1887

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Volume 53, Issue 7

Do procalcitonin and C-reactive protein levels have a place in the diagnosis and follow-up of infections? Free

Abstract

The aims of this study were to determine the levels of procalcitonin (PCT) and C-reactive protein (CRP) in -positive (HP) patients diagnosed with duodenal and gastric ulcer and to evaluate the correlation of PCT and CRP levels with other invasive and non-invasive diagnostic methods for determination of eradication in post-treatment follow-up. Thirty-five HP patients with dyspepsia were included in this study. Serum samples (5 ml) were collected at admission and after 24 h. Antimicrobial therapy (omeprazole, amoxycillin and clarithromycin) was given for 1 week to HP patients who were positive only by culture or by urease test plus pathology. After 1 month, serum samples (5 ml) were collected again and culture, urease and pathology investigations were performed on endoscopic samples. PCT and CRP levels were measured in the collected blood samples. Thirty-five -negative (HP) cases with dyspepsia, 38 cases with bacteraemia and 35 healthy blood donors were included in this study as control groups. The mean and minimum–maximum levels of PCT were 1.39 (0.25–6.75), 0.35 (0.12–0.71), 7.45 (0.68–51.5) and 0.40 (0.12–0.71) ng ml for the groups of HP, HP and bacteraemia patients and healthy donors, respectively. Mean CRP levels were 1.00 (<0.5–8.11), 0.62 (<0.5–3.2), 11.5 (3.2–43.5) and 0.63 (<0.5–5.46) mg dl for the same groups. A statistically significant difference was found between HP patients and both HP cases and healthy blood donors for PCT levels, and higher PCT levels were found on admission in cases of bacteraemia than in the other groups ( < 0.05). PCT levels of HP cases decreased significantly (from 1.39 to 0.86) between admission and the post-treatment period (30 days); however, PCT levels remained higher than the cut-off value (0.5 ng ml). Similar ranges of CRP levels were found over the same time-period. The sensitivity of PCT was found to be higher than that of CRP on admission, but the specificity of PCT was found to be lower than that of CRP on the day of admission (65 and 74 %, respectively). The sensitivity of PCT was the same as that of CRP for the post-treatment period, but specificity of PCT was higher than that of CRP for the post-treatment period (83 and 76 %, respectively). It was concluded that PCT and CRP are not very effective markers for infection in primary diagnosis or in eradication follow-up after therapy when used in parallel with conventional diagnostic methods, even if there is a difference in PCT and CRP levels between HP and HP cases on admission.

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2004-07-01
2024-04-20
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References

