Procalcitonin Patterns in Sepsis: An Indian Insight into Tropical Infections | Chapter 12 | An Overview of Disease and Health Research Vol. 5

 

Background: Sepsis remains a critical global health challenge, particularly in tropical regions where diverse pathogens—ranging from bacteria and fungi to malaria and dengue—trigger complex host responses.

 

Aim: This study aimed to characterise procalcitonin (PCT) dynamics in sepsis patients, with a special focus on tropical infections, at a rural teaching hospital in India.

 

Methods: A cross-sectional study was conducted at the Microbiology and General Medicine departments of SBKS Medical Institute & Research Centre, Sumandeep Vidyapeeth, between September 2012 and December 2015. After ethical approval, we enrolled 155 adult patients (aged >18 years) clinically diagnosed with sepsis (according to the 1992/2001 definitions). Initial PCT measurement employed a semi-quantitative assay (until March 2015), later transitioned to a QDx Instacheck quantitative method. Patients were categorised by aetiology: 98 tropical sepsis, 46 non-tropical sepsis, and 11 with unidentified causes.

 

Results: PCT levels on admission were distributed as follows: ≤0.5 ng/mL in 43 patients, >0.5 to <2 ng/mL in 32, ≥2 to <10 ng/mL in 55, and ≥10 ng/mL in 25. The majority exhibited PCT in the 2–10 ng/mL range. Elevated PCT (≥2 ng/mL) was common across bacterial, fungal, and malarial infections, whereas dengue cases predominantly had PCT ≤0.5 ng/mL. Peak PCT levels (≥10 ng/mL) were strongly associated with severe disease and higher mortality.

 

Conclusions: In the rural Indian cohort, PCT elevation was not specific enough to distinguish among bacterial, fungal, and malarial sepsis but proved highly indicative of dengue when levels remained ≤0.5 ng/mL. Exceptionally high PCT correlated with disease severity and mortality. These findings underscore PCT’s potential as a rapid biomarker to guide early diagnostic assessments and risk stratification in tropical sepsis settings—and particularly for identifying dengue cases with low PCT.

 

 

Author(s) Details

Hairya Ajaykumar Lakhani
SBKS Medical Institute and Research Centre, Vadodara, India.

 

Aarjuv Majmundar
Department of Medicine, SBKS Medical Institute and Research Centre, Vadodara, India.

 

Miloni Mineshbhai Nada
Surat Municipal Institute of Medical Education and Research (SMIMER), Affiliated to the Veer Narmad South Gujarat University, Surat, India.

 

Radhika Khara
Department of Microbiology, Banas Medical College & Research Institute, Palanpur, India.

 

Sucheta Lakhani
Department of Microbiology, SBKS Medical Institute and Research Centre, Vadodara, India.

 

Jitendra D. Lakhani
Department of Medicine, SBKS Medical Institute and Research Centre, Vadodara, India.

 

Please see the book here :- https://doi.org/10.9734/bpi/aodhr/v5/6189

Procalcitonin Level Recommendation as a Predictive Biomarker for Post-Operative Complication in Colorectal Cancer | Chapter 8 | New Advances in Medicine and Medical Science Vol. 6

 Although it can not be supported in after second hospitals, specifically in developing nations, C-sensitive protein (CRP) has been issued as a new biomarker parameter of post-active complications and has once been widely used in routine dispassionate practice. Early research found that when anticipating the post-operative depression following major gastrointestinal incision, the sensitivity and precision of the CRP level are better predictive indicators than the WBC level unique.During major gastrointestinal medical procedure (resection of colorectal malignancy), anastomosis leak was reported in 7 to 10% of cases. Clinical judgments in the early stages of anastomosis leak are frequently lacking to establish this difficulty and are occasionally incorrect as post-operative pain. Procalcitonin (PCT) is individual of the potential biomarkers that has been announced currently as a post-operative problem examination.

Author(s) Details:

Budhi Ida Bagus,
Department of Surgery, Sebelas Maret University, Indonesia.

Please see the link here: https://stm.bookpi.org/NAMMS-V6/article/view/10989

Determining the Role of Procalcitonin and C-reactive Protein in Diagnostic Tests for Respiratory Adenovirus Infections in Children| Chapter 2 | Current Overview on Science and Technology Research Vol. 2

 The reason for this review is to decide if procalcitonin testing can recognize bacterial and AdV contaminations when intense stage values are essentially high. Adenovirus (AdV) contaminations contrast in type and seriousness. The most predominant are diseases of the aviation routes.

The examinations were done in the pediatric division of a nearby emergency clinic as a feature of routine clinical consideration. 40 patients of baby and little child age were partitioned into two patient gatherings (n = 23) and (n = 17) for examination in view of PCT 0.5 μg/L. Not set in stone by polymerase-chain-response.

