Details
Category: Volume 07 Issue 02 February 2019
Hits: 1004

Title: Procalcitonin as a marker for early diagnosis of sepsis

Authors: Ranvir Singh Tyagi, Pramod Sood

 DOI: https://dx.doi.org/10.18535/jmscr/v7i2.154

Abstract

Background: Procalcitonin (PCT) has been newly proposed indicator of presence of infection and as a useful marker of the severity sepsis.

Methods: The cross sectional study was conducted on patients of suspected or established sepsis who were admitted in the hospital. The study samples included all patients aged above 15 years presenting with acute sepsis as diagnosed by clinical presentation.

Results: The study included 50 ICU patients with suspected sepsis. Patients age ranged 15 to 75 years. Out of 50, 32 patients were male & 18 female. Among these, patients PCT above 30 ng/ml were seen in 3 patients, 10-30 ng/ml in 3 patients, 2-10 ng/ml in 19 patients, 0.5-2 ng/ml in 1 patients & less than 0.5 ng/ml in 24 patients. There was a statistically significant correlation with the presence of sepsis determined using either PCT ≥05 ng/ml or ≥2 ng/ml.

Conclusions: PCT is among the most promising sepsis markers capable of completing clinical signs and routine lab parameters suggestive of severe infection.

Keywords: Procalcitonin, Sepsis, ICU.

References

  1. Markus B, Peter AW. The inflammatory response in sepsis. Trends Immunol. 2013;34(3):129–136. doi: 10.1016/j.it.2012.09.004. 
  2. Lever A, Mackenzie I. Sepsis: definition, epidemiology, and diagnosis. Br Med J. 2007;335:879–883. doi: 10.1136/bmj.39346.495880.AE. 
  3. Dunja M, Snezana B, Arsen U, Biljana D, Vladimir V. Use of presepsin and procalcitonin for prediction of SeptiFast results in critically ill patients. J Crit Care. 2017;40:197–201. doi: 10.1016/j.jcrc.2017.04.008.
  4. Angus DC, Van der Poll T. Severe sepsis and septic shock. N Engl J Med. 2013;369:840–851. doi: 10.1056/NEJMra1208623. 
  5. Moore LJ, McKinley BA, Turner K. The epidemiology of sepsis in general surgery patients. J Trauma. 2011;70(3):672–680. doi: 10.1097/TA.0b013e31820e7803. 
  6. Slade E, Tamber PS, Vincent JL. The surviving sepsis, campaign, raising awareness to reduce mortality. Crit Care. 2003;7(1):1–2. doi: 10.1186/cc1876. 
  7. Divatia JV, Amin PR, Ramakrishnan N, Kapadia FN, Todi S, Sahu S, Govil D, Chawla R, Kulkarni AP, Samavedam S, Jani CK, Rungta N, Samaddar DP, Mehta S, Venkataraman R, Hegde A, Bande BD, Dhanuka S, Singh V, Tewari R, Zirpe K, Sathe P, INDICAPS Study Investigators Intensive care in India: the Indian intensive care case mix and practice patterns study. Indian J Crit Care Med. 2016;20(4):216–225. doi: 10.4103/0972-5229.180042. 
  8. Feldmann H, Geistbert TW. Ebola, hemorrhagic, fever. Lancet. 2011;377 (97768):849–862. doi: 10.1016/S0140-6736(10)60667-8. 
  9. Calrk IA, Alleva LM, Mills AC, Cowden WB. Pathogen of malaria and clinically similar conditions. Clin Microbio Rev. 2004;17(3):509–539. doi: 10.1128/CMR.17.3.509-539.2004. 
  10. Paessler S, Walker DH. Pathogenesis of the viral hemorrhagic fever. Annu Rev Pathol. 2013;8:411–440. doi: 10.1146/annurev-pathol-020712-164041.
  11. Livorsi DJ, Stenehjem E, Stephens DS. Virulence factors of gram-negative bacteria in sepsis with a focus on Neisseria meningitidis. Contrib Microbiol. 2011;17:31–47. doi: 10.1159/000324008. 
  12. Willey J, Sherwood L, Christopher JW. Prescotts’s Microbiol. 8. 2011. p. 97.
  13. Rimmelé T, Leli C, Payen D, Cantaluppi V, Marshall J, Gomez H, Gomez A, Murray P, Kellum JA. Immune cell phenotype and function in sepsis. Shock. 2016;45(3):282–291. doi: 10.1097/SHK.0000000000000495
  14. Chen X-h, Yin Y-j, Zhang J-x. Sepsis and immune response. World J Emerg Med. 2011;2(2):88–92. doi: 10.5847/wjem.j.1920-8642.2011.02.002. 
  15. Reinhart K, Bauer M, Reideman NC, Hartog CS. New approaches to sepsis: molecular diagnostics and biomarkers. J Cln Microbiol. 2010;25:609–634. 
  16. Sakr Y, Brgett U, Nacul FE, Reinhart K, Brunkhorst F. Lipopolysaccharide binding protein in a surgical intensive care unit: a marker of sepsis? Crit Care Med. 2008;36:2014–2022. doi: 10.1097/CCM.0b013e31817b86e3.
  17. Jin M, Khan A. Procalcitonin uses in the clinical laboratory for the diagnosis of sepsis. Lab Med. 2010;41(3):173-7.
  18. Sand KE, Bates DW, Lanken PN, Graman PS, Hibberd PL, Kahn KL. Epidemiology of sepsis syndrome in 8 academic medical centres. JAMA. 1997;278:234-40.
  19. Todi S, Chatterjee S, Bhattacharyya M. Epidemiology of severe sepsis in India. Crit Care Med. 2007;11:65.
  20. Calandra T, Cohen J. International sepsis forum definition of infection in the ICU consensus conference. Crit Care Med. 2005;33:1538-48.

Corresponding Author

Pramod Sood

Associate Professor, Department of Critical Care Medicine, Dayanand Medical College and Hospital Ludhiana, India