Evaluation of procalcitonin accuracy for the distinction between gram-negative and gram-positive bacterial sepsis in burn patients
Autor(a) principal: | |
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Data de Publicação: | 2019 |
Outros Autores: | , , , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | http://hdl.handle.net/10773/25670 |
Resumo: | Sepsis is the main cause of death in burns. Early institution of antimicrobial therapy is crucial to optimize outcomes but superfluous therapy increases adverse events, microbial resistance, and costs. Blood cultures are the gold standard for diagnosis but can take 48 to 72 hours. Biomarkers are used to help sepsis diagnosis and distinction between Gram-negative and Gram-positive bacterial cause. The aim of this work is to evaluate procalcitonin (PCT) accuracy for this distinction in burn patients. Retrospective observational study of adult septic burn patients with ≥15% total burn surface area admitted from January 2011 to December 2014 at a Burn Unit in Portugal. A statistical analysis was done, evaluating the correlation between PCT levels on the day of the first positive blood culture and microbiological data for Gram-negative and Grand-positive bacteria. Patients with mixed bacterial and/or fungal blood cultures were excluded. Data were summarized by quartiles statistics. Blood cultures were positive in 189 patients: 75 (39.7%) showed growth for Gram-negative and 114 (60.3%) for Gram-positive bacteria. Patients with Gram-negative bacteria have significantly higher PCT levels. Receiver operating characteristic curve analysis showed accuracy for Gram-negative discrimination with area under the curve = 0.687. Most elevated levels were related to nonfermentative Gram-negative bacteria and by Klebsiella pneumoniae and other Enterobacteriaceae. PCT levels were significantly higher in burn patients with Gram-negative sepsis comparing to patients with Gram-positive sepsis and controls. The determination of PCT levels may help the choice of empirical antimicrobial therapy while microbiological culture results are not available, despite not fully ensuring the desirable degree of precision. |
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Evaluation of procalcitonin accuracy for the distinction between gram-negative and gram-positive bacterial sepsis in burn patientsSepsis is the main cause of death in burns. Early institution of antimicrobial therapy is crucial to optimize outcomes but superfluous therapy increases adverse events, microbial resistance, and costs. Blood cultures are the gold standard for diagnosis but can take 48 to 72 hours. Biomarkers are used to help sepsis diagnosis and distinction between Gram-negative and Gram-positive bacterial cause. The aim of this work is to evaluate procalcitonin (PCT) accuracy for this distinction in burn patients. Retrospective observational study of adult septic burn patients with ≥15% total burn surface area admitted from January 2011 to December 2014 at a Burn Unit in Portugal. A statistical analysis was done, evaluating the correlation between PCT levels on the day of the first positive blood culture and microbiological data for Gram-negative and Grand-positive bacteria. Patients with mixed bacterial and/or fungal blood cultures were excluded. Data were summarized by quartiles statistics. Blood cultures were positive in 189 patients: 75 (39.7%) showed growth for Gram-negative and 114 (60.3%) for Gram-positive bacteria. Patients with Gram-negative bacteria have significantly higher PCT levels. Receiver operating characteristic curve analysis showed accuracy for Gram-negative discrimination with area under the curve = 0.687. Most elevated levels were related to nonfermentative Gram-negative bacteria and by Klebsiella pneumoniae and other Enterobacteriaceae. PCT levels were significantly higher in burn patients with Gram-negative sepsis comparing to patients with Gram-positive sepsis and controls. The determination of PCT levels may help the choice of empirical antimicrobial therapy while microbiological culture results are not available, despite not fully ensuring the desirable degree of precision.Oxford University Press2019-03-29T10:51:22Z2019-01-01T00:00:00Z2019-01-01info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttp://hdl.handle.net/10773/25670eng1559-047X10.1093/jbcr/iry058Cabral, LuísAfreixo, VeraMeireles, RitaVaz, MiguelFrade, João-GonçaloChaves, CatarinaCaetano, MarisaAlmeida, LuísPaiva, José-Arturinfo:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2024-02-22T11:49:39Zoai:ria.ua.pt:10773/25670Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-20T02:58:48.258878Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