The PCT esteem in Group 1 is 0.21 ± 0.12 μg/L, middle 0.2, and 1.56 ± 1.07 μg/L, middle 1.3 (p = 0.0001) in Group 2. At a cut-off worth of <0.5 μg/L, C-receptive protein, leucocytes, age, fever temperature, and the term of fever didn't vary essentially. This determination likewise applies to a PCT worth to <0.9 μg/L.

In AdV contaminations, CRP upsides of >40 mg/L are seen in over 80% of patients. A clinically significant finish of our discoveries is that free of CRP levels anti-toxin treatment isn't demonstrated up to PCT levels of 0.5 μg/l. The incendiary system can be started, for instance, by extreme tissue injury, consumes, broad medical procedure, relentless perfusion deformity, cardiogenic shock and furthermore by serious AdV contaminations by means of the arrival of cytokines (interleukin-6, growth putrefaction factor) without bacterial disease being the reason.

Author(s) Details:

Wolfgang Kunze,
Department of Children and Adolescent Medicine, Community Hospital Wurzen, Wurzen, Germany.

Thorsten Klemm,
MVZ Laboratory Dr. Reising-Ackermann and Colleagues, Leipzig, Germany.

Jan-Peter Streidl,
Department of Children and Adolescent Medicine, Community Hospital Wurzen, Wurzen, Germany.

Please see the link here: https://stm.bookpi.org/COSTR-V2/article/view/7984

Prediction of Anastomotic Leakage in Colorectal Surgeries Using Biomarkers | Chapter 16 | Recent Developments in Medicine and Medical Research Vol. 9

 Patients with colon illness are recovering more quickly after surgery because to minimum access surgery and standardised recovery methods. Despite these advancements, anastomotic leaking remains one of the most feared consequences after colorectal surgery, with rates ranging from 3-27 percent depending on risk factors. Clinical indications of peritonitis and/or clinical evidence of free faecal fluid within the belly or emerging from the drain site are both examples of anastomotic leakage. Biomarkers including lactate/pyruvate ratio and cytokines like IL-6, IL-10, and TNF-alpha were shown to be elevated in patients who developed symptomatic anastomotic leakage before clinical symptoms appeared in some investigations.

The following are the goals and objectives:

1. To determine the sensitivity and specificity of systemic (CRP, leukocytes, procalcitonin) and peritoneal drain-fluid biomarkers interleukin-6, interleukin-10, tumour necrosis factor- (IL-6, IL-10, TNF-) in the early detection of anastomotic leak after colo-rectal surgery.

2. To see if there's a link between rising biomarker levels and the severity of clinical symptoms in people who've had colo-rectal surgery.

After getting sufficient ethical permission, the current study was a prospective observational study done on 60 patients over a two-year period in the Postgraduate Department of Surgery, Government Medical College, Srinagar. All patients who had various colo-rectal surgeries for various purposes were thoroughly monitored in the post-operative period, and their systemic and drain fluid markers were sent for estimation on days 1-7 post-operatively, with the data analysed using SPSS V 22.

The average age of the patients was 54.8711.901 years, with 44 patients (73.3%) being males and 16 patients (26.7%) being females. The average CRP level was 2.78000.500 mg/L, the average total leukocyte count was 10.7830.940 thousands, and the average serum procalcitonin level was 0.3650.1385 ng/ml among systemic producers. The mean IL-6 level was 3551.0661311.965 pg/ml, the mean IL-10 level was 628.533460.358 pg/ml, and the mean TNF-a level was 16.3916.736 pg/ml among peritoneal fluid drain bio-makers. In 16 individuals, anastomotic leak following colorectal surgery was discovered (26.7 percent ). In our study, there was a significant correlation between the rise in levels of peritoneal drain fluid biomarkers and the severity of clinical symptoms in patients who had colo-rectal surgeries, but no such correlation existed between the rise in levels of systemic markers and the severity of clinical symptoms.

Conclusion: Systemic biomarkers are poor predictors of anastomotic leak following colorectal surgery. Peritoneal fluid drain biomarkers, on the other hand, show a high sensitivity and specificity when it comes to predicting anastomotic leak.

Author(S) Details

Ferkhand Mohi Ud Din
Department of Surgery, Govt. Medical College, Srinagar, Jammu and Kashmir, India.

Ashiq Hussain Raina
Department of Surgery, Govt. Medical College, Srinagar, Jammu and Kashmir, India.

Irshad Ahmad Kumar
Department of Surgery, Govt. Medical College, Srinagar, Jammu and Kashmir, India.

Mumtaz Din wani
Department of Surgery, Govt. Medical College, Srinagar, Jammu and Kashmir, India.

Aabid Rasool Bhat
Department of Surgery, Govt. Medical College, Srinagar, Jammu and Kashmir, India.

