calca-protein--human and Streptococcal-Infections

A short-cut review was performed to evaluate whether inflammatory markers such as C reactive protein (CRP), erythrocyte sedimentation rate (ESR), white cell count (WCC) and procalcitonin (PCT) are able to discriminate between streptococcal and viral tonsillitis, enabling a reduction in the overuse of antibiotics. Eight studies with a total of 1031 participants were found. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of these papers are tabulated. The clinical bottom line is that WCC, CRP and PCT levels are higher in patients with streptococcal tonsillitis compared to patients with tonsillitis or pharyngitis without group A streptococcus isolated from a throat swab. Which of these markers has the best test performance characteristics requires further study.

Topics: Biomarkers; Blood Sedimentation; C-Reactive Protein; Calcitonin; Calcitonin Gene-Related Peptide; Diagnosis, Differential; Evidence-Based Medicine; Humans; Leukocyte Count; Protein Precursors; Streptococcal Infections; Tonsillitis; Virus Diseases

We investigated serum procalcitonin (PCT) and C-reactive protein (CRP) in children with streptococcal tonsillopharyngitis or nonstreptococcal tonsillopharyngitis and in healthy children. The median (range) for PCT was 0.374 (0.11-6.5), 0.105 (0.01-0.53) and 0.02 (0.01-0.08) ng/mL in the streptococcal, nonbacterial tonsillopharyngitis and control groups, respectively. PCT had a greater specificity than CRP for detection of bacterial tonsillopharyngitis.

Topics: Biomarkers; C-Reactive Protein; Calcitonin; Calcitonin Gene-Related Peptide; Child; Child, Preschool; Egypt; Female; Humans; Leukocyte Count; Male; Pharyngitis; Protein Precursors; Sensitivity and Specificity; Streptococcal Infections; Streptococcus; Tonsillitis

The objective of this study was to test the hypothesis that serum procalcitonin is increased in patients with bacterial cerebral ventricular infections after the insertion of temporary external ventricular drains.. This open, prospective study included patients requiring temporary external ventricular drains for various neurologic conditions such as intracerebral hemorrhage with ventricular hemorrhage or space-occupying lesions in the posterior fossa (cerebellar infarctions or hemorrhages). Patients experiencing primary central nervous system infection or sepsis were excluded. Procalcitonin, C-reactive protein, and white blood cell count were measured daily. Cerebrospinal fluid was investigated every other day, including cerebrospinal fluid cell count, lactate, glucose, and cerebrospinal fluid culture. Results were categorized according to presence of bacterial cerebrospinal fluid infection as determined by positive cerebrospinal fluid cultures.. A total of 34 consecutive patients were included. Procalcitonin was significantly higher (4.7 vs. 0.2 ng/mL) in patients with proven bacterial ventriculitis. Cerebrospinal fluid cell count (456 vs. 478 cells/microL) could not distinguish bacterial infection from abacterial reactions, mainly because of blood contamination of the cerebrospinal fluid.. Cerebrospinal fluid of patients treated with temporary external ventricular drains is frequently characterized by blood contamination because of the insertion procedure, the underlying neurologic disorder such as ventricular hemorrhage, or the presence of an abacterial chemical ventriculitis. Thus, diagnosis of a bacterial ventricular infection requiring immediate antibiotic therapy is less certain. Serum procalcitonin adds to the diagnostic precision in bacterial ventriculitis.

Topics: Aged; Biomarkers; C-Reactive Protein; Calcitonin; Calcitonin Gene-Related Peptide; Cerebral Ventricles; Encephalitis; Female; Humans; Male; Middle Aged; Predictive Value of Tests; Prospective Studies; Protein Precursors; Sensitivity and Specificity; Staphylococcal Infections; Streptococcal Infections

We investigated the utility of procalcitonin in early diagnosis of bacterial central nervous system (CNS) infection. Serum procalcitonin level was markedly elevated in the patients with systemic meningitis but not in the patients with brain abscess and subdural empyema. Procalcitonin may be useless to diagnose focal bacterial CNS infection.

Topics: Adolescent; Biomarkers; Brain Abscess; C-Reactive Protein; Calcitonin; Calcitonin Gene-Related Peptide; Child; Child, Preschool; Empyema, Subdural; Female; Haemophilus Infections; Haemophilus influenzae; Humans; Infant; Infant, Newborn; Male; Meningitis, Bacterial; Protein Precursors; Retrospective Studies; Staphylococcal Infections; Staphylococcus epidermidis; Streptococcal Infections

To limit the regulation of antibiotherapy in neonatal early infections by improving the tracking and the diagnosis of infected newborns.. First part: analysis of procalcitonin (PCT) in the cord. Method of tracking: 87 cases. Cut-off PCT=0.5 ng/mL. Measurement of CRP at 24 h if PCT>0.5 ng/mL. Second part: analysis of the PCT between 4 h and 6 h in the event of infectious risk; 47 cases over 6 months. Cut-off PCT=2 ng/mL. Measurement of CRP at 12 h and/or 24 h.. In 2012, there were 10 antibiotherapies prescribed per 1000 births versus 30/1000 in 2011. A reduction in two thirds of the indications was seen.. Markers of inflammation, i.e., the PCT (good specificity and good negative predictive value from 0 to 6 h of life) and CRP (good sensitivity and good positive predictive value from 12 to 24 of life) should be combined in time.

