Usefulness Of Serum Procalcitonin Research Articles

The Diagnostic Accuracy of Procalcitonin and Its Combination with Other Biomarkers for Candidemia in Critically Ill Patients.

Background: The aim of this study was to investigate the usefulness of serum procalcitonin (PCT), C-reactive protein (CRP), neutrophil to lymphocyte count ratio (NLR), and their combination, in distinguishing candidemia from bacteremia in intensive care unit (ICU) patients. Methods: This is a retrospective study in ICU patients with documented bloodstream infections (BSIs) and with both serum PCT and CRP measurements on the day of the positive blood sample. Illness severity was assessed by sequential organ failure assessment (SOFA) score on both admission and BSI day. Demographic, clinical, and laboratory data, including PCT and CRP levels and NLR on the day of the BSI, were recorded. Results: A total of 63 patients were included in the analysis, of whom 32 had bacteremia and 31 had candidemia. PCT, CRP, and NLR values were all significantly lower in candidemia compared with bacteremia (0.29 (0.14-0.69) vs. 1.73 (0.5-6.9) ng/mL, p < 0.001, 6.3 (2.4-11.8) vs. 19 (10.7-24.8) mg/dl, p < 0.001 and 6 (3.7-8.6) vs. 9.8 (5.3-16.3), p = 0.001, respectively). PCT was an independent risk factor for candidemia diagnosis (OR 0.153, 95%CI: 0.04-0.58, p = 0.006). A multivariable model consisting of the above three variables had better predictive ability (AUC-ROC = 0.88, p < 0.001), for candidemia diagnosis, as compared to that of PCT, CRP, and NLR, whose AUC-ROCs were all lower (0.81, p < 0.001, 0.78, p < 0.001, and 0.68, p = 0.015, respectively). Conclusions: A combination of routinely available laboratory tests, such as PCT, CRP, and NLR, could prove useful for the early identification of ICU patients with candidemia.

Utility of Serum Procalcitonin and Its Clearance in Predicting Outcomes in COVID-19 Patients.

Introduction Identification of coronavirus disease 2019 (COVID-19) patients at risk of worse clinical outcomes is crucial to improving patient care. Various biochemical markers have been used to predict outcomes in such patients. We aimed to evaluate the role of serum PCT (procalcitonin) and the utility of PCT clearance (PCTc) in predicting the outcome of patients with COVID-19 illness. Methods We prospectively included 39 patients with severe or critical COVID-19 illness with an age equal to more than 18 years. In addition to routine baseline investigations, serum PCT was measured at admission (PCT1) and day 5 of hospitalization (PCT2). PCTc was calculated using the formula [Formula: see text]. Results We observed that serum PCT at admission was significantly higher in non-survivors (median: 1.9 ng/ml IQR: 0.51-4.23) compared to survivors (median 0.35 (IQR: 0.1-1.2), p 0.002). On serial serum-PCT estimation, non-survivors had persistently elevated serum-PCT (median PCT1:1.9 ng/ml (IQR: 0.51-4.23) to median PCT2: 1.9ng/ml (IQR: 0.83-2.72), p 0.51) than survivors (median PCT1:0.35ng/ml (IQR: 0.1-1.19) to median PCT2: 0.15ng/ml (IQR: 0.05-0.29), p 0.01). However, no difference in serum PCTc was observed between the two groups (median: 35.3% (IQR: 12.5-84.9) in survivors vs. 71.7% (33.3-91.7) in non-survivors, p = 0.165). Conclusion Serum PCT is a potential biochemical marker that could predict outcomes in COVID-19 patients. Measurement of serial serum PCT and estimation of PCT clearance may serve as better predictors than a single value; however, well-designed studies are required to identify the definite role of serum PCT in COVID-19 patients of varying severity.

The Usefulness of Serum Procalcitonin in Determining the Severity of Spreading Odontogenic Infections in Patients Seen at Ile-Ife, Nigeria

The Usefulness of Serum Procalcitonin in Determining the Severity of Spreading Odontogenic Infections in Patients Seen at Ile-Ife, Nigeria

Diagnostic usefulness of serum procalcitonin in patients with bacterial sepsis.

