Procalcitonin: A Marker of Bacteraemia in SIRS

Autor: E Stachowski, Katy J.L. Bell, R Silvestrini, E M Benson, Karen Byth, P Clark, M Wattie
Rok vydání: 2003
Předmět:
Calcitonin
Male
congenital
hereditary
and neonatal diseases and abnormalities
medicine.medical_specialty
Calcitonin Gene-Related Peptide
Bacteremia
Critical Care and Intensive Care Medicine
Procalcitonin
law.invention
Sepsis
03 medical and health sciences
0302 clinical medicine
law
Intensive care
Internal medicine
parasitic diseases
medicine
Humans
Hospital Mortality
Protein Precursors
Intensive care medicine
biology
business.industry
C-reactive protein
Australia
030208 emergency & critical care medicine
Middle Aged
bacterial infections and mycoses
medicine.disease
Intensive care unit
Systemic Inflammatory Response Syndrome
Systemic inflammatory response syndrome
Intensive Care Units
C-Reactive Protein
Anesthesiology and Pain Medicine
030228 respiratory system
biology.protein
Sputum
Female
medicine.symptom
business
Biomarkers
hormones
hormone substitutes
and hormone antagonists
Zdroj: Anaesthesia and Intensive Care. 31:629-636
ISSN: 1448-0271
0310-057X
DOI: 10.1177/0310057x0303100603
Popis: A number of European studies have documented the ability of procalcitonin (PCT), a novel inflammatory marker, to discriminate patients with sepsis from those with other causes of systemic inflammatory response syndrome (SIRS). The aim of this study was to assess procalcitonin's performance in an Australian intensive care unit (ICU) setting to examine whether it could discriminate between these two conditions. One hundred and twenty-three consecutive adult ICU patients fulfilling criteria for SIRS were enlisted in the study. Over a period of five days, daily serum PCT and C-reactive protein (CRP) levels were measured. At least two sets of cultures were taken of blood, sputum/broncho-alveolar lavage (BAL) and urine. Other cultures were taken as clinically indicated. Questionnaires to ascertain clinical suspicion of sepsis were prospectively answered by the ICU senior registrars. PCT values were ten times higher in patients with positive blood cultures; CRP values were also significantly higher in the bacteraemic patients. Both PCT and CRP had a good ability to discriminate bacteraemia from non-infectious SIRS, with the area under receiver operating characteristics (ROC) curves for PCT being 0.8 and for CRP being 0.82. However neither PCT or CRP was able to discriminate patients with localized sepsis from those without. Utilizing both tests resulted in a more sensitive screen than either one alone, while PCT was a more accurate diagnostic test for bacteraemia than CRP. The PCT value also differed between those who died in hospital and those who survived. Measurement of PCT alone or in combination with CRP can aid discrimination of septicaemia/bacteraemia with associated SIRS from non-infectious SIRS in an Australian ICU setting.
Databáze: OpenAIRE
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