Evaluation of procalcitonin accuracy for the distinction between gram-negative and gram-positive bacterial sepsis in burn patients |
title |
Evaluation of procalcitonin accuracy for the distinction between gram-negative and gram-positive bacterial sepsis in burn patients |
spellingShingle |
Evaluation of procalcitonin accuracy for the distinction between gram-negative and gram-positive bacterial sepsis in burn patients Cabral, Luís |
title_short |
Evaluation of procalcitonin accuracy for the distinction between gram-negative and gram-positive bacterial sepsis in burn patients |
title_full |
Evaluation of procalcitonin accuracy for the distinction between gram-negative and gram-positive bacterial sepsis in burn patients |
title_fullStr |
Evaluation of procalcitonin accuracy for the distinction between gram-negative and gram-positive bacterial sepsis in burn patients |
title_full_unstemmed |
Evaluation of procalcitonin accuracy for the distinction between gram-negative and gram-positive bacterial sepsis in burn patients |
title_sort |
Evaluation of procalcitonin accuracy for the distinction between gram-negative and gram-positive bacterial sepsis in burn patients |
author |
Cabral, Luís |
author_facet |
Cabral, Luís Afreixo, Vera Meireles, Rita Vaz, Miguel Frade, João-Gonçalo Chaves, Catarina Caetano, Marisa Almeida, Luís Paiva, José-Artur |
author_role |
author |
author2 |
Afreixo, Vera Meireles, Rita Vaz, Miguel Frade, João-Gonçalo Chaves, Catarina Caetano, Marisa Almeida, Luís Paiva, José-Artur |
author2_role |
author author author author author author author author |
dc.contributor.author.fl_str_mv |
Cabral, Luís Afreixo, Vera Meireles, Rita Vaz, Miguel Frade, João-Gonçalo Chaves, Catarina Caetano, Marisa Almeida, Luís Paiva, José-Artur |
description |
Sepsis is the main cause of death in burns. Early institution of antimicrobial therapy is crucial to optimize outcomes but superfluous therapy increases adverse events, microbial resistance, and costs. Blood cultures are the gold standard for diagnosis but can take 48 to 72 hours. Biomarkers are used to help sepsis diagnosis and distinction between Gram-negative and Gram-positive bacterial cause. The aim of this work is to evaluate procalcitonin (PCT) accuracy for this distinction in burn patients. Retrospective observational study of adult septic burn patients with ≥15% total burn surface area admitted from January 2011 to December 2014 at a Burn Unit in Portugal. A statistical analysis was done, evaluating the correlation between PCT levels on the day of the first positive blood culture and microbiological data for Gram-negative and Grand-positive bacteria. Patients with mixed bacterial and/or fungal blood cultures were excluded. Data were summarized by quartiles statistics. Blood cultures were positive in 189 patients: 75 (39.7%) showed growth for Gram-negative and 114 (60.3%) for Gram-positive bacteria. Patients with Gram-negative bacteria have significantly higher PCT levels. Receiver operating characteristic curve analysis showed accuracy for Gram-negative discrimination with area under the curve = 0.687. Most elevated levels were related to nonfermentative Gram-negative bacteria and by Klebsiella pneumoniae and other Enterobacteriaceae. PCT levels were significantly higher in burn patients with Gram-negative sepsis comparing to patients with Gram-positive sepsis and controls. The determination of PCT levels may help the choice of empirical antimicrobial therapy while microbiological culture results are not available, despite not fully ensuring the desirable degree of precision. |
publishDate |
2019 |
dc.date.none.fl_str_mv |
2019-03-29T10:51:22Z 2019-01-01T00:00:00Z 2019-01-01 |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://hdl.handle.net/10773/25670 |
url |
http://hdl.handle.net/10773/25670 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
1559-047X 10.1093/jbcr/iry058 |
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info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf |
dc.publisher.none.fl_str_mv |
Oxford University Press |
publisher.none.fl_str_mv |
Oxford University Press |
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reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
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Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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RCAAP |
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RCAAP |
reponame_str |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
collection |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
repository.name.fl_str_mv |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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1799137642491674624 |