The Sequential Organ Failure Assessment (SOFA) score is used for the diagnosis of sepsis and involves clinical and laboratory parameters that may not be readily and/or timely available in most resource-poor settings. Procalcitonin (PCT) has its level changed in response to bacterial sepsis and its measurement costs only a fraction of the total cost of investigations required to calculate SOFA score. This study aims to determine the diagnostic usefulness of PCT in bacterial sepsis. Ninety-nine participants were studied, divided into three groups: apparently healthy volunteers, those with bacterial infection without sepsis (SOFA score <2), and patients with bacterial sepsis (positive culture and SOFA ≥2). PCT level of each participant was measured and median group levels compared. Pearson's correlation was used to determine the correlation between serum PCT levels and SOFA scores in the sepsis group using a significance level of 5 percent (P < 0.05). Diagnostic usefulness of PCT was assessed using receiver operating characteristic (ROC). Positive correlation was found between serum PCT levels and SOFA scores among patients with sepsis r = 0.42, P = 0.016. At a concentration of ≥4.25 ng/ml, serum PCT as a surrogate for SOFA score had a sensitivity and specificity of 57.60% and 84.80%, respectively, for indicating sepsis. The area under the ROC curve (AUC) was 0.74 (95% CI {0.62 to 0.86}, P = 0.001). Serum PCT concentration was significantly higher in bacterial sepsis compared to bacterial infection without sepsis and healthy state. PCT concentration demonstrated positive correlation with SOFA score in bacterial sepsis and can be used as surrogate for sepsis screening/monitoring in resource-poor settings.

Usefulness of serum procalcitonin and point-of-care multiplex PCR gastro-intestinal panel in acute diarrhoea or colitis in the emergency department

Introduction Acute infectious diarrhoea is one of the most common diseases worldwide. Procalcitonin (PCT) is useful for antibiotic stewardship in lower respiratory tract infections but has been poorly studied in infectious diarrhoea. Our objective is to describe the PCT concentrations according to diarrhoea aetiology. Methods This is a single-center prospective cohort study involving adults consulting the emergency department (ED) for an acute diarrhoea or colitis. Serum PCT was measured and a stool sample was tested with FilmArray® Gastro-Intestinal Panel. The primary endpoint is the PCT concentration according to each type of pathogen identified using Gastro-Intestinal-panel and/or stool cultures at ED admission. Results 125 patients were included: 80 had an acute infectious diarrhoea, 21 an acute colitis and 24 another illness causing diarrhoea. The median (interquartile ranges) PCT values (ng/ml) were 0.13 (0.08-0.28), 0.07 (0.06-0.54), 0.13 (0.09-0.26) and 0.05 (0.03-0.17), respectively if there was a bacteria (n = 41), parasite (n = 3), virus (n = 10) or no pathogen identified and 0.34 (0.13-1.03) if the diarrhoea was due to another illness (n = 24). Conclusion In patients admitted to the ED with an acute infectious diarrhoea or acute colitis, PCT remained low when a bacteria was identified. It may not be informative in current practice to guide antibiotic therapy.

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.

Procalcitonin to Predict Severity of Acute Cholangitis and Need for Urgent Biliary Decompression: Systematic Scoping Review.

Serum procalcitonin (PCT) has been reported as a potential biomarker to predict the severity of acute cholangitis (AC) or the need for urgent biliary decompression. This study aimed to identify and summarize the existing research about serum PCT and the severity of AC, and to find gaps towards which future studies can be targeted. Following the PRISMA extension for scoping reviews, MEDLINE, EMBASE, and Google Scholar were searched for all peer-reviewed articles with relevant keywords including “cholangitis” and “procalcitonin” from their inception to 13 July 2021. We identified six studies. All the studies employed a case-control design and aimed to evaluate the usefulness of serum PCT to predict the severity of AC with key identified outcomes. While the potential cut-off values of serum PCT for severe AC ranged from 1.8–3.1 ng/mL, studies used different severity criteria and the definition of urgent biliary decompression. No studies proposed cut-off PCT values for the need for urgent biliary decompression. This scoping review identified the current level of evidence regarding the usefulness of serum PCT in assessing the severity of AC. Further clinical research is warranted with a focus on standardized outcome measures employing prospective or experimental designs.

