Urogenit Tract Infect.  2016 Dec;11(3):109-113. 10.14777/uti.2016.11.3.109.

Clinical Usefulness of Procalcitonin as a Predictive Marker in Accordance with the Severity of Female Patients with Uncomplicated Acute Pyelonephritis

Affiliations
  • 1Department of Urology, Jeju National University Hospital, Jeju, Korea. kurology@jejunu.ac.kr

Abstract

PURPOSE
Acute pyelonephritis (APN) is accompanied by bacteremia and has a high incidence of mortality. Currently, there is a limited number of rapid diagnostic tests that can predict the severity of infection and suitable treatments for patients with APN. Herein, we determined whether serum procalcitonin (PCT) is a useful predictive and early cognitive marker according to the severity of APN.
MATERIALS AND METHODS
Patients were divided into four groups according to the severity of infection: (1) No systemic inflammatory response syndrome (SIRS), (2) SIRS, (3) severe sepsis, and (4) septic shock. We measured the inflammatory biomarkers"”PCT, C-reactive protein (CRP), and erythrocyte sedimentation rate. One way ANOVA analysis was performed between the measured infection markers and the severity of infection. The p-value of less than 0.05 was considered by the post-hoc multiple comparisons.
RESULTS
A total of 381 patients with APN were divided into four groups: (1) no SIRS (n=126, 33.1%), (2) SIRS (n=185, 48.6%), (3) severe sepsis (n=47, 12.3%), and (4) septic shock (n=23, 6.0%). PCT (p<0.001) and CRP (p=0.002) showed a significant difference among the group. Greater severity of infection grade was associated with higher PCT and CRP values. According to the multivariate analysis, there was a statistically significant difference of PCT among all grades.
CONCLUSIONS
The serum PCT was a helpful marker for predicting severity of APN. Moreover, be a useful predictor of sepsis and septic shock.

Keyword

Procalcitonin; C-reactive protein; Pyelonephritis

MeSH Terms

Bacteremia
Blood Sedimentation
C-Reactive Protein
Diagnostic Tests, Routine
Female*
Humans
Incidence
Mortality
Multivariate Analysis
Pyelonephritis*
Sepsis
Shock, Septic
Systemic Inflammatory Response Syndrome
C-Reactive Protein

Figure

  • Fig. 1. Procalcitonin (PCT) increased depending on the infection severity (p<0.001). PCT did show all significant differences among four subgroups. SIRS: systemic inflammatory response syndrome.

  • Fig. 2. C-reactive protein (CRP) increased depending on the infection severity (p=0.002). However, there was no difference in CRP between severe sepsis and septic shock (p=0.851). SIRS: systemic inflammatory response syndrome.


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