Archives of Clinical Infectious Diseases

Published by: Kowsar

Procalcitonin May Not Discriminate Between Sepsis and Non-Infective Systemic Inflammatory Response Syndrome (SIRS) in Heterogonous Critically Ill Patients

Ata Mahmoodpoor 1 , Niloofar Farzan 2 , Kamran Shadvar 3 , Taher Entezari-Maleki 4 and Hadi Hamishehkar 4 , *
Authors Information
1 Department of Anesthesiology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
2 Iranian Evidence Based Medicine Center of Excellence, Tabriz University of Medical Sciences, Tabriz, Iran
3 Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
4 Drug Applied Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
Article information
  • Archives of Clinical Infectious Diseases: January 2018, 13 (1); e55618
  • Published Online: January 23, 2018
  • Article Type: Research Article
  • Received: July 10, 2016
  • Revised: June 19, 2017
  • Accepted: September 20, 2017
  • DOI: 10.5812/archcid.55618

To Cite: Mahmoodpoor A, Farzan N, Shadvar K, Entezari-Maleki T, Hamishehkar H. Procalcitonin May Not Discriminate Between Sepsis and Non-Infective Systemic Inflammatory Response Syndrome (SIRS) in Heterogonous Critically Ill Patients, Arch Clin Infect Dis. 2018 ; 13(1):e55618. doi: 10.5812/archcid.55618.

