help button home button
AJRCCM
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Online Data Supplement
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by HARBARTH, S.
Right arrow Articles by the Geneva Sepsis Network
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by HARBARTH, S.
Right arrow Articles by the Geneva Sepsis Network,

Am. J. Respir. Crit. Care Med., Volume 164, Number 3, August 2001, 396-402

Diagnostic Value of Procalcitonin, Interleukin-6, and Interleukin-8 in Critically Ill Patients Admitted with Suspected Sepsis

STEPHAN HARBARTH, KATARINA HOLECKOVA, CÉLINE FROIDEVAUX, DIDIER PITTET, BARA RICOU, GEORGES E. GRAU, LASZLO VADAS, JÉRÔME PUGIN, and the Geneva Sepsis Network

Infection Control Program, Division of Infectious Diseases, Division of Medical Intensive Care, Division of Surgical Intensive Care, Department of Pathology, and Laboratoire Central de Chimie Clinique, The University of Geneva Hospitals, Geneva, Switzerland

To assess the diagnostic value of procalcitonin (PCT), interleukin (IL)-6, IL-8, and standard measurements in identifying critically ill patients with sepsis, we performed prospective measurements in 78 consecutive patients admitted with acute systemic inflammatory response syndrome (SIRS) and suspected infection. We estimated the relevance of the different parameters by using multivariable regression modeling, likelihood-ratio tests, and area under the receiver operating characteristic curves (AUC). The final diagnosis was SIRS in 18 patients, sepsis in 14, severe sepsis in 21, and septic shock in 25. PCT yielded the highest discriminative value, with an AUC of 0.92 (CI, 0.85 to 1.0), followed by IL-6 (0.75; CI, 0.63 to 0.87), and IL-8 (0.71; CI, 0.59 to 0.83; p < 0.001). At a cutoff of 1.1 ng/ml, PCT yielded a sensitivity of 97% and a specificity of 78% to differentiate patients with SIRS from those with sepsis-related conditions. Median PCT concentrations on admission (ng/ ml, range) were 0.6 (0 to 5.3) for SIRS; 3.5 (0.4 to 6.7) for sepsis; 6.2 (2.2 to 85) for severe sepsis; and 21.3 (1.2 to 654) for septic shock (p < 0.001). The addition of PCT to a model based solely on standard indicators improved the predictive power of detecting sepsis (likelihood ratio test; p = 0.001) and increased the AUC value for the routine value-based model from 0.77 (CI, 0.64 to 0.89) to 0.94 (CI, 0.89 to 0.99; p = 0.002). In contrast, no additive effect was seen for IL-6 (p = 0.56) or IL-8 (p = 0.14). Elevated PCT concentrations appear to be a promising indicator of sepsis in newly admitted, critically ill patients capable of complementing clinical signs and routine laboratory parameters suggestive of severe infection.

Keywords: Critical care; biological markers, blood; calcitonin, blood; protein precursors, blood; interleukin-6, blood; interleukin-8, blood; sepsis, blood, diagnosis; sepsis syndrome, blood, diagnosis




This article has been cited by other articles:


Home page
 Am. J. Respir. Crit. Care Med.Home page
C. Meisel, J. C. Schefold, R. Pschowski, T. Baumann, K. Hetzger, J. Gregor, S. Weber-Carstens, D. Hasper, D. Keh, H. Zuckermann, et al.
Granulocyte-Macrophage Colony-stimulating Factor to Reverse Sepsis-associated Immunosuppression: A Double-Blind, Randomized, Placebo-controlled Multicenter Trial
Am. J. Respir. Crit. Care Med., October 1, 2009; 180(7): 640 - 648.
[Abstract] [Full Text] [PDF]

Home page
 JAMAHome page
P. Schuetz, M. Christ-Crain, R. Thomann, C. Falconnier, M. Wolbers, I. Widmer, S. Neidert, T. Fricker, C. Blum, U. Schild, et al.
Effect of Procalcitonin-Based Guidelines vs Standard Guidelines on Antibiotic Use in Lower Respiratory Tract Infections: The ProHOSP Randomized Controlled Trial
JAMA, September 9, 2009; 302(10): 1059 - 1066.
[Abstract] [Full Text] [PDF]

