title: Clinical value of procalcitonin for patients with suspected bloodstream infection.
abstract: OBJECTIVE
  Procalcitonin (PCT) might be a useful marker to exclude bacteremia or to predict the severity of bacteremia and its outcome. However, most previous studies of PCT were limited to particular patient populations. In addition, reports about PCT levels in patients with renal dysfunction have been conflicting. We investigated the predictive value of PCT in an unselected population with suspected bloodstream infections and also assessed the relationship between PCT and renal function.
  
  
  METHODS
  We retrospectively analyzed medical records of 1,331 patients (age ≥1 8 years) with suspected bloodstream infections who had concurrent biochemical data and blood culture results.
  
  
  RESULTS
  The PCT level was significantly elevated in patients with positive blood cultures, and it showed a significant relation with survival in patients with bacteremia. The optimal cutoff value of PCT for predicting a positive blood culture showed an increase as the estimated glomerular filtration rate declined.
  
  
  CONCLUSIONS
  PCT can be a useful marker to exclude bacteremia and also to predict severe bacteremia, but renal function should be taken into account.
authors.affiliation: Dept of Clinical Laboratory, Japanese Red Cross Nagoya Daiichi Hospital, 3-35 Michishita-cho, Nakamura-ku, Nagoya 453-8511, Japan; hattori. takuya@gmail.com.
authors.forename: Takuya
authors.initials: T
authors.lastname: Hattori
authors.forename: Hideki
authors.initials: H
authors.lastname: Nishiyama
authors.forename: Hideki
authors.initials: H
authors.lastname: Kato
authors.forename: Shinobu
authors.initials: S
authors.lastname: Ikegami
authors.forename: Madoka
authors.initials: M
authors.lastname: Nagayama
authors.forename: Saori
authors.initials: S
authors.lastname: Asami
authors.forename: Miyuki
authors.initials: M
authors.lastname: Usami
authors.forename: Mayuko
authors.initials: M
authors.lastname: Suzuki
authors.forename: Itsuka
authors.initials: I
authors.lastname: Murakami
authors.forename: Makoto
authors.initials: M
authors.lastname: Minoshima
authors.forename: Hiroe
authors.initials: H
authors.lastname: Yamagishi
authors.forename: Norihiro
authors.initials: N
authors.lastname: Yuasa
mesh_terms: D000328:Adult; D000368:Aged; D016470:Bacteremia / Q000097:blood* / Q000175:diagnosis; D015415:Biomarkers / Q000097:blood; D001769:Blood / Q000382:microbiology; D002097:C-Reactive Protein / Q000032:analysis; D002116:Calcitonin / Q000097:blood*; D015740:Calcitonin Gene-Related Peptide; D003404:Creatinine / Q000097:blood; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D053208:Kaplan-Meier Estimate; D007668:Kidney / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011498:Protein Precursors / Q000097:blood*; D012189:Retrospective Studies
chemical_list: D015415:Biomarkers; C000606589:CALCA protein, human; D011498:Protein Precursors; D002116:Calcitonin; D002097:C-Reactive Protein; D003404:Creatinine; D015740:Calcitonin Gene-Related Peptide
keywords: Blood culture; Bloodstream infection; C-reactive protein; Procalcitonin; Renal function