Topics: Anti-Bacterial Agents; Bacterial Infections; C-Reactive Protein; Calcitonin; Calcitonin Gene-Related Peptide; Drug Utilization; Enterobacteriaceae Infections; Female; Fetal Blood; Humans; Infant, Newborn; Infant, Premature, Diseases; Infectious Disease Transmission, Vertical; Male; Pregnancy; Pregnancy Complications, Infectious; Protein Precursors; Streptococcal Infections; Streptococcus agalactiae

Diagnosis of early neonatal infection remains an emergency. Since clinical symptoms and biological markers are neither sensitive nor specific, many newborns suspected of infection undergo biological analysis and empirical antibiotic treatment while awaiting results. Recent studies underline the benefit of using procalcitonin (PCT) to differentiate inflammatory diseases and viral infections from bacterial infections. Joram shows that it is possible to go beyond the physiological peak of PCT in the first days of life by measuring PCT concentration in cord blood. The aim of this prospective study was to evaluate a new algorithm integrating the value of PCT in blood cord for taking care of newborns who have suspected infection.. The diagnostic value of the new algorithm was compared to the diagnostic value of the algorithm currently in use, by analyzing a 9-month prospective database of 1267 newborns suspected of infection. Infection status was established with the ANAES definition and clinical progression.. Each infected newborn (n=8) would have been treated without delay with the current algorithm (based on ANAES guidelines) and this new algorithm. The new algorithm had the same diagnostic value as the current algorithm (P=0.5) with 87.5% sensitivity (95%CI [52-98]) versus 100% (95%CI [87-100]) and 87.4% specificity (95%CI [85-90]) versus 83.8% (95%CI [81-86]). Fewer biological analyses 13.1% (95%CI [11-16]) versus 42.2% (95%CI [39-45]) were performed with the PCT cord-guided algorithm than with the current algorithm (P<0.05), leading to a 64.2% cost reduction. Antibiotics were significantly less used with the new algorithm: 13.1% (95%CI [11-16]) versus 16.7% (95%CI [14-19]).. PCT in cord blood could become a new and efficient marker to help neonatologists take care of newborns suspected of infection. These results must be confirmed by a larger multicenter prospective study.

Topics: Algorithms; Biomarkers; Calcitonin; Calcitonin Gene-Related Peptide; Early Diagnosis; Fetal Blood; Humans; Infant, Newborn; Infant, Premature; Prospective Studies; Protein Precursors; Streptococcal Infections

The role of procalcitonin (PCT) in the diagnosis of infective endocarditis (IE) remains unclear. The aim of our study was to test the accuracy of PCT in the early diagnosis of IE and analyse if the accuracy of PCT is dependent on the type of pathogen causing IE. We carried out a prospective analysis of hospitalised patients referred for transthoracic echocardiography to search for an IE. The plasma PCT value was measured at the time of echocardiography. The diagnosis of IE was made using the modified Duke criteria. A total of 77 patients were included. IE was confirmed in 15 patients. The mean PCT values were 6.9 (+/-21.6) ug/l in patients without IE and 6.4 (+/-11.7) ug/l in patients with confirmed IE (p=0.92). IE patients with Staphylococcus aureus bacteraemia (n=7) had significantly higher PCT values compared to IE patients with other types of bacteraemia (n=8) (13.1 vs. 0.435, p=0.0299). This study demonstrates that PCT levels markedly differ at the time when IE is diagnosed. While PCT values are very high in patients with S. aureus bacteraemia, they are surprisingly low in patients with Streptococcus viridans bacteraemia, which are common offenders of endocarditis. We conclude that serum PCT has the potential to be used in the early diagnosis of S. aureus endocarditis.

