tailieunhanh - Báo cáo y học: " Procalcitonin reflects bacteremia and bacterial load in urosepsis syndrome: a prospective observational study"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về ngành y học đề tài: Procalcitonin reflects bacteremia and bacterial load in urosepsis syndrome: a prospective observational study. | van Nieuwkoop et al. Critical Care 2010 14 R206 http content 14 6 R206 c CRITICAL CARE RESEARCH Open Access Procalcitonin reflects bacteremia and bacterial load in urosepsis syndrome a prospective observational study 1 1 3 4 Cees van Nieuwkoop 1 Tobias N Bonten 1 Jan W vant Wout 1 Ed J Kuijper Geert H Groeneveld 1 K lartin I Rofl Oi 5 ToH ICr ictoi 6 NanLo A 2i f ol-l mi lie7 Klafhalio l l riolfme8 I 12 me Ahlii9 Rliarno KA s I ữ ton4 Manin J Becker 1 led Kosiei 1 G Hanke vvattel Louis 1 Nathalie M Denos 1 Hans C Ablij 1 Eliane Ms Leyten 1 Jaap T van Dissel1 Abstract Introduction Guidelines recommend that two blood cultures be performed in patients with febrile urinary tract infection UTIX to detect bacteremia and help diagnose urosepsis. The usefulness and cost-effectiveness on this practice have been criticized. This study aimed to evaluate clinical characteristics and the biomarker procalcitonin PCT as an aid in predicting bacteremia. Methods A prospective observational multicenter cohort study included consecutive adults with febrile UTI in 35 primary care units and 8 emergency departments of 7 regional hospitals. Clinical and microbiological data were collected and PCT and time to positivity TTP of blood culture were measured. Results Of 581 evaluable patients1 136 23 had bacteremia. The median age was 66 years interquartile range 46 to 78 years and 219 38 were male. We evaluated three different models a clinical model including seven bedside characteristics1 the clinical model plus PCT1 and a PCT only model. The diagnostic abilities of these models as reflected by area under the curve of the receiver operating characteristic were 95 confidence interval CI to 1 95 CI to and 95 CI to respectively. Calculating corresponding sensitivity and specificity for the presence of bacteremia after each step of adding a significant predictor in the model yielded that the PCT qg l only model had the best .