Lab
Procalcitonin
search
Procalcitonin
, proCT
Indication
Marker of
Bacterial Infection
and
Sepsis
Physiology
Peptide produced in the
Thyroid
, lung and intestin
Calcitonin
precursor (involved in
Calcium Homeostasis
)
Remains at low levels when well
Increases in inflammatory states, rising within 4 hours of infection onset and peaking at 12 to 48 hours
Postulated to increase markedly in
Bacterial Infection
Postulated to allow for monitoring treatment response due to Procalcitonin short half-life
Interpretation
Procalcitonin level <0.05: Normal
Procalcitonin level <0.25:
Bacteria
l
Sepsis
unlikely
Vijayan (2017) J Intensive Care 5:51 +PMID: 28794881 [PubMed]
Efficacy
Adults
Mediocre efficacy in
Sepsis
diagnosis
Test Sensitivity
: 77%
Test Specificity
: 79%
Wacker (2013) Lancet Infect Dis 13(5): 426-35 +PMID: 23375419 [PubMed]
Low efficacy in
Pneumonia
diagnosis
Maisel (2013) Ear J Heart Fail 14(3): 278-86 +PMID: 22302662 [PubMed]
Worse outcomes in ICU when Procalcitonin was used to direct antibiotic management
Bouadma (2010) Lancet 375(9713): 463-74 +PMID: 20097417 [PubMed]
Efficacy
Children
See Serious
Bacterial Infection
in Children (
Occult Bacteremia
)
Variable efficacy, although initial studies had very high accuracy in septic children
Test Sensitivity
: 26-55% for
Bacterial Infection
Test Specificity
: 75 to 82% for
Bacterial Infection
Interpretation
PCT <0.5 ng/ml has a
Negative Predictive Value
for serious
Bacterial Infection
of 90%
PCT >0.6 (and WBC >19k, blasts >1.8k,
Neutrophil
s >13k) suggests serious
Bacterial Infection
References
Gendrel (1996) J Pediatr 128:570-3 [PubMed]
Olaciregui (2009) Arch Dis Child 94(7): 501-5 +PMID:19158133 [PubMed]
Mahajan (2014) Acad Emerg Med 21(2): 171-9 +PMID:24673673 [PubMed]
References
Orman, Herbert, Spiegel in Herbert (2016) EM:Rap 16(10):12-3
Dolatabadi (2015) Niger Med J 56(1):17-22 +PMID:25657488 [PubMed]
Type your search phrase here