Journals / Journal of Health Sciences and Medicine / 2023 / Cilt: 6 Sayı: 6

Can high procalcitonin levels be a biomarker for detecting multidrug-resistant Gram-negative bacteremia?

Pages
1162–1169
Publication Date
2023-10-29
DOI
—
🏛️Bibliographic metadata and full text access for this article are provided via DergiPark.
DergiPark Record ↗
✨

AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

A ROC analysis was performed, and the AUC distinguishing MDR pathogens from non-MDR was found as 0.633(CI: 95%, 0.586-0.681; p <0.0001), with a best PCT cutoff of 11.4 ng/mL, a sensitivity of 54.8%, and a specificity of 66.3% Conclusion: High levels of PCT can guide empirical antibiotic treatments, with its property to predict GN bacteria and that they might be MDR GN BSIs.

📌 3 Key Takeaways

🎯
Objective & Hypothesis:Aims: Clinicians prefer broad-spectrum empirical antibiotic therapy in patients with suspected bloodstream infection (BSI) due to long test turnaround times of conventional methods.
📊
Key Findings & Data:Methods: The results of inpatients whose blood cultures and samples for PCT tests had been sent simultaneously between 2018 and 2022 were analyzed retrospectively.
💡
Conclusion & Impact:A ROC analysis was performed, and the AUC distinguishing MDR pathogens from non-MDR was found as 0.633(CI: 95%, 0.586-0.681; p <0.0001), with a best PCT cutoff of 11.4 ng/mL, a sensitivity of 54.8%, and a specificity of 66.3% Conclusion: High levels of PCT can guide empirical antibiotic treatments, with its property to predict GN bacteria and that they might be MDR GN BSIs.
🔬Design:Research Article
📍Scope:2018 Verileri
⚙️Variables:Procalcitonin · bloodstream infection · Gram negative bacteriae

Abstract

Aims: Clinicians prefer broad-spectrum empirical antibiotic therapy in patients with suspected bloodstream infection (BSI) due to long test turnaround times of conventional methods. We aimed to assess the contribution of procalcitonin (PCT) to the selection of antibiotics to be used in empirical treatment. Methods: The results of inpatients whose blood cultures and samples for PCT tests had been sent simultaneously between 2018 and 2022 were analyzed retrospectively. Antibiotic susceptibility results of Enterobacteriaceae, Acinetobacter baumannii complex and Pseudomonas aeruginosa, were evaluated for multidrug-resistance (MDR). Results: Results of 1206 patients who met the inclusion criteria were included in the study. The PCT median value in BSIs caused by the Gram-negative bacteria found to be statistically significantly higher than those caused by the Gram-positive bacteria, fungal and polymicrobial infections (p<0.05). The best cutoff value of ROC, with an AUC value of 0.607 (CI: 95%: 0.578-0.635, p< .0001), a sensitivity of 72.1%, and a specificity of 55.4%, for distinguishing GN BSIs from other BSIs was determined as 2.5 ng/ml. The PCT median value of MDR pathogens was found to be statistically significantly higher than that of non-MDR pathogens (p < 0.05). A ROC analysis was performed, and the AUC distinguishing MDR pathogens from non-MDR was found as 0.633(CI: 95%, 0.586-0.681; p <0.0001), with a best PCT cutoff of 11.4 ng/mL, a sensitivity of 54.8%, and a specificity of 66.3% Conclusion: High levels of PCT can guide empirical antibiotic treatments, with its property to predict GN bacteria and that they might be MDR GN BSIs.

🔖

Cite This Article

DİNÇER, Ş. D., ORAL, Ü., AYAŞ, M., AKSARAY, S. (2023). Can high procalcitonin levels be a biomarker for detecting multidrug-resistant Gram-negative bacteremia?. Journal of Health Sciences and Medicine, Cilt: 6 Sayı: 6, 1162–1169. https://ajindex.com/articles/969235

📄 Full Text PDF Viewer

📄

PDF görüntüleyici hazırlanıyor...

References (11)

  1. Kibe S, Adams K, Barlow G. Diagnostic and prognostic biomarkers of sepsis in critical care. J Antimicrob Chemother. 2011;66(Supplement 2):ii33-ii40. Grant MJC, Olson J, Gerber A. Clinician response time for positive blood culture results in a pediatric ICU. Heart & Lung. 2015;44(5):426-429.
  2. Zanon F, Caovilla JJ, Michel RS, et al. Sepse na unidade de terapia intensiva: etiologias, fatores prognósticos e mortalidade. Rev Bras Ter Intensiva. 2008;20(2):128-134
  3. Marshall JC, Vincent J, Guyatt G, et al. Outcome measures for clinical research in sepsis: a report of the 2nd Cambridge Colloquium of the International Sepsis Forum. Crit Care Med. 2005;33(8):1708-1716.
  4. Marik PE, Taeb AM. SIRS, qSOFA and new sepsis definition. J Thorac Dis. 2017;9(4):943-945.
  5. Lai L, Lai Y, Wang H, et al. Diagnostic accuracy of procalcitonin compared to C-reactive protein and interleukin 6 in recognizing Gram-negative bloodstream infection: a meta-analytic study. Dis Markers. 2020;2020:1-14.
  6. Hausfater P, Garric S, Ayed SB, Rosenheim M, Bernard M, Riou B. Usefulness of procalcitonin as a marker of systemic infection in emergency department patients: a prospective study. Clin Infect Dis. 2002;34(7):895-901.
  7. Panico C, Nylen E. Procalcitonin beyond the acute phase: novel biomediator properties? BMC Med. 2013;11(1): 89. Bassetti M, Russo A, Righi E, et al. Role of procalcitonin in bacteremic patients and its potential use in predicting infection etiology. Exp Rev Anti-infective Ther. 2019;17(2):99-105.
  8. Lin J, Chen Z, Chen X. Elevated serum procalcitonin predicts Gram-negative bloodstream infections in patients with burns. Burns. 2020;46(1):182-189.
  9. Luo X, Chen S, Zhang J, et al. Procalcitonin as a marker of Gram-negative bloodstream infections in hematological patients with febrile neutropenia. Leukemia & Lymphoma. 2019;60(10):2441-2448.
  10. Yan ST, Sun LC, Jia HB, Gao W, Yang JP, Zhang GQ. Procalcitonin levels in bloodstream infections caused by different sources and species of bacteria. Am J Emerg Med. 2017;35(4):579-583. 13 Kirn T, Weinstein M. Update on blood cultures: how to obtain, process, report, and interpret. Clin Microbiol Infect. 2013;19(6):513-520. European Committee on Antimicrobial Susceptibility Testing (EUCAST). Archive of EUCAST tables and documents. 2023 Available at: https://www.eucast.org/ast_of_bacteria/previous_versions_of_documents
  11. Magiorakos A, Srinivasan A, Carey R, et al. Multidrug-resistant, extensively drug-resistant and pandrug-resistant bacteria: an international e