Correlation of procalcitonin level to site of infection or organism Joshua J. Hicks, Brian J. McCullough, Michael P. Veve, Mahmoud A. Shorman University of Tennessee Medical Center - Knoxville - Knoxville, TN
Background/Purpose: The objective of this IRB-approved study is to determine if a correlation exists between procalcitonin level and the site of an infection or specific organisms. Published literature has primarily focused on the clinical utility of procalcitonin in guiding antibiotic therapy for the treatment of pneumonia. The aim of this project is to generate more data for the utilization of procalcitonin in infections other than pneumonia, as well as to investigate any organism-specific influences on procalcitonin that may exist.
Methodology: A retrospective chart review will be conducted to identify patients who have had at least one procalcitonin level measured and a positive microbiologic culture of pre-specified sites of infection during an inpatient admission. Approximately 700 to 1,300 patients will need to be enrolled to meet 80% power for secondary analyses. Patients will be excluded from the study based on the following: less than 18 years of age, concurrent viral or fungal infection, contaminated cultures, acute myocardial infarction (troponin greater than or equal to the 99th percentile), or shock liver (AST/ALT greater than or equal to 20 times the upper limit of normal). The following data will be collected for eligible patients: age, gender, length of stay, ICU admission, in-hospital mortality, 30-day readmission, procalcitonin level, white blood cell count, 24-hour maximum temperature, site of infection, and isolated organism. Co-primary endpoints to be evaluated include sensitivity, specificity, positive predictive value, and negative predictive value of a procalcitonin level of 0.5 ng/mL, for each site of infection. Secondary analyses will include between-group comparisons amongst specific organisms and polymicrobial infections.
Presentation Objective: Evaluate the usefulness of procalcitonin in the management of endocarditis, cystitis/pyelonephritis, osteomyelitis/septic arthritis, and central-line associated bloodstream infections.
Self-Assessment: What is the role of procalcitonin in the management of the infection, outside of respiratory illness?
