Serum procalcitonin elevation in critically ill patients at the onset of bacteremia caused by either Gram negative or Gram positive bacteria.
Serum procalcitonin elevation in critically ill patients at the onset of bacteremia caused by either Gram negative or Gram positive bacteria.
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DOI：
10.1186/1471-2334-8-38
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发表时间：
2008-03-26
影响因子：
3.7
通讯作者：
Blettery B
中科院分区：
文献类型：
--
作者：
Charles PE;Ladoire S;Aho S;Quenot JP;Doise JM;Prin S;Olsson NO;Blettery B
在ICU中，菌血症是一种危及生命的感染，其预后高度依赖于早期识别和适当的抗生素治疗。降钙素原水平已被证明可以在危重患者中准确快速地区分菌血症和非感染性炎症状态。然而，我们仍然不知道根据革兰氏染色结果，菌血症发作时PCT升高的幅度变化到何种程度。审查2004年5月至2006年12月期间接受治疗的每例患者的病历，这些患者患有由革兰氏阳性（GP）或革兰氏阴性（GN）细菌引起的菌血症，并且其感染开始时的PCT剂量可用。纳入了97例GN菌血症（n = 52）或GP菌血症（n = 45）。GN菌血症患者的降钙素原水平明显高于GP菌血症患者，而两组的SOFA评分值相似。此外，在研究人群中，发现高PCT值与GN菌血症独立相关。PCT水平16.0 ng/mL产生研究队列中GN相关菌血症的83.0%阳性预测值和74.0%阴性预测值（AUROCC = 0.79; 95% CI，0.71-0.88）。在临床脓毒症的危重患者中，GN菌血症可能与高于GP菌血症的PCT值相关，无论疾病的严重程度如何。
In the ICU, bacteremia is a life-threatening infection whose prognosis is highly dependent on early recognition and treatment with appropriate antibiotics. Procalcitonin levels have been shown to distinguish between bacteremia and noninfectious inflammatory states accurately and quickly in critically ill patients. However, we still do not know to what extent the magnitude of PCT elevation at the onset of bacteremia varies according to the Gram stain result. Review of the medical records of every patient treated between May, 2004 and December, 2006 who had bacteremia caused by either Gram positive (GP) or Gram negative (GN) bacteria, and whose PCT dosage at the onset of infection was available. 97 episodes of either GN bacteremia (n = 52) or GP bacteremia (n = 45) were included. Procalcitonin levels were found to be markedly higher in patients with GN bacteremia than in those with GP bacteremia, whereas the SOFA score value in the two groups was similar. Moreover, in the study population, a high PCT value was found to be independently associated with GN bacteremia. A PCT level of 16.0 ng/mL yielded an 83.0% positive predictive value and a 74.0% negative predictive value for GN-related bacteremia in the study cohort (AUROCC = 0.79; 95% CI, 0.71–0.88). In a critically ill patient with clinical sepsis, GN bacteremia could be associated with higher PCT values than those found in GP bacteremia, regardless of the severity of the disease.
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影响因子：
120.7
作者：
PITTET, D;TARARA, D;WENZEL, RP
通讯作者：
WENZEL, RP
影响因子：
4.4
作者：
Skerrett, SJ;Liggitt, HD;Wilson, CB
通讯作者：
Wilson, CB
影响因子：
15.1
作者：
Meisner, M;Tschaikowsky, K;Schmidt, J
通讯作者：
Schmidt, J
影响因子：
20.3
作者：
Elson, Greg;Dunn-Siegrist, Irene;Pugin, Jerome
通讯作者：
Pugin, Jerome
DOI：
10.1128/cdli.12.9.1085-1093.2005
发表时间：
2005-09-01
期刊：
CLINICAL AND DIAGNOSTIC LABORATORY IMMUNOLOGY
影响因子：
--
作者：
Tavares, E;Maldonado, R;Miñano, FJ
通讯作者：
Miñano, FJ