THE DIAGNOSTIC VALUE OF PROCALCITONIN FOR EARLY DETECTION OF UROSEPSIS

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Published 2012-01-02
M. Andriady S. Nasution Sunaryo Hardjowijoto Doddy M. Soebadi Aryati Aryati Widodo J Pujiraharjo

Abstract

Objective: To study procalcitonin as an early and accurate marker for urosepsis. Material & Method: We performed a diagnostic study of procalcitonin, CRP and peripheral blood leucocyte in 21 patients. Patients included 12 urosepsis patients with urosepsis, and 9 trauma patients without urosepsis. This study was conducted from September 2010 to December 2010. Results: Mean and standard deviation of procalcitonin level in urosepsis patients was 27,9 ± 30,7 ng/ml, CRP was 8,9 ± 7,9 mg/l and blood leucocyte was 15125,0 ± 8969,9 mm3. Sensitivity of procalcitonin in diagnosis of urosepsis was 83,3%, specificity was 77,8%, positive predictive value was 83,3%, negative predictive value was 77,8%, positive odds ratio was 3,75 and negative odds ratio was 0,2. Diagnostic value of procalcitonin was better compared to CRP and blood leucocyte. In the receiver operating characteristics (ROC) plot, area under the curve (AUC) for procalcitonin, blood leucocyte, and CRP were 0,806 (95% CI = 0,607 – 1,004), 0,773 (95% CI = 0,568 – 0,979), and 0,602 (95% CI = 0,341 – 0,863), respectively. Conclusion: Procalcitonin is an early marker for urosepsis cases with better diagnostic value than CRP and blood leucocyte. Keywords: Urosepsis, Procalcitonin, CRP, Blood Leucocyte.


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References

Wagenlehner FME, Pilatz A, Naber KG, Weidner M. Therapeutic challenges of urosepsis. European Journal of Clinical Investigation. 2008; 38: 45-9.

Marx G, Reinhart K. Urosepsis: From the intensive care viewpoint. Internasional Journal of Antimicrobial Agents. 2008; 31S: S79-S84.

Schiefer HG, Diemer TH, Weidner W. Urosepsis in: Hohenfeller M, Santucci (edits): Emergencies in Urology. Springer – Verlag, Berlin, Heidelberg, New York. 2007; 5: 45-9.

Schuetz P, Crain MC, Muller B. Procalcitonin and other biomarkers for the assessment of disease severity and guidance of treatment in bacterial infections. Advances in Sepsis. 2008; 6(3): 82-9.

Landenberg PV, Shoenfeld Y. New approaches in the diagnosis of sepsis. IMAJ. 2001; 3: 439-42.

Reinhart K, Meisner M, Brunkhorst FM. Markers for sepsis diagnosis: What is usefull? Crit Care Clin. 2006; 22: 503-19.

Lever A, Mackenzie I. Sepsis: Definition, epidemiology and diagnosis. BMJ. 2007; 335: 879-83.

Redl H, Spittler A, Strohmaider W. Markers of sepsis in: Vincent JL, Carlet J, Opal SM (edits): The Sepsis Text. New York; Kluwer Academic Publishers. 2002; 4: 47-66.

Buchori, Prihatini. Diagnosis sepsis menggunakan procalcitonin. Indonesian Journal of Clinical Pathology and Medical Laboratory. 2006; 12(3): 131-7.

Kosanke R, Beier W, Lipecky R, Meisner M. Clinical benefits of procalcitonin. Tanaffos. 2008; 7(1): 14-8.

Maruna P, Nedelnikova K, Gurlich R. Physiology and genetics of procalcitonin. Physiol. Res. 2000; 49(Suppl. 1): S57-S61.

Muller B, Becker KL. Procalcitonin how a hormone became a marker and mediator of sepsis. Swiss Med Wkly. 2001; 131: 595-602.

Balci C, Sungurtekin H, Gurses E, Sungurtekin U, Kaptanoglu B. Usefull of procalcitonin for diagnosis of sepsis in the intensive care unit. Critical Care. 2003; 7: 85-90.

Castelli GP, Pognani C, Meisner M. Procalcitonin and C – reactive protein during systemic inflammatory response syndrome, sepsis and organ dysfunction. Critical care. 2004; 8: R234-R42.

Claeys R, Vinken S, Spapen H, Elst K, Decochez K, Huyghens L. Plasma procalcitonin and C – reactive protein in acute septic shock: Clinical and biological correlates. Crit Care Med. 2002; 30(4): 757-62.

Barati M, Alinejad F, Bahar MA, Tabrisi MS, Shamshiri AR, Bodouhi A. Comparison of WBC, ESR, CRP and PCT serum levels in septic and non – septic burn cases. Burns Journal. 2008; 34: 770-4.

Christoph F, Weikert S, Muller M, Miller K, Schrader M. How septic is urosepsis? Clinical course of infected hydronephrosis and therapeutic strategies. World J Urol. 2005; 23: 243-7.

Chiwakata CB, Manegold C, Bonicke L, Waase I, Julch C, Dietrich M. Procalcitonin as a parameter of disease severity and risk of mortality in patients with plasmodium falciparum malaria. The Journal of Infectious Diseases. 2000; 183: 1161-4.

Vitanata M. Infeksi berat gram positif. Journal of Institute of Tropical Disease. 2010; 29(3): 205-12.

Kuntaman, Mudihardi E, Harsono S, Debora K, Mertaniasih NM. Aspek mikrobiologi pada infeksi saluran kemih in: Nasronudin, Hadi U, Vitanata, Erwin AT, Baramantono, Suharto, Soewandojo E: Penyakit infeksi di Indonesia solusi kini dan mendatang. Airlangga University Press, Surabaya, Indonesia; 2007. p. 166-8.

Bonacorsi M, Lefevre S, Clermont O, Houdouin V, Bourrillon A, Loirat C. Escherichia coli strains causing urinary tract infection in uncircumcised infants resemble urosepsis – like adult strains. J Urol. 2005; 173(2): 195-7.

Angulo JC, Gaspar MJ, Rodriguez N, Tello AG, Torres G, Nunez C. The value C – reactive protein determination in patients with renal colic to decide urgent urinary diversion. J Urol. 2010; 76(2): 301-6.

Hirakata Y, Yanagihara K, Kurihara S, Izumikawa K, Seki M, Miyazaki Y. Comparison of usefulness of plasma procalcitonin and C – reactive protein measurements for estimation of severity in adults with community – acquired pneumonia. Diagnostic Microbiology and Infectious Disease. 2008; 1: 170-4.

Munoz P, Simarro N, Rivera M, Alonso R, Alcala L, Bouza E. Evaluation of procalcitonin as a marker of infection in a nonselected sample of febrile hospitalized patients. Diagnosis Microbiology and Infectious Disease. 2004; 49: 237-41.

Kotoula A, Gardikis S, Tsalkidis A, Mantadakis E, Zissimopoulus AA, Deftereos S. Comparative efficacies of procalcitonin and conventional inflammatory markers for prediction of renal parenchymal inflammation in pediatric first urinary tract infection. J Urol. 2009; 73(4): 782-6.

Hochreiter M, Kohler T, Schweiger AM, Keck FS, Bein B, Spiegel TV. Procalcitonin to guide duration of antibiotic therapy in intensive care patients: A randomized prospective controlled trial. Critical Care. 2009; 13(R83): 1-7.

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January 2012 Vol. 19 No. 1
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Department of Urology, Faculty of Medicine/Airlangga University