Home page
 Clin. Chem.Home page
J. Struck, M. Strebelow, S. Tietz, C. Alonso, N. G. Morgenthaler, J. G. van der Hoeven, P. Pickkers, and A. Bergmann
Method for the Selective Measurement of Amino-Terminal Variants of Procalcitonin
Clin. Chem., September 1, 2009; 55(9): 1672 - 1679.
[Abstract] [Full Text] [PDF]

Home page
 J Intensive Care MedHome page
M.J. Ruiz-Alvarez, S. Garcia-Valdecasas, R. De Pablo, M. Sanchez Garcia, C. Coca, T.W. Groeneveld, A. Roos, M.R. Daha, and I. Arribas
Diagnostic Efficacy and Prognostic Value of Serum Procalcitonin Concentration in Patients With Suspected Sepsis
J Intensive Care Med, January 1, 2009; 24(1): 63 - 71.
[Abstract] [PDF]

Home page
 ThoraxHome page
R Menendez, M Cavalcanti, S Reyes, J Mensa, R Martinez, M A Marcos, X Filella, M Niederman, and A Torres
Markers of treatment failure in hospitalised community acquired pneumonia
Thorax, May 1, 2008; 63(5): 447 - 452.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
V. Nobre, S. Harbarth, J.-D. Graf, P. Rohner, and J. Pugin
Use of Procalcitonin to Shorten Antibiotic Treatment Duration in Septic Patients: A Randomized Trial
Am. J. Respir. Crit. Care Med., March 1, 2008; 177(5): 498 - 505.
[Abstract] [Full Text] [PDF]

Home page
 Eur Respir JHome page
S. Kruger, S. Ewig, R. Marre, J. Papassotiriou, K. Richter, H. von Baum, N. Suttorp, T. Welte, and on behalf of the CAPNETZ Study Group
Procalcitonin predicts patients at low risk of death from community-acquired pneumonia across all CRB-65 classes
Eur. Respir. J., February 1, 2008; 31(2): 349 - 355.
[Abstract] [Full Text] [PDF]

Home page
 ChestHome page
A. P. Wheeler
Recent Developments in the Diagnosis and Management of Severe Sepsis
Chest, December 1, 2007; 132(6): 1967 - 1976.
[Abstract] [Full Text] [PDF]

Home page
 Eur Respir JHome page
M. Christ-Crain and B. Muller
Biomarkers in respiratory tract infections: diagnostic guides to antibiotic prescription, prognostic markers and mediators
Eur. Respir. J., September 1, 2007; 30(3): 556 - 573.
[Abstract] [Full Text] [PDF]

Home page
 Arch SurgHome page
B. M. Rau, I. Frigerio, M. W. Buchler, K. Wegscheider, C. Bassi, P. A. Puolakkainen, H. G. Beger, and M. K. Schilling
Evaluation of Procalcitonin for Predicting Septic Multiorgan Failure and Overall Prognosis in Secondary Peritonitis: A Prospective, International Multicenter Study
Arch Surg, February 1, 2007; 142(2): 134 - 142.
[Abstract] [Full Text] [PDF]

Home page
 J. Immunol.Home page
M. F. Osuchowski, K. Welch, J. Siddiqui, and D. G. Remick
Circulating Cytokine/Inhibitor Profiles Reshape the Understanding of the SIRS/CARS Continuum in Sepsis and Predict Mortality
J. Immunol., August 1, 2006; 177(3): 1967 - 1974.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
M. Christ-Crain, D. Stolz, R. Bingisser, C. Muller, D. Miedinger, P. R. Huber, W. Zimmerli, S. Harbarth, M. Tamm, and B. Muller
Procalcitonin Guidance of Antibiotic Therapy in Community-acquired Pneumonia: A Randomized Trial
Am. J. Respir. Crit. Care Med., July 1, 2006; 174(1): 84 - 93.
[Abstract] [Full Text] [PDF]

Home page
 Arch. Dis. Child.Home page
R Arkader, E J Troster, M R Lopes, R R Junior, J A Carcillo, C Leone, and T S Okay
Procalcitonin does discriminate between sepsis and systemic inflammatory response syndrome
Arch. Dis. Child., February 1, 2006; 91(2): 117 - 120.
[Abstract] [Full Text] [PDF]

Home page
 CMAJHome page
E. P. Rivers, L. McIntyre, D. C. Morro, and K. K. Rivers
Early and innovative interventions for severe sepsis and septic shock: taking advantage of a window of opportunity
Can. Med. Assoc. J., October 25, 2005; 173(9): 1054 - 1065.
[Abstract] [Full Text] [PDF]