Zubair Gul
Department of Surgery, Govt. Medical College, Srinagar, Jammu and Kashmir, India.

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Utility of Serum Procalcitonin as a Biomarker to Determine the Duration of Antibiotic Therapy in Adult Patients with Sepsis and Septic Shock in Intensive Care Units | Chapter 5 | Recent Developments in Medicine and Medical Research Vol. 5

 Background: Procalcitonin is a biomarker used to determine the length of antibiotic therapy in sepsis patients. The severity of systemic infection and the existence of organ failure are linked to the degree of Procalcitonin induction. As a result, PCT is considered a helpful biomarker for the diagnosis of sepsis, and new research suggests that dynamic variations in PCT may be predictive of specific outcomes in patients with severe sepsis and septic shock.

Materials and Methods: A prospective, randomised, controlled, interventional trial was done in a mixed adult intensive care unit (ICU). In a nonblinded trial, 90 adult patients with sepsis and septic shock were randomly assigned to one of two groups: group P (procalcitonin) or group C (calcitonin) (group control). In comparison to usual treatment procedures in group C, the duration of antibiotic therapy for patients in group P was determined based on serum procalcitonin levels. The criteria for stopping antibiotic medication was set at a procalcitonin value of 0.01 ng/mL or a subsequent decline of more than 80% from the baseline. The major purpose was to compare the two groups' antibiotic treatment durations (in days). The secondary purpose was to compare and analyse the length of ICU stay, reinfection, secondary infection rate, readmission rate, and mortality rate of the different groups.

The average duration of antibiotic therapy in patients in the group of. P (4.98 2.56 vs 7.73 3.06 days, p 0.001) was significantly shorter. Patients in group C stayed in the ICU for longer (8.80 3.35 days vs 5.98 2.73 days, p 0.001). Group C had a considerably greater rate of secondary infection (26.7 percent vs. 4.4 percent, p = 0.014). Readmission and death rates were similar among groups.

Conclusion: A serum procalcitonin-based approach could reduce antibiotic medication, ICU stay, and associated morbidities such secondary infection rates in critically ill sepsis patients. It also encourages antibiotic stewardship without negatively impacting the patient's result. As a result, generalising the findings to a group that includes all of the cases indicated above is impossible. To confirm the findings of our investigation, more multicenter studies with larger populations are needed.

Author (S) Details

S. M. Gowri Vishalakshi

Department of Anaesthesia and Intensive Care, Safdarjung Hospital and Vardhman Mahavir Medical College, New Delhi, India.

Poonam Gupta

Department of Anaesthesia and Intensive Care, Safdarjung Hospital and Vardhman Mahavir Medical College, New Delhi, India.

Pardeep Kumar Verma

Department of Anaesthesia and Intensive Care, Safdarjung Hospital and Vardhman Mahavir Medical College, New Delhi, India.

 

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Procalcitonin as a Diagnostic Biomarker of Sepsis: A Prospective Study in a Tertiary Care Centre | Chapter 14 | Highlights on Medicine and Medical Science Vol. 3

 Introduction: Despite advances in diagnostic methods, sepsis remains a significant cause of morbidity and mortality. It is still difficult to distinguish between sepsis and non-infectious disease conditions. The procalcitonin (PCT) test is useful for diagnosing sepsis, but the cut-off levels differ depending on the clinical situation. The goal of this study was to correlate serum PCT levels with cultures in order to determine the appropriate cut-off values for PCT with high sensitivity and specificity. Methodology: This prospective study included 305 patients from various hospital wards; the patients were divided into three groups: group I: controls (n = 46), group II: culture-negative sepsis (n = 76), and group III: sepsis (n = 76). PCT levels were significantly higher in groups II and III when compared to group I. The best PCT cut-off point in group II was 1.3 ng/ml, with 87.30 percent sensitivity and 78.26 percent specificity (area under curve 0.86). The best cut-off value in group III was 2.20 ng/ml, with 98.47 percent sensitivity and 89.13 percent specificity (AUC 0.96). Conclusion: Procalcitonin is a promising biomarker for the diagnosis of bacterial sepsis because it can distinguish between culture-negative and culture-positive sepsis from non-infectious diseases.

Author (S) Details

Shefali Gupta
Department of Microbiology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India.

Pradeep Jaswani
Department of Nephrology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India.

Raj K. Sharma
Department of Nephrology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India.

Suraksha Agrawal
Department of Hematology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India.

Narayan Prasad
Department of Nephrology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India.

Chinmoy Sahu
Department of Microbiology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India.

Amit Gupta
Department of Nephrology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India.

Kashi N. Prasad
Department of Microbiology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India.

View Book :- https://stm.bookpi.org/HMMS-V3/article/view/1605