Procalcitonin: Uses in the Clinical Laboratory for the Diagnosis of Sepsis

Ming Jin, PhD; Adil I. Khan, PhD

Disclosures

Lab Med. 2010;41(3):173-177. 

In This Article

Abstract and Introduction

Abstract

Sepsis is the systemic response to infection by microbial organisms. A differential diagnosis of infection caused by either bacteria or other microbial organisms is essential for effective treatment and prognostic assessment. Current clinical laboratory methods in the diagnosis of bacterial infections are either non-specific or require longer turnaround times. Procalcitonin (PCT) is a biomarker that exhibits greater specificity than other proinflammatory markers (eg, cytokines) in identifying patients with sepsis and can be used in the diagnosis of bacterial infections. In this article, we review the current knowledge of PCT and its use in the clinical laboratory setting.

Introduction

Identifying whether the cause of inflammation in patients is of bacterial origin has been an important area of development in the clinical laboratory. Several clinical laboratory tests have been applied to the diagnosis of sepsis.[1] The broth culture method is the gold standard for the diagnosis of bacterial infection, but a definitive result can take 24 hours or more before a conclusive diagnosis. A number of the inflammatory markers, such as leukocyte cell count, C reactive protein (CRP), and cytokines (TNF-α, IL-1β, or IL-6), have been applied in the diagnosis of inflammation and infection, but their lack of specificity has generated a continued interest to develop more specific clinical laboratory tests.[2] One promising marker has been procalcitonin (PCT), whose concentration has been found to be elevated in sepsis. Owing its specificity to bacterial infections, PCT has been proposed as a pertinent marker in the rapid diagnosis of bacterial infection, especially for use in hospital emergency departments and intensive care units. Since its identification and association with sepsis in the 1990s, a large number of studies involving PCT and its clinical application have been conducted. A test to determine PCT levels has been available in Europe for several years and recently was approved by the FDA for use in the United States.[3]

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