Home page
 Br J AnaesthHome page
D. Mokart, M. Merlin, A. Sannini, J. P. Brun, J. R. Delpero, G. Houvenaeghel, V. Moutardier, and J. L. Blache
Procalcitonin, interleukin 6 and systemic inflammatory response syndrome (SIRS): early markers of postoperative sepsis after major surgery
Br. J. Anaesth., June 1, 2005; 94(6): 767 - 773.
[Abstract] [Full Text] [PDF]

Home page
 ANN INTERN MEDHome page
Correction: Plasma Level of a Triggering Receptor Expressed on Myeloid Cells-1
Ann Intern Med, April 5, 2005; 142(7): 592 - 592.
[Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
B. Muller
Procalcitonin and Ventilator-associated Pneumonia: Yet Another Breath of Fresh Air
Am. J. Respir. Crit. Care Med., January 1, 2005; 171(1): 2 - 3.
[Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
C.-E. Luyt, V. Guerin, A. Combes, J.-L. Trouillet, S. B. Ayed, M. Bernard, C. Gibert, and J. Chastre
Procalcitonin Kinetics as a Prognostic Marker of Ventilator-associated Pneumonia
Am. J. Respir. Crit. Care Med., January 1, 2005; 171(1): 48 - 53.
[Abstract] [Full Text] [PDF]

Home page
 BloodHome page
J. Pugin, S. Stern-Voeffray, B. Daubeuf, M. A. Matthay, G. Elson, and I. Dunn-Siegrist
Soluble MD-2 activity in plasma from patients with severe sepsis and septic shock
Blood, December 15, 2004; 104(13): 4071 - 4079.
[Abstract] [Full Text] [PDF]

Home page
 Nutr Clin PractHome page
P. E. Marik
Monitoring Therapeutic Interventions in Critically Ill Septic Patients
Nutr Clin Pract, October 1, 2004; 19(5): 423 - 432.
[Abstract] [Full Text] [PDF]

Home page
 Journal of the American Animal Hospital AssociationHome page
B. A. Fransson, E. Karlstam, A. Bergstrom, A.-S. Lagerstedt, J. S. Park, M. A. Evans, and C. A. Ragle
C-reactive Protein in the Differentiation of Pyometra From Cystic Endometrial Hyperplasia/Mucometra in Dogs
J. Am. Anim. Hosp. Assoc., September 1, 2004; 40(5): 391 - 399.
[Abstract] [Full Text] [PDF]

Home page
 Clin. Chem.Home page
S. D. Carrigan, G. Scott, and M. Tabrizian
Toward Resolving the Challenges of Sepsis Diagnosis
Clin. Chem., August 1, 2004; 50(8): 1301 - 1314.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
C. Alberti, C. Brun-Buisson, S. V. Goodman, D. Guidici, J. Granton, R. Moreno, M. Smithies, O. Thomas, A. Artigas, and J. R. Le Gall
Influence of Systemic Inflammatory Response Syndrome and Sepsis on Outcome of Critically Ill Infected Patients
Am. J. Respir. Crit. Care Med., July 1, 2003; 168(1): 77 - 84.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
P. Eggimann, S. Harbarth, B. Ricou, S. Hugonnet, K. Ferriere, P. Suter, and D. Pittet
Acute Respiratory Distress Syndrome after Bacteremic Sepsis Does Not Increase Mortality
Am. J. Respir. Crit. Care Med., May 1, 2003; 167(9): 1210 - 1214.
[Abstract] [Full Text] [PDF]

Home page
 Arch SurgHome page
S. Harbarth, K. Ferriere, S. Hugonnet, B. Ricou, P. Suter, and D. Pittet
Epidemiology and Prognostic Determinants of Bloodstream Infections in Surgical Intensive Care
Arch Surg, December 1, 2002; 137(12): 1353 - 1359.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
M. J. TOBIN
Critical Care Medicine in AJRCCM 2001
Am. J. Respir. Crit. Care Med., March 1, 2002; 165(5): 565 - 583.
[Full Text] [PDF]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Proc. Am. Thorac. Soc. Am. J. Respir. Cell Mol. Biol.
Copyright © 2001 American Thoracic Society 		  ATS Coding and Billing Quarterly