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Procalcitonin as a potent marker of bacterial infection in febrile Afro-Caribbean patients at the emergency department.

Limper M, de Kruif MD, Ajubi NE, van Zanten AP, Brandjes DP, Duits AJ, van Gorp EC - Eur. J. Clin. Microbiol. Infect. Dis. (2011)

Bottom Line: Prospective, blinded PCT measurements were performed in patients with a microbiologically or serologically confirmed diagnosis or a strongly suspected diagnosis on clinical grounds.C-reactive protein (CRP) levels were shown to be less accurate when comparing the same groups.These results may improve diagnostics and eventually decrease antibiotic prescriptions in resource-limited settings.

View Article: PubMed Central - PubMed

Affiliation: Immunology Laboratory Department, Red Cross Blood Bank Foundation, Pater Euwensweg 36, Willemstad, Curaçao, Netherlands Antilles. maarten.limper@slz.nl

ABSTRACT
Procalcitonin (PCT) has been shown to be of additional value in the work-up of a febrile patient. This study is the first to investigate the additional value of PCT in an Afro-Caribbean febrile population at the emergency department (ED) of a general hospital. Febrile patients were included at the ED. Prospective, blinded PCT measurements were performed in patients with a microbiologically or serologically confirmed diagnosis or a strongly suspected diagnosis on clinical grounds. PCT analysis was performed in 93 patients. PCT levels differentiated well between confirmed bacterial and confirmed viral infection (area under the curve [AUC] of 0.82, sensitivity 85%, specificity 69%, cut-off 0.24 ng/mL), between confirmed bacterial infection and non-infectious fever (AUC of 0.84, sensitivity 90%, specificity 71%, cut-off 0.21 ng/mL) and between all bacterial infections (confirmed and suspected) and non-infectious fever (AUC of 0.80, sensitivity 85%, specificity 71%, cut-off 0.21 ng/mL). C-reactive protein (CRP) levels were shown to be less accurate when comparing the same groups. This is the first study showing that, in a non-Caucasian febrile population at the ED, PCT is a more valuable marker of bacterial infection than CRP. These results may improve diagnostics and eventually decrease antibiotic prescriptions in resource-limited settings.

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Related in: MedlinePlus

Levels of C-reactive protein (CRP), procalcitonin (PCT) and leukocytes in patients presenting with fever to the emergency department. Panel A shows the levels of all patients together, panel B shows the levels in patients with (confirmed or suspected) bacterial infection, panel C shows the levels in patients with non-bacterial fever and panel D shows the levels in patients with (confirmed or suspected) viral infection
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Fig1: Levels of C-reactive protein (CRP), procalcitonin (PCT) and leukocytes in patients presenting with fever to the emergency department. Panel A shows the levels of all patients together, panel B shows the levels in patients with (confirmed or suspected) bacterial infection, panel C shows the levels in patients with non-bacterial fever and panel D shows the levels in patients with (confirmed or suspected) viral infection

Mentions: The levels of PCT, CRP and leukocytes are shown in Fig. 1. The median PCT levels were 0.96 ng/mL (IQR 0.19–5.22 ng/mL) in the overall cohort, 1.91 ng/mL (IQR 0.31–9.01 ng/mL) in patients with confirmed and suspected bacterial infection and 0.22 ng/mL (IQR 0.11–1.52 ng/mL) in patients with confirmed and suspected viral infection; the median CRP levels were 12.1 mg % (IQR 2.4–22.0 mg %), 15.3 mg % (IQR 6.0–25.6 mg %) and 2.7 mg % (IQR 1.3–5.8 mg %); and the median leukocyte levels were 11.4 giga/L (IQR 6.9–18.6 giga/L), 13.1 giga/L (IQR 8.0–19.7 giga/L) and 6.6 giga/L (IQR 4.8 – 10.0 giga/L) in the same groups, respectively.Fig. 1


Procalcitonin as a potent marker of bacterial infection in febrile Afro-Caribbean patients at the emergency department.

