Online ISSN: 2515-8260

Keywords : Procalcitonin

Procalcitonin as a marker of infection in patients with sepsis: a prospective study

Dr. Pandere Kaustubh Anil; Dr. Virendra C. Patil

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 7, Pages 5220-5229

Background and Objective: Sepsis is characterized by multiple organ dysfunction due to inflammation. It is generally credited to pathogenic infection, but there are several cases of non-infectious sepsis. Procalcitonin is a small protein that signals increased inflammation during sepsis. This study aims to characterize the prognostic value of procalcitonin in predicting sepsis severity and discriminating infectious and non-infectious sepsis.
Methods: We performed a prospective non-Interventional study, including 75 participants suffering from sepsis. The patients were grouped according to disease severity and their procalcitonin levels measured. The biochemical and microbiological outcomes were analyzed with respect to procalcitonin levels. Results were analyzed by the chi - square test, Kruskal-Wallis test, or Mann-Whitney test. Further, the receiver operating characteristic curve (ROC) was plotted for procalcitonin levels and type of infection and the area under the ROC curve was calculated.
Results: Procalcitonin was found to be correlated with sepsis severity (p=1.80E-09). A significant relationship was observed between procalcitonin levels and the presence of infection (p=0.03996). The area under the ROC curve of procalcitonin for determining presence of infection was 65.18%. At cut-off of 0.6494 (ng/mL) the sensitivity and specificity was found to be 69.81% and 63.63%. Moreover, the presence of methicillin resistant Staphylococcus aureus conferred increased procalcitonin than methicillin sensitive variety (p= 0.0098).
Conclusion: We show that procalcitonin is a predictor of sepsis severity. It can be used to predict the type of infection in patients of sepsis in a critical care setting.

Assessment of the role of procalcitonin in the management of severe surgical patients with sepsis

Dr. Ashutosh Singh, Dr. MA Reshamwala, Dr. Kartikeya Sharma

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 2, Pages 1394-1397

Background: The assessment of procalcitonin not only provides valuable information about the diagnosis but is also useful in the selection of the corresponding antibiotics for the management of sepsis. The studies related to this procalcitonin role are comparatively sparse.
Objective: The present study was undertaken to observe the role of procalcitonin in the management of severe surgical patients with sepsis.
Materials and methods: A total of 50 patients diagnosed with sepsis and aged more than 18 years including both males and females were part of the study after obtaining the written, voluntary informed consent. Unwilling participants were excluded from the study. Patients with any severe complications were also excluded from the study.
Results: Results were presented in Tables no 1 and 2. Table no 1 presents the gender distribution of the participants. The majority of the participants were males with 56% and females were 44%. Table no 2 presents the levels of procalcitonin levels in the participants. The majority of the participants have excessive levels of procalcitonin levels. That is procalcitonin was more than 10ng/ml in 40 patients which means nearly 80 percent of the patients have excessive levels of procalcitonin. This will testify to the importance of procalcitonin in the diagnosis of sepsis.
Conclusion: Significantly higher levels of procalcitonin levels were observed in the patients with sepsis. The study results testify to the diagnostic value of the procalcitonin. The study recommends further detailed studies in this area to support the procalcitonin in the diagnosis of sepsis.


Dr. Anurag Singh Chauhan, Dr. Manisha Thakur, Dr. Kavita Yadav, Dr.Kishori Lal Meena, Dr. Ghanshyam Gahlot

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 11456-11462

Background: The concept, definition and understanding of sepsis may have undergone several changes in the past years, but its omniscient nature in modern day critical care medicine has made accurate diagnosis, early initiation of therapy and relatively accurate prognostication, imperative. In recent times, procalcitonin has been used to initiate, de-escalate and guide antibiotic therapy. However, the data on its ability to predict all cause mortality in patients with sepsis remains nebulous. There is adequate evidence to merit considering both sides of the story.
Methods: We studied 99 consecutive patients meeting the diagnostic criteria for sepsis according to Sepsis 3 consensus criteria. Serum procalcitonin levels were compared head to head with 30-day all-cause mortality. Chi squarepaired and unpaired T and Pearson’s coefficient were used to analyze the data. 
Results: Our study showed that patients with a higher baseline value of serum procalcitonin had higher rate of in-hospital mortality (SD – 1.8 vs SD - 0.68, 2-tailed P<0.001). However, no statistically significant association was noted between baseline PCT and duration of ICU stay.
Conclusions: The predictive value of serum PCT, for mortality has been a matter of debate and controversy with compelling evidence to both sides of the story available in contemporary literature. Our study re-enforces the dictum of early diagnosis and treatment of sepsis in conjunction with the judicious use of serum procalcitonin. On the horizon, the authors see a plethora of newer biomarkers (SUPAR and sTREM-1) which may be used standalone or in combination to improve outcomes.

