• H Giamarellou, E J Giamarellos-Bourboulis, P Repoussis, L Galani, N Anagnostopoulos, P Grecka, D Lubos, M Aoun, K Athanassiou, E Bouza, E Devigili, V Krçmery, F Menichetti, E Panaretou, E Papageorgiou, and D Plachouras.
• 4th Department of Internal Medicine, Athens Medical School, Athens, Greece. giamarel@internet.gr
• Clin. Microbiol. Infect. 2004 Jul 1; 10 (7): 628-33.

AbstractIn order to assess the diagnostic value of procalcitonin, 158 patients with febrile neutropenia from centres across Europe were studied. Patients with fever were diagnosed on the basis of either: (1) clinical, radiological and microbiological criteria; or (2) the procalcitonin value. In the latter case, concentrations of 0.5-1.0 ng/mL were considered diagnostic of localised infection, concentrations of 1.0-5.0 ng/mL of bacteraemia, and concentrations of > 5.0 ng/mL of severe sepsis. Procalcitonin and C-reactive protein were estimated daily in serum by immunochemiluminescence and nephelometry, respectively. Overall, the sensitivity (specificity) of procalcitonin for bacteraemia was 44.2% (64.3%) at concentrations of 1.0-5.0 ng/mL, and 83.3% (100%) for severe sepsis at concentrations of > 5.0 ng/mL. It was concluded that procalcitonin is a marker strongly suggestive of severe sepsis at concentrations of > 5.0 ng/mL. Estimated concentrations of < 0.5 ng/mL indicate that infection is unlikely, but it was observed that bacteraemia associated with coagulase-negative staphylococci may fail to elevate serum procalcitonin levels.

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