Evaluation of the Clinical Performance of an Automated Procalcitonin Assay for the Quantitative Detection of Bloodstream Infection.
10.3343/kjlm.2010.30.2.153
- Author:
Kyung Eun KIM
1
;
Jin Yeong HAN
Author Information
1. Department of Laboratory Medicine, Dong-A University College of Medicine, Busan, Korea. jyhan@dau.ac.kr
- Publication Type:Original Article ; Evaluation Studies
- Keywords:
Procalcitonin;
C-reactive protein;
Sepsis;
Bacteremia
- MeSH:
Adult;
Bacteremia/*diagnosis;
Biological Markers/analysis/blood;
C-Reactive Protein/analysis;
Calcitonin/*blood;
Female;
Humans;
Male;
Middle Aged;
Protein Precursors/*blood;
ROC Curve;
Sensitivity and Specificity;
Sepsis/diagnosis
- From:The Korean Journal of Laboratory Medicine
2010;30(2):153-159
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: Bloodstream infection (BSI) is associated with a high mortality rate. Since the origin of infection is demonstrated in approximately 2/3rds of cases, early and established biomarkers are warranted. We evaluated the clinical performances of automated procalcitonin (PCT) and C-reactive protein (CRP) assays for the quantitative detection of BSI. Analytical performance of the VIDAS(R) B.R.A.H.M.S PCT assay (bioMerieux, France) was assessed and also compared with the semi-quantitative PCT-Q test (B.R.A.H.M.S Aktiengesellschaft, Germany). METHODS: We prospectively included consecutive patients divided into 3 groups at the Dong-A University Medical Center. Patients were categorized according to the criteria of the American College of Chest Physicians/Society of Critical Care Medicine Consensus Conference (ACCP/SCCM), and also on the basis of catheter-associated bacteremia. RESULTS: A total 77 patients were enrolled. All mean values of PCT and PCT-Q were consistent with the reference value. Measured PCT concentrations showed good linearity (r=0.983). The between-run, within-run, and total imprecisions were below 5%. The PCT levels in gram-negative bacteremia were significantly higher than those in gram-positive bacteremia. Furthermore, the PCT concentrations were significantly different among non-infection, bacteremia, sepsis, severe sepsis, and septic shock groups. Our study showed that PCT >0.3 ng/mL had 95.0% sensitivity and 97.3% specificity, whereas CRP >5.46 mg/dL had 85.0% sensitivity and 86.5% specificity for diagnosing sepsis. CONCLUSIONS: We suggest that, compared with CRP, PCT is a better diagnostic and discriminative biomarker of sepsis categorized according to the ACCP/SCCM. Moreover, catheter-associated bacteremia could be discriminated from sepsis using PCT concentration.
