Review Article

Procalcitonin, a Reliable Biomarker in Management of Sepsis

Abstract

Procalcitonin is widely used as a biomarker for diagnosis and prognosis for sepsis and infection as well as monitoring the response to antibiotic therapy. In this study we systematically reviewed the value of procalcitonin in diagnosis, treatment, and prognosis in patients with sepsis or infection.

Wacker C, Prkno A, Brunkhorst FM, Schlattmann P. Procalcitonin as a diagnostic marker for sepsis: a systematic review and meta-analysis. Lancet Infect Dis. 2013; 13(5):426-35.

Prkno A, Wacker C, Brunkhorst FM, Schlattmann P. Procalcitonin-guided therapy in intensive care unit patients with severe sepsis and septic shock – a systematic review and meta-analysis. Crit Care. 2013; 17(6):R291.

Koutroulis I, Loscalzo S, Kratimenos P, Singh S, Weiner E, Syriopoulou V, et al. Clinical Applications of Procalcitonin in Pediatrics: An Advanced Biomarker for Inflammation and Infection—Can It Also Be Used in Trauma?. International Scholarly Research Notices. 2014;2014:1-5.

Li H, Luo YF, Blackwell TS, Xie CM. Meta-Analysis and Systematic Review of Procalcitonin-Guided Therapy in Respiratory Tract Infections. Antimicrob Agents Chemother. 2011; 55(12):5900-5906.

Agarwal R, Schwartz DN. Procalcitonin to Guide Duration of Antimicrobial Therapy in Intensive Care Units: A Systematic Review. Clin Infect Dis. 2011; 53(4):379-87.

Chaudhury A, Sachin Sumant GL, Jayaprada R, Kalawat U, Ramana BV. Procalcitonin in sepsis and bacterial infections. J Clin Sci Res. 2013; 2:216-224.

Gilbert DN. Use of Plasma Procalcitonin Levels as an Adjunct to Clinical Microbiology. J Clin Microbiol. 2010; 48(7):2325-9.

Hatipoglu M, Karagoz E. Clinical usefulness of procalcitonin as a marker of sepsis: a novel predictor of causative pathogens?. Intern Med. 2015; 54(9):1163.

Foushee JA, Hope NH, Grace EE. Applying biomarkers to clinical practice: a guide for utilizing procalcitonin assays. J Antimicrob Chemother. 2012 ;67(11):2560-9.

Jekarl DW, Lee SY, Lee J, Park YJ, Kim Y, Park JH, et al. Procalcitonin as a diagnostic marker and IL-6 as a prognostic marker for sepsis. Diagn Microbiol Infect Dis. 2013; 75(4):342-7.

Anand D, Das S, Bhargava S, Srivastava LM, Garg A, Tyagi N, et al. Procalcitonin as a rapid diagnostic biomarker to differentiate between culture-negative bacterial sepsis and systemic inflammatory response syndrome: A prospective, observational, cohort study. J Crit Care. 2015; 30(1):218.e7-12.

Lin KH, Wang FL, Wu MS, Jiang BY, Kao WL, Chao HY, et al. Serum procalcitonin and C-reactive protein levels as markers of bacterial infection in patients with liver cirrhosis:a systematic review and meta-analysis. Diagn Microbiol Infect Dis. 2014; 80(1):72-8.

Sotillo-Díaz JC, Bermejo-López E, García-Olivares P, Peral-Gutiérrez JA, Sancho-González M, Guerrero-Sanz JE. [Role of plasmaprocalcitonin in the diagnosis of ventilator-associated pneumonia: systematic review and metaanalysis]. Med Intensiva. 2014; 38(6):337-46.

Shomali W, Hachem R, Chaftari AM, Bahu R, El Helou G, Jiang Y, et al. Can procalcitonin differentiate Staphylococcus aureus from coagulase-negative staphylococci in clustered gram-positive Bacteremia. Diagn Microbiol Infect Dis. 2013; 76(2):158-61.

Tang J, Long W, Yan L, Zhang Y, Xie J, Lu G, et al. Procalcitonin guided antibiotic therapy of acute exacerbations of asthma: a randomized controlled trial. BMC Infect Dis. 2013; 13:596.

Abdelkader NA, Mahmoud WA, Saber SM. Serum procalcitonin in Egyptian patients with acute meningitis and a negative directcerebrospinal fluid examination. J Infect Public Health. 2014; 7(2):106-13.

Li Y, Zhang G, Ma R, Du Y, Zhang L, Li F, et al. The diagnostic value of cerebrospinal fluids procalcitonin and lactate for the differential diagnosis of post-neurosurgical bacterial meningitis and aseptic meningitis. Clin Biochem. 2015; 48(1-2):50-4.

