title: Can procalcitonin differentiate Staphylococcus aureus from coagulase-negative staphylococci in clustered gram-positive bacteremia?
abstract: Procalcitonin (PCT) and pro-adrenomedullin (ProADM) have been proposed as diagnostic and prognostic biomarkers of infection. Between July 2009 and January 2012, we studied the role of these biomarkers in 163 patients with clustered gram-positive and gram-negative bacteremia. PCT levels were significantly higher in patients with Staphylococcus aureus and gram-negative bacteremia than those with coagulase-negative staphylococci (CoNS) isolated from blood cultures (P = 0.29 and <0.001, respectively). ProADM levels were only significantly higher in patients with gram-negative bacteremia (median 1.46 nmol/L) than those with CoNS (median 1.01 nmol/L) (P = 0.04). Among patients with CoNS, PCT, and ProADM, levels failed to differentiate blood contamination (medians 0.24 ng/mL and 0.97 nmol/L) from true bacteremia (medians 0.26 ng/mL and 1.14 nmol/L) (P = 0.51 and 0.57, respectively). In cancer patients, PCT (and to a lesser extent, ProADM) was useful in differentiating CoNS from S. aureus and gram-negative bacteremia.
authors.affiliation: UT MD Anderson Cancer Center, Dept. of Infectious Diseases, Infection Control & Employee Health, Houston, TX 77030, USA.
authors.forename: William
authors.initials: W
authors.lastname: Shomali
authors.forename: Ray
authors.initials: R
authors.lastname: Hachem
authors.forename: Anne-Marie
authors.initials: AM
authors.lastname: Chaftari
authors.forename: Ramez
authors.initials: R
authors.lastname: Bahu
authors.forename: Gilbert El
authors.initials: GE
authors.lastname: Helou
authors.forename: Ying
authors.initials: Y
authors.lastname: Jiang
authors.forename: Alexander N
authors.initials: AN
authors.lastname: Hanania
authors.forename: Alex
authors.initials: A
authors.lastname: Hanania
authors.forename: Ruth
authors.initials: R
authors.lastname: Reitzel
authors.forename: Issam
authors.initials: I
authors.lastname: Raad
mesh_terms: D000293:Adolescent; D053607:Adrenomedullin / Q000097:blood*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016470:Bacteremia / Q000175:diagnosis; D015415:Biomarkers / Q000097:blood; D002116:Calcitonin / Q000097:blood*; D015740:Calcitonin Gene-Related Peptide; D002648:Child; D002675:Child, Preschool; D006801:Humans; D007223:Infant; D008875:Middle Aged; D011498:Protein Precursors / Q000097:blood*; D012189:Retrospective Studies; D013203:Staphylococcal Infections / Q000175:diagnosis* / Q000382:microbiology; D013210:Staphylococcus / Q000145:classification* / Q000302:isolation & purification; D013211:Staphylococcus aureus / Q000145:classification* / Q000302:isolation & purification; D055815:Young Adult
chemical_list: D015415:Biomarkers; C000606589:CALCA protein, human; D011498:Protein Precursors; C088633:proadrenomedullin; D053607:Adrenomedullin; D002116:Calcitonin; D015740:Calcitonin Gene-Related Peptide