Copyright © 2018, Archives of Clinical Infectious Diseases. This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License ( which permits copy and redistribute the material just in noncommercial usages, provided the original work is properly cited
1. Background
2. Objectives
3. Patients and Methods
4. Results
5. Discussion
  • 1. Angus DC, Linde-Zwirble WT, Lidicker J, Clermont G, Carcillo J, Pinsky MR. Epidemiology of severe sepsis in the United States: analysis of incidence, outcome, and associated costs of care. Crit Care Med. 2001;29(7):1303-10. [PubMed: 11445675].
  • 2. Rangel-Frausto MS, Pittet D, Costigan M, Hwang T, Davis CS, Wenzel RP. The natural history of the systemic inflammatory response syndrome (SIRS). A prospective study. JAMA. 1995;273(2):117-23. [PubMed: 7799491].
  • 3. Lever A, Mackenzie I. Sepsis: definition, epidemiology, and diagnosis. BMJ. 2007;335(7625):879-83. doi: 10.1136/bmj.39346.495880.AE. [PubMed: 17962288].
  • 4. Ruokonen E, Ilkka L, Niskanen M, Takala J. Procalcitonin and neopterin as indicators of infection in critically ill patients. Acta Anaesthesiol Scand. 2002;46(4):398-404. [PubMed: 11952440].
  • 5. Schneider HG, Lam QT. Procalcitonin for the clinical laboratory: a review. Pathology. 2007;39(4):383-90. doi: 10.1080/00313020701444564. [PubMed: 17676478].
  • 6. Whicher J, Bienvenu J, Monneret G. Procalcitonin as an acute phase marker. Ann Clin Biochem. 2001;38(Pt 5):483-93. doi: 10.1177/000456320103800505. [PubMed: 11587126].
  • 7. Gogos CA, Drosou E, Bassaris HP, Skoutelis A. Pro- versus anti-inflammatory cytokine profile in patients with severe sepsis: a marker for prognosis and future therapeutic options. J Infect Dis. 2000;181(1):176-80. doi: 10.1086/315214. [PubMed: 10608764].
  • 8. Becker KL, Nylen ES, White JC, Muller B, Snider RJ. Clinical review 167: Procalcitonin and the calcitonin gene family of peptides in inflammation, infection, and sepsis: a journey from calcitonin back to its precursors. J Clin Endocrinol Metab. 2004;89(4):1512-25. doi: 10.1210/jc.2002-021444. [PubMed: 15070906].
  • 9. Brunkhorst FM, Wegscheider K, Forycki ZF, Brunkhorst R. Procalcitonin for early diagnosis and differentiation of SIRS, sepsis, severe sepsis, and septic shock. Intensive Care Med. 2000;26 Suppl 2:S148-52. doi: 10.1007/BF02900728. [PubMed: 18470710].
  • 10. Aouifi A, Piriou V, Bastien O, Blanc P, Bouvier H, Evans R, et al. Usefulness of procalcitonin for diagnosis of infection in cardiac surgical patients. Crit Care Med. 2000;28(9):3171-6. [PubMed: 11008977].
  • 11. Selberg O, Hecker H, Martin M, Klos A, Bautsch W, Kohl J. Discrimination of sepsis and systemic inflammatory response syndrome by determination of circulating plasma concentrations of procalcitonin, protein complement 3a, and interleukin-6. Crit Care Med. 2000;28(8):2793-8. [PubMed: 10966252].
  • 12. Suprin E, Camus C, Gacouin A, Le Tulzo Y, Lavoue S, Feuillu A, et al. Procalcitonin: a valuable indicator of infection in a medical ICU? Intensive Care Med. 2000;26(9):1232-8. [PubMed: 11089747].
  • 13. Bell K, Wattie M, Byth K, Silvestrini R, Clark P, Stachowski E, et al. Procalcitonin: a marker of bacteraemia in SIRS. Anaesth Intensive Care. 2003;31(6):629-36. [PubMed: 14719423].
  • 14. Tsalik EL, Jaggers LB, Glickman SW, Langley RJ, van Velkinburgh JC, Park LP, et al. Discriminative value of inflammatory biomarkers for suspected sepsis. J Emerg Med. 2012;43(1):97-106. doi: 10.1016/j.jemermed.2011.05.072. [PubMed: 22056545].
  • 15. Du B, Pan J, Chen D, Li Y. Serum procalcitonin and interleukin-6 levels may help to differentiate systemic inflammatory response of infectious and non-infectious origin. Chinnes Med J. 2003;116(4):538-42.
  • 16. Tang BM, Eslick GD, Craig JC, McLean AS. Accuracy of procalcitonin for sepsis diagnosis in critically ill patients: systematic review and meta-analysis. Lancet Infect Diseas. 2007;7(3):210-7.
  • 17. Amour J, Birenbaum A, Langeron O, Le Manach Y, Bertrand M, Coriat P, et al. Influence of renal dysfunction on the accuracy of procalcitonin for the diagnosis of postoperative infection after vascular surgery. Crit Care Med. 2008;36(4):1147-54. doi: 10.1097/CCM.0b013e3181692966. [PubMed: 18379240].
  • 18. Harbarth S, Holeckova K, Froidevaux C, Pittet D, Ricou B, Grau GE, et al. Diagnostic value of procalcitonin, interleukin-6, and interleukin-8 in critically ill patients admitted with suspected sepsis. Am J Respir Crit Care Med. 2001;164(3):396-402. doi: 10.1164/ajrccm.164.3.2009052. [PubMed: 11500339].
  • 19. Ugarte H, Silva E, Mercan D, De Mendonca A, Vincent JL. Procalcitonin used as a marker of infection in the intensive care unit. Crit Care Med. 1999;27(3):498-504. [PubMed: 10199528].
  • 20. Cheval C, Timsit JF, Garrouste-Orgeas M, Assicot M, De Jonghe B, Misset B, et al. Procalcitonin (PCT) is useful in predicting the bacterial origin of an acute circulatory failure in critically ill patients. Intensive Care Med. 2000;26 Suppl 2:S153-8. doi: 10.1007/BF02900729. [PubMed: 18470711].
  • 21. Meisner M, Tschaikowsky K, Palmaers T, Schmidt J. Comparison of procalcitonin (PCT) and C-reactive protein (CRP) plasma concentrations at different SOFA scores during the course of sepsis and MODS. Crit Care. 1999;3(1):45-50. doi: 10.1186/cc306. [PubMed: 11056723].
  • 22. Karlsson S, Heikkinen M, Pettila V, Alila S, Vaisanen S, Pulkki K, et al. Predictive value of procalcitonin decrease in patients with severe sepsis: a prospective observational study. Crit Care. 2010;14(6):R205. doi: 10.1186/cc9327. [PubMed: 21078153].
  • 23. Schneider CP, Yilmaz Y, Kleespies A, Jauch KW, Hartl WH. Accuracy of procalcitonin for outcome prediction in unselected postoperative critically ill patients. Shock. 2009;31(6):568-73. doi: 10.1097/SHK.0b013e318193cb52. [PubMed: 19008783].

Featured Image:

Creative Commons License Except where otherwise noted, this work is licensed under Creative Commons Attribution Non Commercial 4.0 International License .

Search Relations:



Create Citiation Alert
via Google Reader

Readers' Comments