El-Solh AA, Vora H, Knight PR 3rd, Porhomayon J. Diagnostic use of serum procalcitonin levels in pulmonary aspiration syndromes. Crit Care Med. 2011; 39(6):1251-6.

Dou YH, Du JK, Liu HL, Shong XD. The role of procalcitonin in the identification of invasive fungal infection-a systemic review and meta-analysis. Diagn Microbiol Infect Dis. 2013; 76(4):464-9.

Seoane L, Pe´rtega S, Galeiras R, Astola I, Bouza T. Procalcitonin in the Burn Unit and the Diagnosis of Infection. Burns. 2014; 40(2):223-9.

Ren H, Li Y, Han C, Hu H. Serum procalcitonin as a diagnostic biomarker for sepsis in burned patients: A meta-analysis. Burns. 2015; 41(3):502-9.

Bode-Jänisch S, Schütz S, Schmidt A, Tschernig T, Debertin AS, Fieguth A, et al. Serum procalcitonin levels in the postmortem diagnosis of sepsis. Forensic Sci Int. 2013; 226(1-3):266-72.

Nakajima A, Yazawa J, Sugiki D, Mizuguchi M, Sagara H, Fujisiro M, et al. Clinical utility of procalcitonin as a marker of sepsis: a potential predictor of causative pathogens. Intern Med. 2014; 53(14):1497-503.

Porfyridis I, Georgiadis G, Vogazianos P, Mitis G, Georgiou A. C-reactive protein, procalcitonin, clinical pulmonary infection score, and pneumonia severity scores in nursing home acquired pneumonia. Respir Care. 2014; 59(4):574-81.

Suberviola B, Castellanos-Ortega A, González-Castro A, García-Astudillo LA, Fernández-Miret B. [Prognostic value of procalcitonin, C-reactive protein and leukocytes in septic shock]. Med Intensiva. 2012; 36(3):177-84.

Jain S, Sinha S, Sharma SK, Samantaray JC, Aggrawal P, Vikram NK, et al. Procalcitonin as a prognostic marker for sepsis: a prospective observational study. BMC Res Notes. 2014; 7:458.

Suberviola B, Castellanos-Ortega A, González-Castro A, García-Astudillo LA, Fernández-Miret B. [Prognostic value of procalcitonin, C-reactive protein and leukocytes in septic shock]. Med Intensiva. 2012; 36(3):177-84.

Tian G, Pan SY, Ma G, Liao W, Su QG, Gu BC, et al. Serum levels of procalcitonin as a biomarker for differentiating between sepsis and systemic inflammatory response syndrome in the neurological intensive care unit. J Clin Neurosci. 2014; 21(7):1153-8.

Rowland T, Hilliard H, Barlow G. Procalcitonin: Potential Role in Diagnosis and Management of sepsis. Adv Clin Chem. 2015; 68:71-86.

Silvestre J, Rebanda J, Lourenço C, Póvoa P. Diagnostic accuracy of C-reactive protein and procalcitonin in the early detection of infection after elective colorectal surgery - a pilot study. BMC Infect Dis. 2014; 14:444.

Robriquet L, Séjourné C, Kipnis E, D'Herbomez M, Fourrier F. A composite score combining procalcitonin, C-reactive protein and temperature has a high positive predictive value for the diagnosis of intensive care-acquired infections. BMC Infect Dis. 2013; 13:159.

Calfee CS, Pugin J. The search for diagnostic markers in sepsis: many miles yet to go. Am J Respir Crit Care Med. 2012; 186(1):2-4.

Schrag B, Roux-Lombard P, Schneiter D, Vaucher P, Mangin P, Palmiere C. Evaluation of C-reactive protein, procalcitonin, tumor necrosis factor alpha,interleukin-6, and interleukin-8 as diagnostic parameters in sepsis-related fatalities. Int J Legal Med. 2012; 126(4):505-12.

Bloos F, Marshall JC, Dellinger RP, Vincent JL, Gutierrez G, Rivers E, et al. Multinational, observational study of procalcitonin in ICU patients with pneumonia requiring mechanicalventilation: a multicenter observational study. Crit Care. 2011; 15(2):R88

Schuetz P, Maurer P, Punjabi V, Desai A, Amin DN, Gluck E. Procalcitonin decrease over 72 hours in US critical care units predicts fatal outcome in sepsis patients. Crit Care. 2013; 17(3):R115.

