Procalcitonin and procalcitonin kinetics for diagnosis and prognosis of intravascular catheter-related bloodstream infections in selected critically ill patients: a prospective observational study

• Published in: BMC infectious diseases 2012-10, Vol.12 (1), p.247-247, Article 247
• Main Authors: Theodorou, Vasiliki P, Papaioannou, Vasilios E, Tripsianis, Gregory A, Panopoulou, Maria K, Christophoridis, Elias K, Kouliatsis, Georgios A, Gioka, Theodora M, Maltezos, Efstratios S, Ktenidou-Kartali, Sophia I, Pneumatikos, Ioannis A
• Format: Article
• Language: English
• Subjects: Accuracy; Adult; Aged; Aged, 80 and over; Antibiotics; Bacterial infections; Biological markers; Biomarkers; C-reactive protein; Calcitonin - blood; Calcitonin Gene-Related Peptide; Catheter-Related Infections - diagnosis; Catheterization; Catheters; Cohort Studies; Confidence intervals; Critical Illness; Development and progression; Diagnosis; Female; Health aspects; Hospital costs; Humans; Infection; Infection control; Infections; Intensive care; Male; Medical research; Medical statistics; Medicine, Experimental; Middle Aged; Predictive Value of Tests; Prognosis; Prospective Studies; Protein Precursors - blood; Sensitivity and Specificity; Sepsis; Sepsis - diagnosis; Studies; Teaching hospitals
• ISSN: 1471-2334; 1471-2334
• DOI: 10.1186/1471-2334-12-247

Procalcitonin (PCT) has emerged as a valuable marker of sepsis. The potential role of PCT in diagnosis and therapy monitoring of intravascular catheter-related bloodstream infections (CRBSI) in intensive care unit (ICU) is still unclear and was evaluated. Forty-six patients were included in the study, provided they were free of infection upon admission and presented the first episode of suspected CRBSI during their ICU stay. Patients who had developed any other infection were excluded. PCT was measured daily during the ICU hospitalization. Primary endpoint was proven CRBSI. Therapy monitoring as according to infection control was also evaluated. Among the 46 patients, 26 were diagnosed with CRBSI. Median PCT on the day of infection suspicion (D0) was 7.70 and 0.10 ng/ml for patients with and without proven CRBSI, respectively (p 0.20 ng/ml of PCT between the D0 and any of the 4 preceding days was associated with a positive predictive value exceeding 96%. PCT concentrations from the D2 to D6 after suspected infection tended to decrease in controlled patients, whereas remained stable in non-controlled subjects. A PCT concentration exceeding 1.5 ng/ml during D3 was associated with lack of responsiveness to therapy (p = 0.028). We suggest that PCT could be a helpful diagnostic and prognostic marker of CRBSI in critically ill patients. Both absolute values and variations should be considered.