Limper M, de Kruif MD, Ajubi NE, van Zanten AP, Brandjes DP, Duits AJ, van Gorp EC - Eur. J. Clin. Microbiol. Infect. Dis. (2011)

Levels of C-reactive protein (CRP), procalcitonin (PCT) and leukocytes in patients presenting with fever to the emergency department. Panel A shows the levels of all patients together, panel B shows the levels in patients with (confirmed or suspected) bacterial infection, panel C shows the levels in patients with non-bacterial fever and panel D shows the levels in patients with (confirmed or suspected) viral infection
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3104135&req=5

Fig1: Levels of C-reactive protein (CRP), procalcitonin (PCT) and leukocytes in patients presenting with fever to the emergency department. Panel A shows the levels of all patients together, panel B shows the levels in patients with (confirmed or suspected) bacterial infection, panel C shows the levels in patients with non-bacterial fever and panel D shows the levels in patients with (confirmed or suspected) viral infection
Mentions: The levels of PCT, CRP and leukocytes are shown in Fig. 1. The median PCT levels were 0.96 ng/mL (IQR 0.19–5.22 ng/mL) in the overall cohort, 1.91 ng/mL (IQR 0.31–9.01 ng/mL) in patients with confirmed and suspected bacterial infection and 0.22 ng/mL (IQR 0.11–1.52 ng/mL) in patients with confirmed and suspected viral infection; the median CRP levels were 12.1 mg % (IQR 2.4–22.0 mg %), 15.3 mg % (IQR 6.0–25.6 mg %) and 2.7 mg % (IQR 1.3–5.8 mg %); and the median leukocyte levels were 11.4 giga/L (IQR 6.9–18.6 giga/L), 13.1 giga/L (IQR 8.0–19.7 giga/L) and 6.6 giga/L (IQR 4.8 – 10.0 giga/L) in the same groups, respectively.Fig. 1

Bottom Line: Prospective, blinded PCT measurements were performed in patients with a microbiologically or serologically confirmed diagnosis or a strongly suspected diagnosis on clinical grounds.C-reactive protein (CRP) levels were shown to be less accurate when comparing the same groups.These results may improve diagnostics and eventually decrease antibiotic prescriptions in resource-limited settings.

View Article: PubMed Central - PubMed

Affiliation: Immunology Laboratory Department, Red Cross Blood Bank Foundation, Pater Euwensweg 36, Willemstad, Curaçao, Netherlands Antilles. maarten.limper@slz.nl

ABSTRACT
Procalcitonin (PCT) has been shown to be of additional value in the work-up of a febrile patient. This study is the first to investigate the additional value of PCT in an Afro-Caribbean febrile population at the emergency department (ED) of a general hospital. Febrile patients were included at the ED. Prospective, blinded PCT measurements were performed in patients with a microbiologically or serologically confirmed diagnosis or a strongly suspected diagnosis on clinical grounds. PCT analysis was performed in 93 patients. PCT levels differentiated well between confirmed bacterial and confirmed viral infection (area under the curve [AUC] of 0.82, sensitivity 85%, specificity 69%, cut-off 0.24 ng/mL), between confirmed bacterial infection and non-infectious fever (AUC of 0.84, sensitivity 90%, specificity 71%, cut-off 0.21 ng/mL) and between all bacterial infections (confirmed and suspected) and non-infectious fever (AUC of 0.80, sensitivity 85%, specificity 71%, cut-off 0.21 ng/mL). C-reactive protein (CRP) levels were shown to be less accurate when comparing the same groups. This is the first study showing that, in a non-Caucasian febrile population at the ED, PCT is a more valuable marker of bacterial infection than CRP. These results may improve diagnostics and eventually decrease antibiotic prescriptions in resource-limited settings.

Show MeSH
Related in: MedlinePlus