Changes of Procalcitonin Kinetics According to Renal Clearance in Critically Ill Patients with Primary Gram-Negative Bloodstream Infections.

Autor: Özger HS; Infectious Disease and Clinical Microbiology, Gazi University School of Medicine, Ankara, Türkiye., Çorbacıoğlu ŞK; Emergency Departments, Atatürk Sanatoryum Training and Research Hospital, Ankara, Türkiye., Boyacı-Dündar N; Department of Internal Medicine, Division of Intensive Care Medicine, Gazi University School of Medicine, Ankara, Türkiye., Yıldız M; Infectious Disease and Clinical Microbiology, Gazi University School of Medicine, Ankara, Türkiye., Helvacı Ö; Department of Nephrology, Gazi University School of Medicine, Ankara, Türkiye., Altın FB; Infectious Disease and Clinical Microbiology, Gazi University School of Medicine, Ankara, Türkiye., Türkoğlu M; Department of Internal Medicine, Division of Intensive Care Medicine, Gazi University School of Medicine, Ankara, Türkiye., Aygencel G; Department of Internal Medicine, Division of Intensive Care Medicine, Gazi University School of Medicine, Ankara, Türkiye., Dizbay M; Infectious Disease and Clinical Microbiology, Gazi University School of Medicine, Ankara, Türkiye.
Jazyk: angličtina
Zdroj: Infectious diseases & clinical microbiology [Infect Dis Clin Microbiol] 2024 Sep 26; Vol. 6 (3), pp. 206-215. Date of Electronic Publication: 2024 Sep 26 (Print Publication: 2024).
DOI: 10.36519/idcm.2024.363
Abstrakt: Objective: This study aimed to investigate the relationship between procalcitonin (PCT) kinetic and estimated glomerular filtration rates (eGFR) in critically ill patients who had Gram-negative primary bloodstream infection (GN-BSI) and responded to the antimicrobial therapy.
Materials and Methods: This single-centered study was retrospective and observational. Critically ill GN-BSI patients over 18 years old who had clinical and microbiological responses to antibiotic treatment were included in the study. Patients were divided into two groups according to eGFR (eGFR <30 mL/min/1.73m 2 and ≥30 mL/min/1.73m 2 ) and compared for PCT kinetic at seven different measurement points as initial, first, third, fifth, seventh, tenth, and fourteenth days.
Results: The study included 138 patients. Initial PCT levels were higher in patients with eGFR <30 mL/min/1.73m 2 (4.58 [1.36-39.4] ng/mL) than in eGFR ≥30 mL/min/1.73m 2 (0.91 [0.32-10.2]) ( p <0.001). This elevation was present at all measurement points ( p <0.05). The decrease in PCT values by ≥30% (26.0% vs 47.9%; p =0.024) on the third day and ≥50% (69.2% vs 76.6%; p =0.411) on the fifth day was less in the low eGFR (<30 mL/min/1.73m 2 ) group. The effect of low GFR on serum PCT kinetic was present in both fermenter and non-fermenter GN-BSIs but was more prominent in the fermenter group.
Conclusion: Serum PCT levels during therapy were higher in patients with low eGFR. Early PCT (<5 days) response was not obtained in non-fermenter GN-BSI patients with low eGFR. Antibiotic revision decisions should be made more carefully in patients with low eGFR due to high initial PCT levels and slow PCT kinetic.
Competing Interests: The authors declare no conflict of interest.
(Copyright © 2024 Infectious Diseases and Clinical Microbiology.)
Databáze: MEDLINE
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