  1. Aranson M. D., Bor D. H. 1987; Blood cultures. Ann Intern Med 106:246–253 [CrossRef]
     [Google Scholar]
  2. Assicot M., Gendrel D., Carsin H., Raymond J., Guilbaud J., Bohuon C. 1993; High serum procalcitonin concentrations in patients with sepsis and infection. Lancet 341:515–518 [CrossRef]
     [Google Scholar]
  3. Behring Diagnostics 1997 Behring Turbitimer Instruction Manual , version T.T.30 Warburg: Behring Diagnostics;
     [Google Scholar]
  4. Blijlevens N. M. A., Donnelly J. P., Meis J. F. G. M., De Keizer M. H., De Pauw B. E. 2000; Procalcitonin does not discriminate infection from inflammation after allogeneic bone marrow transplantation. Clin Diagn Lab Immunol 7:889–892
     [Google Scholar]
  5. Choussat R., Montalescot G., Collet J.-P. & 10 other authors; 2000; Effect of prior exposure to Chlamydia pneumoniae , Helicobacter pylori , or cytomegalovirus on the degree of inflammation and one-year prognosis of patients with unstable angina pectoris or non-q-wave acute myocardial infarction. Am J Cardiol 86:379–384 [CrossRef]
     [Google Scholar]
  6. Crabtree J. E., Perry S., Moran A. 1994; Neutrophil IL-8 secretion induced by H.pylori . Am J Gastroenterol 89:1337–1338
     [Google Scholar]
  7. D'Elios M. M., Andersen L. P., Del Prete G. 1998; Inflammation and host response. Curr Opin Gastroenterol 14 (Suppl. 1):S15–S20
     [Google Scholar]
  8. Gendrel D., Bohuon C. 2000; Procalcitonin as a marker of bacterial infection. Pediatr Infect Dis J 19:679–688 [CrossRef]
     [Google Scholar]
  9. Gendrel D., Raymond J., Coste J. & 9 other authors; 1999; Comparison of procalcitonin with C-reactive protein, interleukin 6 and interferon-alpha for differentation of bacterial vs .viral infections. Pediatr Infect Dis J 18:875–881 [CrossRef]
     [Google Scholar]
  10. Gramm H.-J., Dollinger P., Beier W. 1995; Procalcitonin – ein neuer Marker der inflammatorischen Wirtsantwort.Longitudinalstudien bei Patienten mit Sepsis und Peritonitis. Chir Gastroenterol 11 (Suppl. 2):51–54 (in German [CrossRef]
     [Google Scholar]
  11. IARC Working Group 1994; Schistosomes, liver flukes and Helicobacter pylori .IARC Working Group on the evaluation of carcinogenic risks to humans. Lyon. 7–14 June 1994; IARC Monogr Eval Carcinog Risks Hum 61:1–241
     [Google Scholar]
  12. Jarešová M., Střiž I., Čermáková J., Lácha J., Sedláček J., Mudra K., Hána I., Vítko Š. 1999; Serum procalcitonin concentrations in transplant patients with acute rejection and bacterial infections. Immunol Lett 69:355–358 [CrossRef]
     [Google Scholar]
  13. Kocazeybek B., Küçükoğlu S., Öner A. 2003; Procalcitonin and C-reactive protein in infective endocarditis: correlation with etiology and prognosis. Chemotherapy 49:76–84 [CrossRef]
     [Google Scholar]
  14. Le Moullec J. M., Jullienne A., Chenais J., Lasmoles F., Guliana J. M., Milhaud G., Moukhtar M. S. 1984; The complete sequence of human preprocalcitonin. FEBS Lett 167:93–97 [CrossRef]
     [Google Scholar]
  15. Logan R. P. H. 1996; The C13 urea breath test. In Helicobacter pylori: Technique for Clinical Diagnosis and Basic Research . pp 74–81 Edited by Lee A., Megraud F. Philadelphia: WB Saunders;
  16. Lorrot M., Moulin F., Coste J. & 7 other authors; 2000; Procalcitonin in pediatric emergencies: comparison with C-reactive protein, interleukin-6 and interpheron alpha in the differentiation between bacterial and viral infections. Presse Med 29:128–134 (in French
    [Google Scholar]
  17. Meisner M. 1996 PCT, procalcitonin – a new, innovative marker for severe infection and sepsis. Biochemical and clinical aspects Berlin: BRAHMS Diagnostica;
     [Google Scholar]
  18. Moran A. 1998; The products of Helicobacter pylori that induce inflammation. Eur J Gastroenterol Hepatol 10 (Suppl. 1):S3–S8 [CrossRef]
     [Google Scholar]
  19. Rothenburger M., Markewitz A., Lenz T., Kaulbach H. G., Marohl K., Kuhlmann W. D., Weinhold C. 1999; Detection of acute phase response and infection.The role of procalcitonin and C-reactive protein. Clin Chem Lab Med 37:275–279
     [Google Scholar]
  20. Soderquist B., Jones I., Fredlund H., Vikerfors J. 1998; Bacterial or crystal-associated arthritis? Discriminating ability of serum inflammatory markers. Scand J Infect Dis 30:591–596 [CrossRef]
     [Google Scholar]
  21. Strömberg E., Edebo A., Svennerholm A.-M., Lindholm C. 2003; Decreased epithelial cytokine responses in the duodenal mucosa of Helicobacter pylori -infected duodenal ulcer patients. Clin Diagn Lab Immunol 10:116–124
     [Google Scholar]
  22. Tunçbilek S., Baykam N., Hızel K., Dokuzoğaz B. 2000; Farklı bakteriyel infeksiyonların tanısında prokalsitoninin rolü. Flora 5:99–103 (in Turkish
    [Google Scholar]
  23. Ugarte H., Silva E., Mercan D., De Mendonca A., Vincent J.-L. 1999; Procalcitonin used as a marker of infection in the intensive care unit. Crit Care Med 27:498–504 [CrossRef]
     [Google Scholar]
  24. Vaira D., Malfertheiner P., Mégraud F. & 8 other authors; 1999; Diagnosis of Helicobacter pylori infection with a new non-invasive antigen-based assay.HpSA European study group. Lancet 354:30–33 [CrossRef]
     [Google Scholar]
  25. Working Party of the European Helicobacter pylori Study Group 1997; Technical annex: tests used to assess Helicobacter pylori infection. Gut 41 (Suppl. 2):S10–S18
     [Google Scholar]
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Do procalcitonin and C-reactive protein levels have a place in the diagnosis and follow-up of Helicobacter pylori infections?
J. Med. Microbiol. 53, 639 (2004); https://doi.org/10.1099/jmm.0.05398-0
/content/journal/jmm/10.1099/jmm.0.05398-0
/content/journal/jmm/10.1099/jmm.0.05398-0
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