| Rey et al.(2727 Rey C, Los Arcos M, Concha A, Medina A, Prieto S, Martinez P, et al. Procalcitonin and C-reactive protein as markers of systemic inflammatory response syndrome severity in critically ill children. Intensive Care Med. 2007;33(3):477-84.)
|
Observational prospective cohort |
359 patient-days included in the study
Evaluation of the use of PCT, CRP and leukocyte count to classify: absence of infection, SRIS, localized infection, sepsis, severe sepsis and septic shock
Area under the receiver operating characteristic (ROC) curve for diagnosis of sepsis was 0.532 for leukocyte count, 0.75 for CRP and 0.912 for PCT |
PCT is a better diagnostic marker for sepsis in critically ill patients than CRP
PCT and CRP may be useful as clinical tools to stratify the severity of patients with SRIS |
| Fioretto et al.(2828 Fioretto JR, Martin JG, Kurokawa CS, Carpi MF, Bonatto RC, de Moraes MA, et al. Comparison between procalcitonin and C-reactive protein for early diagnosis of children with sepsis and septic shock. Inflamm Res. 2010;59(8):581-6.)
|
Prospective cohort |
87 patients (46 patients diagnosed with sepsis and 41 patients diagnosed with septic shock)
PCT and CRP measurement on admission and 12 hours later |
PCT was better than CRP for the diagnosis of sepsis and septic shock, particularly on admission, and was related to disease severity |
| England et al.(2929 England JT, Del Vecchio MT, Aronoff SC. Use of serum procalcitonin in evaluation of febrile infants: a meta-analysis of 2317 patients. J Emerg Med. 2014;47(6):682-8.)
|
Systematic review |
7 studies of 2,317 patients
Evaluation of the use of PCT in the diagnosis of severe bacterial infection in young infants (≤3 months of age)
5 of 7 studies used the same cut-off value (0.3ng/mL)
RR for diagnosis of severe bacterial infection with increased PCT was 3.97
RR for diagnosis of severe bacterial infection using clinical prediction was 30.6 (patients without antibiotic treatment) and 8.75 (patients using antibiotic) |
PCT values < 0.3ng/mL may be useful in the exclusion of severe bacterial infection, as an additional test to clinical prediction, remaining as a key factor to guide the therapeutic approach in these patients |
| Arkader et al.(3030 Arkader R, Troster EJ, Lopes MR, Júnior RR, Carcillo JA, Leone C, et al. Procalcitonin does discriminate between sepsis and systemic inflammatory response syndrome. Arch Dis Child. 2006;91(2):117-20.)
|
Observational prospective cohort |
PCT and CRP kinetics studied in patients undergoing heart surgery with cardiopulmonary bypass (Group 1 - SRIS) and in patients with confirmed bacterial sepsis (Group 2)
The area under the ROC curve was 0.99 for PCT and 0.54 for CRP |
PCT was able to differentiate patients with SRIS and sepsis, and CRP was not
PCT concentrations varied according to the progression of sepsis |
| Han et al.(3131 Han YY, Doughty LA, Kofos D, Sasser H, Carcillo JA. Procalcitonin is persistently increased among children with poor outcome from bacterial sepsis. Pediatr Crit Care Med. 2003;4(1):21-5.)
|
Prospective cohort |
87 patients with sepsis and septic shock
12 critically ill patients with no criteria for sepsis
PCT values were elevated in patients with bacterial sepsis at days 1 and 3 of pediatric ICU admission
Persistently elevated PCT values were found in patients with bacterial sepsis with persistent multiple organ failure and in those who died, but not in patients with non-bacterial sepsis (fungal, viral or sepsis with negative culture) |
PCT is persistently elevated in children with bacterial sepsis and poor prognosis |
| Hu et al.(3434 Hu R, Gong Y, Wang Y. Relationship of serum procalcitonin levels to severity and prognosis in pediatric bacterial meningitis. Clin Pediatr (Phila). 2015;54(12):1141-4.)
|
Prospective cohort |
Investigation of the relationship between the PCT SL and prognosis in children with bacterial meningitis
82 patients included
Patients with bacterial meningitis have higher PCT SL than those with viral meningitis
PCT SL were significantly higher in patients with severe sepsis and septic shock than in patients with non-severe sepsis and without sepsis
A drop in PCT SL was observed in patients with a good response to antibiotic treatment
PCT SL were significantly higher in patients who died than in survivors |
PCT SL are related to disease severity in children with bacterial meningitis
A decrease in PCT SL after treatment may indicate a favorable prognosis |
| Henry et al.(3535 Henry BM, Roy J, Ramakrishnan PK, Vikse J, Tomaszewski KA, Walocha JA. Procalcitonin as a serum biomarker for differentiation of bacterial meningitis from viral meningitis in children: evidence from a meta-analysis. Clin Pediatr (Phila). 2016;55(8):749-64.)
|
Systematic review |
8 studies were included (616 patients)
PCT SL were highly accurate in differentiating the diagnostic etiology of meningitis in children, with 96% sensitivity and 89% specificity
In 6 studies, the accuracy of PCT was higher than that of CRP |
PCT SL are highly accurate in differentiating bacterial meningitis from viral meningitis in children |
| Hatzistilianou et al.(3737 Hatzistilianou M, Rekliti A, Athanassiadou F, Catriu D. Procalcitonin as an early marker of bacterial infection in neutropenic febrile children with acute lymphoblastic leukemia. Inflamm Res. 2010;59(5):339-47.)
|
Prospective cohort |
Assessment of PCT, CRP, TNF-alpha, IL-1b, IL-8 and TNF-receptor II values in the rapid and early diagnosis of infection in patients with acute lymphocytic leukemia and febrile neutropenia and differentiation between bacterial and viral infection
The SL of biomarkers were assessed on admission and for 7 consecutive days
PCT SL were significantly different between bacterial and non-bacterial episodes, with 94% sensitivity and 96.5% specificity |
Serial PCT measurements may be useful in predicting severe sepsis in patients with acute lymphoid leukemia and febrile neutropenia |
| Zurek et al.(4343 Zurek J, Vavrina M. Procalcitonin biomarker kinetics to predict multiorgan dysfunction syndrome in children with sepsis and systemic inflammatory response syndrome. Iran J Pediatr. 2015;25(1):e324.)
|
Prospective cohort |
62 patients (0 - 19 years) with SRIS or sepsis were included
Severity measured using the PELOD
PCT SL were measured from day 1 to day 5 of admission and significantly higher PCT values were found in patients with PELOD >12 than with PELOD < 12 |
PCT SL from day 1 to day 5 of pediatric ICU admission are related to severity and multiple organ dysfunction in children with SRIS/sepsis |
