title: Diagnostic and prognostic role of procalcitonin (PCT) and MR-pro-Adrenomedullin (MR-proADM) in bacterial infections.
abstract: Rapid diagnosis of bacterial infections is crucial for adequate antibiotic treatment. Serum molecules such as Procalcitonin (PCT) have been used as biomarkers of infection. Recently, the mid-regional pro-Adrenomedullin (MR-proADM) has been evaluated in combination with PCT for sepsis diagnosis. The diagnostic role of PCT and MR-proADM both in sepsis and in localized infections together with their contribution to effective antibiotic therapy has been evaluated. One hundred and eighty-two patients with bacterial infection has been enrolled: PCT and MR-proADM were measured at admission (T = 0), at 12-24 h (T = 1) and in the third or fifth day of antibiotic therapy (T = 3-5). ROC curve (receiver operating characteristic) and post-test probability were calculated. MR-proADM increased with the severity of the infection. PCT resulted significantly higher in sepsis than localized infection. After antibiotic therapy, PCT significantly decreased in localized respiratory infections and in sepsis, while MR-proADM decreased significantly after antibiotic therapy only in patients with severe sepsis/septic shock. The threshold values of PCT and MR-proADM were >0.1 ng/mL and >0.8 nmol/L, respectively. The combined use of PCT and MR-proADM increased the post-test probability of the diagnosis of bacterial infections compared to PCT alone. In conclusion, PCT and MR-proADM combination improves the diagnosis of bacterial infection and contribute to prognosis and antibiotic therapy effectiveness.
authors.affiliation: Clinical Pathology and Microbiology Laboratory, University Hospital Campus Bio-Medico of Rome, Rome, Italy.
authors.forename: Silvia
authors.initials: S
authors.lastname: Angeletti
authors.affiliation: Internal Medicine Department, University Hospital Campus Bio-Medico, Rome, Italy.
authors.forename: Silvia
authors.initials: S
authors.lastname: Spoto
authors.affiliation: Internal Medicine Department, University Hospital Campus Bio-Medico, Rome, Italy.
authors.forename: Marta
authors.initials: M
authors.lastname: Fogolari
authors.affiliation: Internal Medicine Department, University Hospital Campus Bio-Medico, Rome, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Cortigiani
authors.affiliation: Clinical Pathology and Microbiology Laboratory, University Hospital Campus Bio-Medico of Rome, Rome, Italy.
authors.forename: Marta
authors.initials: M
authors.lastname: Fioravanti
authors.affiliation: Clinical Pathology and Microbiology Laboratory, University Hospital Campus Bio-Medico of Rome, Rome, Italy.
authors.forename: Lucia
authors.initials: L
authors.lastname: De Florio
authors.affiliation: Internal Medicine Department, University Hospital Campus Bio-Medico, Rome, Italy.
authors.forename: Brunella
authors.initials: B
authors.lastname: Curcio
authors.affiliation: Internal Medicine Department, University Hospital Campus Bio-Medico, Rome, Italy.
authors.forename: Danilo
authors.initials: D
authors.lastname: Cavalieri
authors.affiliation: Internal Medicine Department, University Hospital Campus Bio-Medico, Rome, Italy.
authors.forename: Sebastiano
authors.initials: S
authors.lastname: Costantino
authors.affiliation: Clinical Pathology and Microbiology Laboratory, University Hospital Campus Bio-Medico of Rome, Rome, Italy.
authors.forename: Giordano
authors.initials: G
authors.lastname: Dicuonzo
mesh_terms: D000293:Adolescent; D053607:Adrenomedullin / Q000097:blood*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001424:Bacterial Infections / Q000097:blood / Q000175:diagnosis* / Q000188:drug therapy; D015415:Biomarkers / Q000097:blood; D002116:Calcitonin / Q000097:blood*; D015740:Calcitonin Gene-Related Peptide; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011498:Protein Precursors / Q000097:blood*; D018805:Sepsis / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D015415:Biomarkers; C000606589:CALCA protein, human; D011498:Protein Precursors; D053607:Adrenomedullin; D002116:Calcitonin; D015740:Calcitonin Gene-Related Peptide
keywords: Procalcitonin (PCT); bacterial infections; mild-regional pro-Adrenomedullin (MR-proADM)