Topics: Adult; Aged; Aged, 80 and over; Bacteremia; Calcitonin; Calcitonin Gene-Related Peptide; Endocarditis, Bacterial; Humans; Middle Aged; Prospective Studies; Protein Precursors; Serum; Staphylococcal Infections; Staphylococcus aureus; Streptococcal Infections; Viridans Streptococci

In this study we tested how a combination of early and late paraclinic markers could predict early onset neonatal sepsis (EONS).. The first 24 hours after the suspicion of EONS, we measured interleukine (IL)-6, IL-8, IL-10, IL-18, tumor necrosis factor-alpha (TNF-alpha), interferon gamma (INF-gamma), procalcitonin (PCT) and C-reactive protein (CRP) at 8-hour intervals on 123 neonates clinically suspected for EONS. The neonates were divided into two groups. The sepsis group: 1A with blood culture verified bacteraemia and 1B strongly suspected sepsis (29 patients). The no sepsis group: 2A treated with antibiotics (37 patients) and 2B not treated with antibiotics (57 patients).. Combined evaluation of each of the early markers with PCT > 25 ng/ml for prediction of EONS at time 0, gave the following sensitivities and specificities: IL-6 > 250 pg/ml: 71% and 88%; IL-8 > 900 pg/ml: 50% and 88%; IL-10 > 40 pg/ml: 43% and 87%; and immature/total (I/T) ratio > 0.35: 59% and 88%. The results of IL-18, TNF-alpha and IFN-gamma did not predict EONS.. IL-6 combined with PCT values is a fair way to evaluate EONS at the time of suspicion of infection. The "old" early marker, I/T ratio, is almost as efficient as IL-6. By combining an early and a late marker it may be possible to reduce the diagnostic "non-conclusive" period of paraclinic values.

Topics: Anti-Bacterial Agents; Bacteremia; Biomarkers; C-Reactive Protein; Calcitonin; Calcitonin Gene-Related Peptide; Cytokines; Escherichia coli Infections; Female; Humans; Infant, Newborn; Inflammation Mediators; Interferon-gamma; Interleukin-10; Interleukin-18; Interleukin-6; Interleukin-8; Leukocyte Count; Male; Neutrophils; Protein Precursors; Retrospective Studies; Sensitivity and Specificity; Sepsis; Staphylococcal Infections; Streptococcal Infections; Streptococcus agalactiae; Tumor Necrosis Factor-alpha

To evaluate serum procalcitonin concentration in umbilical cord blood for diagnosis of intrauterine bacterial infection.. A prospective study was conducted between 2000 and 2001. Serum procalcitonin concentrations were evaluated in 187 umbilical cord blood samples. Five groups have been defined: controls A (n=37), full-term noninfected B1 (n=80) and infected neonates B2 (n=8), preterm noninfected C1 (n=38) and infected C2 (n=24) newborns. An immunoluminometric assay was used to determine procalcitonin concentration. The Mann-Whitney U-test and Spearman's correlation ratio were applied. The sensitivity and specificity, the positive and negative predictive values, and the area under receiver operating characteristic curves were calculated.. A statistically higher serum procalcitonin concentration was found in the preterm infected group (p<0.005; C2 vs A and C1).. Serum procalcitonin concentration in umbilical cord blood may be a useful parameter in the diagnosis of early neonatal infection.

Topics: Bacterial Infections; C-Reactive Protein; Calcitonin; Calcitonin Gene-Related Peptide; Escherichia coli Infections; Fetal Blood; Fetal Diseases; Humans; Infant, Newborn; Prospective Studies; Protein Precursors; ROC Curve; Sensitivity and Specificity; Streptococcal Infections; Streptococcus agalactiae

Systemic bacterial infections still remain one of the major causes of neonatal morbidity and mortality. Early detection of neonatal sepsis can be difficult, because the first signs of the disease may be unspecific and similar to symptoms of other non-infectious processes. Procalcitonin became a new, sensitive marker of bacterial infections in newborns. The aim of our study was to assess the value of PCT as a diagnostic and prognostic tool of neonatal maternofetal infections. We also tried to estimate normal ranges of PCT in uninfected newborns.. 74 newborns, born in the Department of Obstetrics and Gynaecology, University of Medicine of Wrocław, then hospitalized in the Department of Neonatology entered the study. They were divided into 2 groups: group 1-29 neonates with recognized materno-fetal infection, group 2-45 newborns without infection. In both groups blood samples to measure PCT concentrations were obtained by venipuncture on the 1st, 2nd, 3rd, 5th and between the 10th and 14th day of life (in the group of infected neonates) Sera were stored at -40 degrees C before analysis. PCT was determined using an immunoluminometric assay (BRAHMS Diagnostica).. Serum procalcitonin values were significantly higher in the infected group than in the uninfected neonates (p < 0.001). The most significant differences were noted on the 2nd and 3rd day of life (p < 0.0001). After the treatment had been finished, the PCT levels in both groups were not statistically different.. PCT is a useful tool in early diagnosing and monitoring the course of early-onset infections in neonates, particularly when blood cultures obtained from neonates remain negative. The decreasing concentrations of PCT level in children treated due to infection, indicate successful treatment and may help one to take a decision on termination of antibiotic therapy.

Topics: Anti-Bacterial Agents; Biomarkers; Calcitonin; Calcitonin Gene-Related Peptide; Humans; Infant, Newborn; Protein Precursors; Reference Values; Reproducibility of Results; Staphylococcal Infections; Streptococcal Infections; Systemic Inflammatory Response Syndrome