CNIE, followed by procalcitonin, and hsCRP, respectively.

The Role of Procalcitonin and Other Markers of Inflammation in Predicting Spontaneous Passage of Ureteral Stones

The Role of Procalcitonin and Other Markers of Inflammation in Predicting Spontaneous Passage of Ureteral Stones

Procalcitonin in infectious diseases: a bibliometric analysis.

Infectious disease is ubiquitous and can represent a major threat to human health. Procalcitonin (PCT) is mainly used to identify the severity of bacterial infections, which can be secondary to many non-bacterial infectious diseases. The purpose of this study was to evaluate current research in the field of infectious diseases and to suggest directions for further investigation. The Science Citation Index Expanded (SCI-E) database in the Web of Science Core Collection (WOSCC) was used as the search data source. The search parameters including the search scope were limited to "infectious disease" and the search term was "procalcitonin". The time range of the target literature was 1900 to the final search date of this research (May 7, 2021), and the language was limited to English. The full records of the search results and cited references were exported in plain text format, and Citespace software was used to analyze the documents. A total of 996 related research documents were found, and the number increased significantly in 2020. The United States, Germany, and the United Kingdom were the main sources of research, and the main research institutions were Aarhus University Hospital and Harvard University. The main journals are publishing material were Clin Infect Dis, Lancet, and Crit Care Med. Analysis of key words showed that the most common current research topics were sepsis and biomarkers of disease monitoring. Research on infectious disease and the role of PCT is increasing. The main research topics are sepsis and biomarkers for disease monitoring.

Evaluation of Some Biomarkers in Diagnosis of Bacterial Bloodstream Infection in Children

Background: Bloodstream infection (BSI) is a life-threatening condition caused by the presence of microorganisms, generally caused by a range of bacteria in the blood. Objectives: The aim of this study was to evaluate the possible role of procalcitonin (PCT) and C-reactive protein (CRP) as biomarkers of pediatric BSI. Methodology: The study was conducted on 150 blood samples collected from the patient who admitted to Children Welfare Teaching Hospital, Medical City, Baghdad. During the period from November 2020 to March 2021, ninety blood samples from them were positive culture and 60 blood samples were negative culture (control group). The isolates were identified depending on the morphological, microscopic examination, and biochemical tests. Moreover, serum was obtained from all participants for the determination of the screening level of human PCT measured by enzyme-linked immunosorbent assay and CRP by slide agglutination test. Results: The results in this study revealed that the mean levels of serum PCT and CRP in Gram-negative group and Gram-positive group were significantly difference from the control group. Conclusions: The adoption of these biomarkers as routine diagnostic tests for sepsis may help in the early diagnosis of pediatric sepsis.