title: Early diagnostic value of plasma PCT and BG assay for CRBSI after OLT.
abstract: OBJECTIVE
  The aim was to evaluate the role of procalcitonin (PCT) and (1-3)-β-D-glucan (BG) tests for early detection or exclusion of central venous catheter-related bloodstream infections (CRBSI) in patients after orthotopic liver transplantation (OLT).
  
  
  METHODS
  Fifty-five patients with clinically suspected CRBSI were assessed after OLT in this prospective study. On the day of clinical suspicion of CRBSI, blood samples were obtained from central venous catheters and a peripheral vein for blood cultures and from a peripheral vein for PCT and BG tests. Plasma PCT and BG values were measured by using an immunoluminometric assay and Fungitell BG assay, respectively. No prisoners or organs from prisoners were used in this study.
  
  
  RESULTS
  Twenty-five patients (45%) were diagnosed with CRBIS. Among them, 13 (52%) displayed gram-positive bacteriemia, 11 (44%) gram-negative bacteriemia, and 1 (4%) fungemia. The PCT values were higher in CRBSI than in non-CRBSI patients (P = .003). CRBSI patients did not show significant increases in plasma BG values compared with non-CRBSI subjects (P = .051). PCT and BG area under receiver operating characteristic curves were 0.840 and 0.486, respectively. Sensitivity, specificity, and positive and negative predictive values of a PCT of ≥ 3.1 ng/mL for the diagnosis of CRBSI were 0.72, 0.87, 0.82, and 0.79, respectively. The figures for a BG of ≥ 83 pg/mL were 0.32, 0.90, 0.73, and 0.61, respectively. Among the 24 patients with bacteria infections, PCT was higher in patients with gram-negative than those with gram-positive bacterial infections (P = .022).
  
  
  CONCLUSIONS
  We concluded that the PCT assay may be a useful rapid diagnostic adjunct for the diagnosis of suspected CRBSI in OLT patients.
authors.affiliation: Department of Laboratory, Tianjin Union Medicine Centre, Tianjin, China.
authors.forename: J
authors.initials: J
authors.lastname: Chen
authors.forename: Y
authors.initials: Y
authors.lastname: Wang
authors.forename: Z
authors.initials: Z
authors.lastname: Shen
authors.forename: Z
authors.initials: Z
authors.lastname: Zhu
authors.forename: Y
authors.initials: Y
authors.lastname: Song
authors.forename: R
authors.initials: R
authors.lastname: Han
mesh_terms: D016470:Bacteremia / Q000097:blood / Q000175:diagnosis*; D002116:Calcitonin / Q000097:blood*; D015740:Calcitonin Gene-Related Peptide; D002408:Catheters, Indwelling / Q000009:adverse effects*; D016469:Fungemia / Q000097:blood / Q000175:diagnosis*; D006801:Humans; D016031:Liver Transplantation; D011498:Protein Precursors / Q000097:blood*; D011509:Proteoglycans; D047071:beta-Glucans / Q000097:blood*
chemical_list: C000606589:CALCA protein, human; D011498:Protein Precursors; D011509:Proteoglycans; D047071:beta-Glucans; C010770:polysaccharide-K; D002116:Calcitonin; D015740:Calcitonin Gene-Related Peptide