Azevedo JR, Torres OJ, Czeczko NG, Tuon FF, Nassif PA, Souza GD. Procalcitonin as a prognostic biomarker of severe sepsis and septic shock. Rev Col Bras Cir. 2012; 39(6):456-61.

Abd El-Azeem A, Hamdy G, Saraya M, Fawzy E, Anwar E, Abdulattif S. The role of procalcitonin as a guide for the diagnosis, prognosis, and decision of antibiotic therapy for lower respiratory tract infections. Egyptian J Chest Diseases and Tuberculosis. 2013; 62(4):687–695.

Abu Elkhashab AE, Swelem RS, Abd Alla AA, Hattata EA, Atta MS. Etiological and prognostic values of procalcitonin in hospital-acquired pneumonia. Egyptian J Chest Diseases and Tuberculosis 2014; 63: 201–206.

Azevedo JR, Torres OJ, Beraldi RA, Ribas C, Malafaia O. Prognostic evaluation of severe sepsis and septic shock: Procalcitonin clearance vs Δ Sequential Organ Failure Assessment. J Crit Care. 2015; 30(1):219.e9-12.

Rumende CM, Mahdi D. Role of combined procalcitonin and lipopolysaccharide-binding protein as prognostic markers of mortality in patients with ventilator-associated pneumonia. Acta Med Indones. 2013; 45(2):89-93.

Burkhardt O, Ewig S, Haagen U, Giersdorf S, Hartmann O, Wegscheider K, et al. Procalcitonin guidance and reduction of antibiotic use in acute respiratory tract infection. Eur Respir J. 2010; 36(3):601-7.

Matthaiou DK, Ntani G, Kontogiorgi M, Poulakou G, Armaganidis A, Dimopoulos G. An ESICM systematic review and meta-analysis of procalcitonin-guided antibiotic therapy algorithms in adult critically ill patients. Intensive Care Med. 2012; 38(6):940–9.

Deliberato RD, Marra AR, Sanches PR, Martino MD, Ferreira CE, Pasternak J, et al. Clinical and economic impact of procalcitonin to shorten antimicrobial therapy in septic patients with proven bacterial infection in an intensive care setting. Diagn Microbiol Infect Dis. 2013; 76(3):266-71.

Huang TS, Huang SS, Shyu YC, Lee CH, Jwo SC, Chen PJ, et al. Aprocalcitonin-based algorithm to guide antibiotic therapy in secondary peritonitis following emergency surgery: a prospective study with propensity score matching analysis. PLoS One. 2014; 9(3):e90539.

Assink-de Jong E, de Lange DW, van Oers JA, Nijsten MW, Twisk JW, Beishuizen A. Stop Antibiotics on guidance of Procalcitonin

Study (SAPS): a randomized prospective multicenter investigator-initiated trial to analyse whether daily measurements of procalcitonin versus a standard-of-care approach can safely shorten antibiotic duration in intensive care unit. BMC Infect Dis. 2013; 13:178.

Agarwal R, Schwartz DN. Procalcitonin to Guide Duration of Antimicrobial Therapy in Intensive Care Units: A Systematic Review. Clin Infect Dis. 2011; 53(4):379-87.

Heyland DK, Johnson AP, Reynolds SC, Muscedere J. Procalcitonin for reduced antibiotic exposure in the critical care setting: A systematic review and an economic evaluation.Crit Care Med. 2011; 39(7):1792-9.

Elizabeth A. Mann EA, Wood GL, Wade CE. Use of procalcitonin for the detection of sepsis in the critically ill burn patient: A systematic review of the literature. Burns. 2011; 37(4):549-58.

Ding J, Chen Z, Feng K. Procalcitonin-guided antibiotic use in acute xacerbations of idiopathic pulmonary fibrosis. Int J Med Sci. 2013; 10(7):903-7.

Maseda E, Suarez-de-la-Rica A, Anillo V, Tamayo E, García-Bernedo CA, Ramasco F, et al. Procalcitonin-guided therapy may reduce length of antibiotic treatment in intensive care unit patients with secondary peritonitis: A multicenter retrospective study. J Crit Care. 2015; 30(3):537-42.

Zielinska-Borkowska U, Skirecki T, Złotorowicz M, Czarnocka B. Procalcitonin in early onset ventilator-associated Pneumonia. J Hosp Infect. 2012; 81(2):92-7.

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IssueVol 2 No 1 (2016): Winter QRcode
SectionReview Article(s)
Keywords
procalcitonin sepsis infection prognosis

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How to Cite
1.
Amini S, Sedaghat A. Procalcitonin, a Reliable Biomarker in Management of Sepsis. Arch Anesth & Crit Care. 2016;2(1):165-168.