Role of procalcitonin in predicting etiology in bacteremic patients: Report from a large single-center experience.
Adult
Aged
Aged, 80 and over
Area Under Curve
Bacteremia
/ diagnosis
Biomarkers
/ blood
Female
Gram-Negative Bacterial Infections
/ blood
Gram-Positive Bacterial Infections
/ blood
Hospitalization
/ statistics & numerical data
Humans
Intensive Care Units
/ statistics & numerical data
Italy
Male
Middle Aged
Procalcitonin
/ blood
Prospective Studies
ROC Curve
Retrospective Studies
Bacteremia
C-reactive protein
Enterobacteriaceae
Gram-negative
Procalcitonin
Journal
Journal of infection and public health
ISSN: 1876-035X
Titre abrégé: J Infect Public Health
Pays: England
ID NLM: 101487384
Informations de publication
Date de publication:
Jan 2020
Jan 2020
Historique:
received:
11
02
2019
revised:
29
04
2019
accepted:
08
06
2019
pubmed:
30
6
2019
medline:
2
7
2020
entrez:
29
6
2019
Statut:
ppublish
Résumé
Procalcitonin (PCT) is routinely used for an early recognition of severe infections and for promoting appropriate use of antibiotics. However, limited data correlating values of PCT with etiology of infection has been reported. During 2016, all positive blood cultures (BC) were retrospectively extracted in a 1100-beds Italian tertiary-care hospital. PCT and C-reactive protein (CRP) values were recorded within 24h from BC collection. Primary endpoint of the study was to investigate the correlation between PCT and CRP values and the occurrence of bloodstream infections (BSI) caused by bacteria or fungi. During the study period, 1296 positive BC were included: 712 (54.9%) due to Gram-positive (GP), 525 (40.5%) due to Gram-negative (GN) strains, and 59 (4.6%) caused by fungi. Among GN isolates, enterobacteriaceae were reported in 453 (86.3%) cases. PCT values were higher in patients with GN etiology (26.1±14.2ng/mL) compared to GP (6.9±4.5) and fungi (3.3±2.4). Mean values for CRP in GN, GP, and fungi were not different. Receiver Operating Characteristic (ROC) curves showed an area under curve (AUC) of 0.71 for PCT and 0.51 for CRP among GN isolates; an AUC of 0.7 for PCT and 0.52 for CRP among enterobacteriaceae. Lower AUC for PCT were reported for GP and fungi. PCT showed moderate performance in early detection (within 24h) of Gram-negative infections, especially those caused by enterobacteriaceae. Further prospective studies are mandatory to confirm these observations.
Sections du résumé
BACKGROUND
BACKGROUND
Procalcitonin (PCT) is routinely used for an early recognition of severe infections and for promoting appropriate use of antibiotics. However, limited data correlating values of PCT with etiology of infection has been reported.
METHODS
METHODS
During 2016, all positive blood cultures (BC) were retrospectively extracted in a 1100-beds Italian tertiary-care hospital. PCT and C-reactive protein (CRP) values were recorded within 24h from BC collection. Primary endpoint of the study was to investigate the correlation between PCT and CRP values and the occurrence of bloodstream infections (BSI) caused by bacteria or fungi.
RESULTS
RESULTS
During the study period, 1296 positive BC were included: 712 (54.9%) due to Gram-positive (GP), 525 (40.5%) due to Gram-negative (GN) strains, and 59 (4.6%) caused by fungi. Among GN isolates, enterobacteriaceae were reported in 453 (86.3%) cases. PCT values were higher in patients with GN etiology (26.1±14.2ng/mL) compared to GP (6.9±4.5) and fungi (3.3±2.4). Mean values for CRP in GN, GP, and fungi were not different. Receiver Operating Characteristic (ROC) curves showed an area under curve (AUC) of 0.71 for PCT and 0.51 for CRP among GN isolates; an AUC of 0.7 for PCT and 0.52 for CRP among enterobacteriaceae. Lower AUC for PCT were reported for GP and fungi.
CONCLUSIONS
CONCLUSIONS
PCT showed moderate performance in early detection (within 24h) of Gram-negative infections, especially those caused by enterobacteriaceae. Further prospective studies are mandatory to confirm these observations.
Identifiants
pubmed: 31248812
pii: S1876-0341(19)30191-1
doi: 10.1016/j.jiph.2019.06.003
pii:
doi:
Substances chimiques
Biomarkers
0
Procalcitonin
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
40-45Informations de copyright
Copyright © 2019 The Authors. Published by Elsevier Ltd.. All rights reserved.