Clinical utility of serum procalcitonin in adult patients admitted with community-acquired pneumonia in Ilorin, Nigeria

Objectives: The usefulness of biomarkers in community acquired pneumonia (CAP) has been under the research light with limited reports from Africa. This study aimed at evaluating the clinical usefulness of serum procalcitonin (PCT) in patients admitted with CAP in a tertiary hospital in Ilorin, Nigeria. Materials and Methods: This was prospective single center observational study of 102 admitted patients with clinical and radiologic features of CAP. All the patients had serum PCT assay, complete blood count, blood culture, sputum microbiology, and serological evaluation for atypical pathogens. Repeat PCT assay was done following 1 week of antibiotic therapy. The patients were classified into one of two diagnostic groups: Those with microbiologically confirmed bacterial CAP and those without bacterial CAP. Results: Over half (58/102; 56.8%) of the patients had microbiologically confirmed bacterial CAP. The baseline serum PCT concentrations were significantly higher in patients with bacterial CAP when compared to the non-bacterial CAP group (2.55 ± 0.14 vs. 0.94 ± 0.61 ng/ml; P &lt; 0.001). There was also a statistically significant difference between the pre- and post-treatment serum PCT concentrations in the bacterial CAP group (P &lt; 0.001) and the non-bacterial CAP group (P = 0.006). The area under the receiver operating characteristic (AUC) for pre-treatment PCT in diagnosing bacterial CAP was 0.795 (95% confidence level [CI]: 0.709–0.881) with a sensitivity of 67.2% and specificity of 79.5% at an optimal cutoff of 1.5 ng/ml. Overall, the biomarker was independently associated with white cell counts &gt;10 × 109/L (AOR = 6.28; 95% CI: 1.30–30.32, P = 0.02). The baseline mean serum PCT levels were also significantly higher in patients admitted for 7 or more days (P = 0.010). Conclusion: Serum PCT had good diagnostic strength in patients admitted with bacterial CAP in Ilorin. The biomarker can also assist clinicians with predicting the pathogenic group and monitoring clinical progress of CAP.

Serum Procalcitonin in the Prediction of Severity and Outcome of Acute Pancreatitis

Background: Different modalities are available for predicting severity and outcome of acute pancreatitis. A single marker with high sensitivity and specificity is yet to be identified.&#x0D; Aim: This study intends to find out the utility of serum procalcitonin in predicting the severity and outcome of acute pancreatitis.&#x0D; Methods: 117 patients admitted with acute pancreatitis were included.Clinical parameters and biochemical tests were recorded on admission, on day-3 &amp; day-5 of admission. CT scan was performed in all patients. Serum procalcitonin was done on admission. Multifactorial scores were calculated using these data.Every patient was followed for identification of organ failure or other complications. Statistical analysis was done with SPSS.&#x0D; Result: Among 117 patients, 67(57.3%) were male. Biliary, hypertriglyceridemia, alcohol, malignancy and post-ERCP complications were found as aetiology in 25(21.4%), 23(19.7%), 8(6.8%), 3(2.6%),2(1.7%) cases respectively. In 53(45.3%) cases no definite etiology could be found. 83(70.9%) patients had mild,15(12.8%) had moderately severe and 19(16.2%) had severe acute pancreatitis. 23(19.65%) patients developed complication, whereas 94 (80.34%) developed none. The mean serum procalcitonin(pg/ml) of patients with mild, moderately severe and severe disease was 146±165.21, 1297±439.44, 4361±1493.55 respectively. The difference among the groups were statistically significant. Mean serum procalcitonin(pg/ml) in patientswho developed complications was 3744±1827.05 and in those without complication it was 301±559.97.ROC curve evaluating the role of serum procalcitonin in predicting outcome of acute pancreatitis showed AUC of 0.985. A cutoff point of 1131.28pg/ml showed highest sensitivity (95.7%) &amp; specificity (94.7%).&#x0D; Conclusion: Serum procalcitonin can be a new promising marker to predict severity and outcome of acute pancreatitis.&#x0D; Bangladesh Crit Care J March 2021; 9(1): 16-21

Usefulness of serum procalcitonin for necrotizing fasciitis as an early diagnostic tool