Role of procalcitonin in diagnosis of late onset sepsis in neonates

Dr. Bheemaraya Shivasharana, Dr. Vasanth Kumar D. L, Dr.Manjunathaswamy. R, Dr. Ananya U Shetty,Ravindra B Patil

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 993-998

Background: Neonatal sepsis refers to systemic infection of the new born. It is characterized
by a constellation of non-specific symptomatology in association with bacteremia.Neonatal
sepsis is the most common cause of (52%) neonatal mortality in our country, which could be
reduced in large proportion by a high index of suspicion, prompt diagnosis and aggressive
management of this condition. Many studies have come up regarding the usefulness of
procalcitonin in the early diagnosis of neonatal sepsis and have found it to be 87-100
sensitive and also highly specific.
Methods: A prospective clinical study was conducted in Neonatal Intensive Care Unit of
Shimoga Institute of Medical Sciences, Shimoga. From November 2020 to November 2021 to
study role of Procalcitonin in diagnosis of LOS.All intramural neonates admitted to NICU
during this period with clinically suspected Late onset sepsis were included in the study and
were subjected to sepsis screen, blood culture and procalcitonin. Study population was further
divided into 3 group as Proven sepsis (sepsis screen positive and blood culture positive),
Probable sepsis group (sepsis screen positive, blood culture negative) and no sepsis group
(sepsis screen negative and blood culture negative, with alternate diagnosis).Sensitivity,
specificity of Procalcitonin at a level of 2ng/ml in diagnosis of late onset sepsis in neonates
was calculated (Proven sepsis was taken as test group and No sepsis group was taken as
control group).
Results: PCT was found to be >2ng/ml in 58.6% of the enrollees,our study had high PCT of
19.2ng/ml in proven sepsis,our study had sensitivity of PCT as high as 78.57% with
specificity of PCT to the tune of 77.78%.
Conclusion: The procalcitonin values were higher in sepsis proven group than in probable
sepsis and no sepsis group. Sensitivity, Specificity, PPV and NPV of Procalcitonin at value
of.2ng/ml in diagnosis of LOS was found to be 78.57%, 77.78%, 76.74%, 78.57.

Prognostic significance ofProcalcitonin, High sensitivity C-reactive proteinandwhite blood cell count incomparison withblood culture in ICU patients with Sepsis and Septic shock inatertiary care Hospital

Dr.Kondle Raghu; Dr. Krishnan Ramalingam

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 3, Pages 2263-2270

Background: Sepsis is a life-threatening condition in ICU with high morbidity and
mortality. Biomarkers which can act as a predictor for diagnosis, prognosis, and patient
outcome in sepsis are needed.
Aim:Aim of the study is to compare the significance of hs-C-reactive Protein (CRP),
Procalcitonin, White blood cell count, and blood culture in patients with bloodstream
infections and compare their prognostic significance with blood cultures in sepsis.
Materials and Methods: This hospital based prospective observational study was conducted
between July 2018 to July 2019 forone year with 216 cases of sepsis. Serial determination
of Procalcitonin and CRP at admission and Day 6 was done. Data was analyzed check to
compare the prognostic significance of the PCT, CRP, and WBC count.
Results:A blood culture positivity rate of 50.9% was reported with male preponderance.
WBC count has significantly reduced after 72hrs of admission (p= 0.007). CRP levels have
significantly reduced on day 6 (p = 0.043) in comparison to at the time of admission (p=
0.032). The serial determination of PCT levels at admission and on day 6 (p= 0.032) was
found to be a better prognostic indicator in patients with sepsis than at the time of
admission. The significant patient outcome in terms of mortality and reduction in length of
hospital stay has been found (p= 0.018, p=0.002). The positive correlation of PCT and CRP
and SOFA score has been reported.
Conclusion: Prognostic significance was found for the biomarkers PCT, CRP, and WBC
count with significant patient outcomes in terms of mortality and hospital stay reduction

Evaluation of procalcitonin level in saliva and in periimplant crevicular fluid in peri- implantitis, peri- mucositis and in healthy subjects

Dr. Anjaneya Mahapatra; Dr. Ankita Priya; Dr. Surabhi Duggal; Dr. Vishvnathe Udayshankar; Dr. Sharmila Kumari; Dr. M Bhavani

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 11, Pages 7174-7178

Background:The present study evaluated level of PCT in saliva as well as in PICF in peri -
implantitis along with healthy subjects.
Materials & Methods: 25 patients of peri-implant mucositis (group I), 25 of peri- implantitis
(group II) and 25 healthy controls (group III) were assessed for peri -implant plaque index,
probing depth, and bleeding on probing at four sites per implant was performed. The
measurement of PCT in saliva and peri- implant crevicular fluid was performed.
Results: The mean salivary flow rate was 0.61 ml/ minute in group I, 0.64 ml/ minute in
group II and 0.63 ml/ minute in group III. The mean salivary procalcitonin level was 3.12
pg/mL in group I, 18.4 pg/mL in group II and 48.5 pg/mL in group III. The mean PICF flow
rate was 0.75 μl/minute in group I, 0.93 μl/minute in group II and 1.05 μl/minute in group III.
The mean PICF procalcitonin level was 7.28 pg/mL in group I, 41.3 pg/mL in group II
and 118.6 pg/mL in group III.
Conclusion: Higher level of salivary and peri- implant crevicular fluid level of procalcitonin
in peri- implantitis and peri- mucositis patients as compared to healthy subjects.