Influence of pathogen and focus of infection on procalcitonin values in sepsis patients with bacteremia or candidemia

Critical Care : the Official Journal of the Critical Care Forum
Daniel O Thomas-RüddelMEDUSA study group

Abstract

This study aimed to evaluate the accuracy of procalcitonin (PCT) serum concentrations to diagnose Gram-negative bacteremia and the association of PCT serum concentrations with more specific pathogens and the focus of infection. Secondary analysis of the prospectively collected patient-level dataset from a cluster randomized quality improvement trial was performed. The trial included sepsis patients with organ dysfunction treated in the participating intensive care units from 2011 to 2015. Test performance for the prediction of Gram-negative bacteremia was assessed by receiver operating curve analysis. Independent effects of specific pathogen groups and foci of infection on PCT concentrations were assessed by linear logistic regression models. Blood cultures (BC) and PCT concentrations had been taken in 4858 of 6561 documented patients. PCT was significantly higher in Gram-negative bacteremia compared to Gram-positive bacteremia or candidemia (p < 0.001). The area under the curve was 0.72 (95% confidence interval 0.71-0.74) for the prediction of Gram-negative bacteremia compared to all other blood culture results including negative blood cultures. The optimized cutoff value was 10 ng/ml (sensitivity 69%, specificity 35%). PCT di...Continue Reading

Associated Clinical Trials

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Citations

Nov 28, 2018·Journal of Burn Care & Research : Official Publication of the American Burn Association·Luís CabralJosé-Artur Paiva
Dec 26, 2018·Expert Review of Anti-infective Therapy·Matteo BassettiFrancesco Curcio
Jan 16, 2019·Future Microbiology·Rita MurriMassimo Fantoni
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Jul 15, 2021·Journal of Medical Microbiology·Dongguang NiuYunzhao Zhao

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Methods Mentioned

BETA
blood culture drawn
gene array

Clinical Trials Mentioned

NCT01187134

Software Mentioned

SPSS Statistics

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