IntroductionWhile the early diagnosis of necrotizing fasciitis (NF) is crucial and could lead to a favorable outcome, it is difficult to differentiate NF from cellulitis, resulting in delay for the appropriate treatment. Patients and methodsFor the purpose of examining which diagnostic tools could correctly differentiate NF from cellulitis, we conducted this case-control study. We retrospectively reviewed all patients who were diagnosed with NF at our institute during 2014–2019. The patients who were diagnosed with cellulitis were randomly selected during the study period as the control group. The severity of NF is evaluated by serum-procalcitonin (PCT), LRINEC score, NTSI assessment and SIARI score. ResultsA total of 25 NF patients were enrolled in this study. The median age was 68 years (range 39–79) and 18 (72%) were male. Comparing NF and cellulitis groups, NF group showed a higher LRINEC score and serum PCT than cellulitis group did, even though there was no statistical significance in serum PCT.With respect to the diagnostic value for differentiating NF from cellulitis, the area under the ROC curve for of serum PCT and LRINEC scores were 0.928 [95% confidential interval (CI) 0.864–0.992, p < 0.001] and 0.846 (95% CI 0.757–0.936, p < 0.001). The appropriate serum-PCT cutoff value was 1.0 and had a sensitivity of 88%, a specificity of 89%, a positive predictive value of 81%, and a negative predictive value of 93%. ConclusionSerum-PCT could be a useful diagnostic marker for differentiating diagnosis of NF from cellulitis.

Diagnostic Value of Serum Procalcitonin Level in HCV Cirrhotic Patients with Spontaneous Bacterial Peritonitis

Background: Early diagnosis and prompt treatment of spontaneous bacterial peritonitis (SBP) due to end-stage liver disease is vital to shorten hospital stays and reduce mortality. Many studies have explored the potential usefulness of serum procalcitonin (PCT) in predicting SBP. Objective: to evaluate the overall diagnostic accuracy of PCT levels for identifying SBP due to end-stage liver disease. Patients and Methods: A prospective case control study was conducted on 60 post-HCV cirrhotic patients and 20 normal individuals (54 M and 26 F), at internal medicine department, Zagazig General Hospital. Full history, routine, physical examination and special investigations were taking. Results: The summary estimates for serum PCT in the diagnosis of SBP attributable to end stage liver disease were: sensitivity 95% and specificity 95%. Serum PCT is a relatively sensitive and specific test for the identification of SBP. However, due to the limited high-quality studies available, medical decisions should be carefully made in the context of both PCT test results and other clinical findings including diagnostic paracentesis. Conclusion: For our study we can concluded that: Serum Procalcitonin level can be used as a diagnostic test for rapid and accurate diagnosis of Spontaneous bacterial peritonitis in HCV cirrhotic patients with sensitivity and specificity about 95%.

The Utility of Serum Procalcitonin and Clinical Pulmonary Infection Score as Diagnostic Tools for Early Ventilator-Associated Pneumonia in Pediatrics

The Utility of Serum Procalcitonin and Clinical Pulmonary Infection Score as Diagnostic Tools for Early Ventilator-Associated Pneumonia in Pediatrics

Clinical usefulness of serum procalcitonin to distinguish between viral pneumonia and Mycoplasma pneumonia in children: A multicenter, cross-sectional study

Purpose: The aim of this study was to compare the clinical usefulness of serum procalcitonin (PCT) levels in Mycoplasma pneu moniae pneumonia (M. pneumonia) and viral pneumonia in children. Methods: We retrospectively analyzed the medical records of 348 patients admitted between June 2015 and December of 2015. There were 162 patients with M. pneumonia without virus coinfection (group 1) and 186 patients with viral pneumonia (group 2). All subjects had radiographic evidence of pneumonia with available specimens for both M. pneumonia and viral testing, and levels of serum PCT, white blood cell counts (WBC), neutrophil portion, and C-reactive protein (CRP). Fifty-eight children who performed follow-up sampling at the time of no fever for more than 48 hours were subdivided into group 3 (M. pneumonia with follow-up sampling, n=41) and group 4 (viral pneumonia with follow-up sampling, n=17). Results: No difference was noted in the levels of serum PCT (P=0.168), CRP (P=0.296), WBC (P=0.732), and neutrophil proportion (P=0.069) between groups 1 and 2, after adjusting for age. Serial changes in serum PCT levels between the first and second samples were significant in group 3 (P=0.046). Serial changes in serum CRP levels between the first and second samples were significant in group 4 (P=0.008). Conclusion: Serum PCT and CRP levels may change differently after infection according to the etiology of pneumonia. (Allergy Asthma Respir Dis 2019;7:22-27)

The usefulness of serum procalcitonin, C-reactive protein, soluble triggering receptor expressed on myeloid cells 1 and Clinical Pulmonary Infection Score for evaluation of severity and prognosis of community-acquired pneumonia in elderly patients

