THE ROLE OF PROCALCITONIN IN BACTERIAL INFECTION RECOGNITION

  • Lucija Gabršek Oddelek za endokrine bolezni in bolezni presnove, Splošna bolnišnica, Oblakova 5, 3000 Celje
  • Gorazd Voga Oddelek za endokrine bolezni in bolezni presnove, Splošna bolnišnica, Oblakova 5, 3000 Celje
  • Bojan Krivec Oddelek za endokrine bolezni in bolezni presnove, Splošna bolnišnica, Oblakova 5, 3000 Celje
  • Rafael Skale Oddelek za endokrine bolezni in bolezni presnove, Splošna bolnišnica, Oblakova 5, 3000 Celje
  • Roman Parežnik Oddelek za endokrine bolezni in bolezni presnove, Splošna bolnišnica, Oblakova 5, 3000 Celje
  • Matej Podbregar Oddelek za endokrine bolezni in bolezni presnove, Splošna bolnišnica, Oblakova 5, 3000 Celje
Keywords: procalcitonin, markers of infection, bacterial infection, systemic inflammatory response syndrome (SIRS), sepsis

Abstract

Background. Early recognition of bacterial infection and antibiotic treatment are very important in critically ill patients. Procalcitonin (PCT) is a marker of bacterial infections accompanied by systemic inflammatory response. Higher values were also noticed with parasitical and fungal infections, but PCT is normal in viral and systemic diseases. The aim of this study was to assess whether PCT is better marker for bacterial infections than C-reactive protein (CRP) and if they have a prognostic value.

Methods. 34 patients were included into our retrospective study. All of them had clinical or laboratory signs of infection at the first PCT determination. We measured PCT, CRP, erythrocyte sedimentation rate (SR) and leukocyte count. On the base of microbiological results we divided patients into three groups. Group A had patients with sterile cultures, group B included the ones with negative blood cultures, but from other cultures causative agents were identified. The patients in group C had positive blood cultures. Retrospectively we studied PCT and CRP values among groups and among survivors and non survivors.

Results. An average median value of PCT in group A was 8.9 ± 13.3 ng/ml, in group B 5.3 ± 9.3 ng/ml and in group C 21.0 ± 25.0 ng/ml. In group B, the average median value of PCT was significantly higher than in group C (p = 0.019), but that was not the case in group A (p = 0.23). The average median values of CRP were 129.9 ± 67.4 mg/l in group A, 104.3 ± 60.1 mg/l in group B and 117.4 ± 46.1 mg/l in group C. Between groups, differences of CRP values were not statistically significant. The average initial value of PCT in group of non survivors (8.9 ± 49) was not significantly higher then in group of survivors (3.14 ± 55.4) (p = 0.48). The average final value was significantly higher (p = 0.0013) in group of non survivors (13.1 ± 23.9 ng/l) than in group of survivors (0.55 ± 7.3 ng/ml). In both groups the average initial values of CRP did not differ significantly (95.1 ±116.4 mg/l; 144.5 ± 91.4 mg/l; p = 0.26), but the average final value of CRP was significantly higher in the non survivors group (115.5 ± 77.1mg/l; 64.5 ± 48.2 mg/l; p = 0.026).

Downloads

Download data is not yet available.

References

Meisner M. PCT, Procalcitonin – a new, innovative infection parameter. Berlin: B.R.H.A.M.S – Diagnostica Gmbh P.O., 1996: ISBN 3-00-000 803.

Karzai W, Oberhoffer M, Meier-Hellman A, Reinhart K. Procalcitonin – a new indicator of the systemic response to severe infections. Infection 1997; 25: 329–34.

Al-Nawas B, Krammer I, Shah PM. Procalcitonin in diagnosis of severe infections. Eur J Med Res 1996; 1: 331–3.

Gendrel D, Bohuon C. Procalcitonin, a marker of bacterial infection. Infection 1997; 25: 133–4.

Al-Nawas B, Shah PM. Procalcitonin in acute malaria. J Med Res 1997; 2: 206–8.

Assicot M, Gendrel D, Carsin H, Raymond J, Guilbaud J, Bohuon C. High serum procalcitonin concentrations in patients with sepsis and infection. The Lancet 1993; 341: 515–8.

Beaune G, Bienvenu F, Pondarre C, Monneret G, Bienvenu J, Souillet G. Serum procalcitonin rise is only light in two cases of disseminated aspergilosis. Infection 1998; 26: 168–9.

Eberhard OK, Haubitz M, Brunkhorst FM, Kliem V, Koch KM, Brunkhorst R. Usefulness of procalcitonin for differentiation between activity of systemic autoimmune disease (systemic lupus erythematosus/systemic antineutrophil cytoplasmic antibody-associated vasculitis) and invasive bacterial infection. Arthritis Rheum 1997; 40: 1250–6.

Rau B, Steinbach G, Gansauge F, Mayer JM, Gruenert A, Beger HG. The potential role of procalcitonin and interleukin 8 in the prediction of infected necrosis in acute pancreatitis. GUT 1997; 41: 832–40.

Brunkhorst B, Eberhardt OK, Haubitz M, Brunkhorst EM. Procalcitonin for the discrimination between activity of systemic autoimmune disease and systemic bacterial infection. Intensive Care Med 2000; 26: 212–6.

Bone RC, Balk RA, Cerra FB et al. Definition for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis. Chest 1992; 101: 1644–55.

Brunkhorst EM, Wegscheider K, Forycki ZE, Brunkhorst E. Procalcitonin for early diagnosis and differentiation of SIRS, sepsis, severe sepsis and septic shock. Intensive Care Med 2000; 26: 148–52.

Cheval C, Timsit JF, Garrouste-Orgeans M et al. Procalcitonin (PCT) is useful in prediction the bacterial origin of an acute circulatory failure in critical ill patients. Intensive Care Med 2000; 26: 153–8.

Al-Nawas B, Shah PM. Procalcitonin in patients with and without immunosuppression and sepsis. Infection 1996; 24: 434–6.

Meisner M, Lohs T, Hutteman E, Reinhart K. Elimination of procalcitonin and plasma concentration during continuous veno-venous hemodiafiltration in septic patients. Eur J Anaesthesiol 2000; 17: 665–71.

Meisner M. Procalcitonin: a new, innovative infection parameter; biochemical and clinical aspects. Stuttgart, New York: Thieme, 2000: ISBN 3-13-105503-0.

Meisner M, Schmid J, Huttner H, Tschaikowsky K. The natural elimination rate of procalcitonin in patients with normal and impaired renal function. Intensive Care Med 2000; 26: 212–6.

How to Cite
1.
Gabršek L, Voga G, Krivec B, Skale R, Parežnik R, Podbregar M. THE ROLE OF PROCALCITONIN IN BACTERIAL INFECTION RECOGNITION. TEST ZdravVestn [Internet]. 1 [cited 5Aug.2024];70. Available from: http://vestnik-dev.szd.si/index.php/ZdravVest/article/view/2513
Section
Professional Article

Most read articles by the same author(s)