Usefulness of procalcitonin serum level for the diagnosis of bacteremia

The predictive value of procalcitonin serum levels to detect or rule out bacteremia was investigated prospectively in a case-control study with 200 hospitalized adults from whom blood samples were taken for culture. Fifty bacteremic patients (cases) had higher procalcitonin serum levels than the 150...

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Bibliographic Details
Published in:European journal of clinical microbiology & infectious diseases 2001-08, Vol.20 (8), p.524-527
Main Authors: LIAUDAT, S, DAYER, E, PRAZ, G, BILLE, J, TROILLET, N
Format: Article
Language:English
Subjects:
Aged
Bacteremia - diagnosis
Bacteremia - microbiology
Bacteria - classification
Bacteria - isolation & purification
Bacterial diseases
Bacterial Infections - diagnosis
Bacterial Infections - microbiology
Bacterial sepsis
Biological and medical sciences
Blood
Blood - microbiology
Calcitonin - blood
Calcitonin Gene-Related Peptide
Case-Control Studies
Culture Media
Female
Human bacterial diseases
Humans
Infectious diseases
Male
Medical sciences
Middle Aged
Multivariate analysis
Predictive Value of Tests
Protein Precursors - blood
Sensitivity and Specificity
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Summary:The predictive value of procalcitonin serum levels to detect or rule out bacteremia was investigated prospectively in a case-control study with 200 hospitalized adults from whom blood samples were taken for culture. Fifty bacteremic patients (cases) had higher procalcitonin serum levels than the 150 controls with sterile blood cultures (11.7 vs. 0.7 ng/ml; P=0.0001), a difference that remained significant after controlling for potential confounders in multivariate analysis. At cut-off values of 0.5 and 0.2 ng/ml, the sensitivity of procalcitonin was 56 and 92%, and the specificity was 83 and 43%, respectively. These results yielded low positive (22 and 12%) and high negative predictive values (96 and 99%), reflecting primarily the low prevalence of bacteremia among patients who undergo blood cultures in hospitals (low pretest probability). Although caution is mandatory when using such markers at the individual level, procalcitonin, possibly together with other parameters, could nonetheless prove useful in future studies to rapidly rule out bacteremia.
ISSN:0934-9723
1435-4373
DOI:10.1007/s100960100548