AimsTo comparatively analyze the usefulness of serum procalcitonin (PCT), C-reactive protein (CRP), soluble triggering receptor expressed on myeloid cells 1 (sTREM-1) and Clinical Pulmonary Infection Score (CPIS) for assessing the severity and prognosis of community-acquired pneumonia (CAP) in the elderly. MethodsA total of 214 elderly patients with CAP and 106 healthy persons were enrolled in this prospective study. On the admission day, serum inflammatory markers, including CRP, PCT, sTREM-1, and CPIS were analyzed. By severity, the CAP patients were subdivided into non-severe CAP group and severe CAP group. By outcome, the patients were classified into survival group and death group. The efficiency of three inflammatory markers and CPIS on predicting prognosis of pneumonia patients was then analyzed. ResultsThe serum inflammatory markers and CPIS were significantly higher in CAP patients than in healthy controls. These biomarkers and CPIS were significantly higher in patients with severe CAP than in patients with non-severe CAP. Compared with patients who would survive, these markers and CPIS were significantly higher in patients who would die. Receiver operating characteristic curve analysis showed that the area under the curve and sensitivity were higher for serum sTREM-1 than for other indicators, while the specificity of serum PCT was the highest. ConclusionsSerum CRP, PCT, and sTREM-1 and CPIS determined on the admission day are effective indicators to evaluate the severity and prognosis of CAP in the elderly. The prognostic value of PCT and sTREM-1 is better than that of CRP and CPIS.

Procalcitonin as an early indicator of urosepsis following prostate biopsy

Background To investigate the usefulness of serum procalcitonin (PCT) in the early diagnosis of urinary tract infection (UTI) and urosepsis following transrectal prostate biopsy. Methods In this prospective observational study, 227 patients who underwent transrectal ultrasound-guided prostate biopsy were evaluated. The relationship between urosepsis and age, serum PCT, C-reactive protein, prostate-specific antigen (PSA), prostate volume, PSA density and pathologic results following biopsy was assessed. Serum PCT level was measured in all patients immediately before the biopsy and at the post-biopsy day 2. Results Of the 227 patients, 11 (4.8%) developed UTI with positive urine culture without urosepsis and 5 (2.2%) developed urosepsis within 30 days after biopsy. The concentration of PCT was within the normal range before the biopsy. Procalcitonin concentration at post-biopsy day 2 was significantly higher in patients who developed urosepsis (1.91 ± 2.99 ng/ml vs. 0.05 ± 0.08 ng/ml; p = .004) compared with non-UTI patients. Only elevated PCT level at post-biopsy day 2 was a statistically significant independent predictor of post-biopsy urosepsis. The area under the ROC curve for the prediction of urosepsis was 0.976 (95%CI: 0.941–1.000) and a cut-off 0.095 ng/ml in the level of PCT at post-biopsy day 2 yielded a sensitivity of 100% and specificity of 93.8% in detecting urosepsis following biopsy. Conclusions Procalcitonin appears to be a useful early biomarker to predict the urosepsis following prostate biopsy. Patients with elevated PCT value should be closely monitored after the biopsy.

Usefulness of Serum Procalcitonin as a Markerfor Coexisting Infection in Patients With Acute Myocardial Infarction

A significant proportion of patients with acute myocardial infarction (AMI) also present with clinical manifestations of inflammatory response, which may be confused with a concomitant infection. This leads to a dilemma regarding the empiric use of antibiotics. We explored if serum procalcitonin (PCT), which is known to be elevated in bacterial infections, may be utilized to rule-out bacterial infection in AMI patients. In this prospective, single center study, PCT was collected within 48 hours from AMI patients. Patients' demographic, clinical, and laboratory data were collected prospectively. Two experienced infectious diseases specialists blinded to the PCT results independently determined the presence of infection in every patient. Sensitivity, specificity, positive predictive value, negative predictive value, and the area under the receiver operating characteristic curve were calculated to determine the accuracy of PCT, fever, white blood cell (WBC) count, and C-reactive protein (CRP) levels for the diagnosis of the infection. The analysis included 230 AMI patients (age 63.0 ± 13.0 years) of whom 36 (15.6%) had coexisting infections. The best cutoff for PCT as a differentiating marker between patients with and without coexisting infection was 0.09 ng/dl (sensitivity 94.4%, specificity 85.1%, area under the curve 0.94). PCT outperformed CRP, WBC, and fever for diagnosing infection. In conclusion, compared with CRP, fever, and WBC, serum PCT had a better performance in differentiating infected from noninfected AMI patients and thus should be considered as an adjunct test when facing the dilemma of initiating empiric antibiotic in AMI patient demonstrating inflammatory signs.

Diagnostic value of serum procalcitonin and C-reactive protein in children with urinary tract infection

Objective To investigate the usefulness of serum procalcitonin (PCT), C-reactive protein(CRP)in urinary tract infection(UTI) in children. Methods A retrospective analysis of 169 children who were diagnosed with UTI from January 2012 to August 2016 was performed. Serum PCT and CRP level were detected before treatment. Results Among the 169 children, 62 cases of upper UTI and 107 cases of lower UTI. The children with upper UTI had higher serum levels of PCT [(3.25±5.90)ng/mL vs. (0.26±0.40)ng/mL] and CRP [(87.42±63.77)mg/L vs. (33.84±49.50)mg/L]than the patients with lower UTI (P<0.01). There was significant correlation in UTI between PCT and CRP ( r=0.788, P<0.01). Conclusions Although this retrospective study comprises a small number of cases, PCT and CRP may be useful to identify children with upper UTI. Key words: Urinary Tract Infections; Calcitonin; C-Reactive Protein

The Clinical Utility of Serum Procalcitonin as a Diagnostic Assay for Predicting Bacteremia in Patients With Sepsis

The Clinical Utility of Serum Procalcitonin as a Diagnostic Assay for Predicting Bacteremia in Patients With Sepsis

Usefulness of serum procalcitonin as a diagnostic biomarker of infection in children with chronic kidney disease.

IntroductionSerum procalcitonin (PCT) levels are known to be low in healthy individuals in healthy subjects but are increased in patients with a severe bacterial infection. It has not been extensively studied in children with chronic kidney disease (CKD), treated either with hemodialysis (HD) or with renal transplantation.Material and methodsDuring a 6-month period, blood samples were taken from 102 (55 HD children and 47 renal transplant recipients) children with a strong clinical suspicion of infection. Procalcitonin levels were measured by ELISA.ResultsThirty-four/102 cases had proven infections as defined previously. Children with proven infections had a significantly higher PCT (0.920 ±0.24 ng/ml) than those without (0.456 ±0.53 ng/ml), p = 0.04. The ideal cutoff value derived for serum PCT was 0.5 ng/ml. This threshold value established a sensitivity of 94.1% and a specificity of 87.9%.ConclusionsThis study indicates that significantly increased PCT concentration is a promising predictor of systemic bacterial infection in children with CKD, with good sensitivity and specificity. This study proposes that serum PCT is a convenient index of infection in CKD children at a cutoff value of 0.5 ng/ml.

Utility of Serum Procalcitonin in Skin and Soft Tissue Infections

Background Procalcitonin (PCT) has been studied as a biomarker to assist in the diagnosis and treatment of severe bacterial infections, mostly in the context of respiratory tract infections and severe sepsis, where it has been shown to reduce antimicrobial use without worsening clinical outcomes. The utility of PCT in guiding duration of antibiotic therapy in skin and soft tissue infections (SSTIs) has not been established. Our aim was to evaluate the relationship between the duration of intravenous antibiotic therapy for SSTIs and serum PCT; as well as the relationship between PCT and conventional markers of inflammation. Methods Serum PCT, leukocyte count, C-reactive protein and blood cultures laboratory, and body temperature were examined in 39 consecutive patients with SSTIs requiring inpatient intravenous antibiotic treatment. Results Thirty-nine consecutive inpatients presenting with SSTIs were evaluated. Procalcitonin values on admission correlated with duration of intravenous antibiotic therapy (Pearson correlation, 0.475; P = 0.002) and length of hospital stay (Pearson correlation, 0.534; P = 0.001). Peak serum PCT values also correlate with peak leukocyte count (Pearson correlation, 0.529; P = 0.001), peak C-reactive protein during hospitalization (Spearman correlation, 0.457; P = 0.003), and presence of Systemic Inflammatory Response Syndrome criteria on admission (P = 0.030). Conclusions Procalcitonin correlates with duration of intravenous antibiotic therapy in SSTIs; it may be a valuable adjunct in the initial diagnosis and management of antibiotic therapy in these infections.