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postgraduate thesis: Retrospective observational study of procalcitonin in oriental intensive care unit patients with suspected nosocomial infection

TitleRetrospective observational study of procalcitonin in oriental intensive care unit patients with suspected nosocomial infection
Authors
Issue Date2012
PublisherThe University of Hong Kong (Pokfulam, Hong Kong)
Abstract
Introduction Procalcitonin (PCT) was one of the recently described bio-markers in rapid diagnosis of severe sepsis. However, the reported sensitivity and specificity of PCT varied among studies and the results of Oriental population was scanty. The objective of this study was to determine the usefulness of serum procalcitonin level of the Oriental intensive care unit patients in diagnosis of nosocomial infection Materials and methods This was a retrospective observational single-arm cohort review study, which was conducted in a mixed medico-surgical Intensive Care Unit (ICU) of a regional public hospital (United Christian Hospital) in Hong Kong SAR, China between 1st January, 2009 and 30th June, 2009, to determine the blood procalcitonin level at early diagnosis (and differentiation) in patients with SIRS and hospital-acquired sepsis, in comparison with other parameters and markers. Results Total 33 patients were recruited in this study. The mean age was 61 years old with nearly 1:1 male to female ratio. The commonest offending organism and involved system in nosocomial sepsis in ICU in this cohort was Gram negative micro-organisms and respiratory tract respectively. The positive likelihood ratios (LR) of nosocomial sepsis in ICU were 4.242 (P = 0.032), 5.711 (P = 0.016) and 8.550 (P = 0.023) with PCT > 0.1 ng/ml, PCT > 0.5 ng/ml and PCT > 5 ng/ml respectively. Good discriminative power of PCT as a test in diagnosing severe sepsis and septicaemia in ICU (AUC of ROC-curve 0.78-0.90) was also demonstrated. In patients with severe sepsis, at serum PCT cut-off point 1.23 ng/ml, the sensitivity and specificity was 89.5% and 71.4% respectively. Conclusion Our study demonstrated the consistent usefulness of PCT, including in diagnosis of severe nosocomial sepsis and septicaemia in oriental ICU patients.
DescriptionThesis (P. Dip.)--University of Hong Kong, 2012.
DegreePostgraduate Diploma in Infectious Diseases
SubjectNosocomial infections -- Diagnosis.
Calcitonin -- Diagnostic use.
Dept/ProgramMicrobiology
Persistent Identifierhttp://hdl.handle.net/10722/173735

 

DC FieldValueLanguage
dc.contributor.authorChan, Chin-pang, Ianen_HK
dc.contributor.author陳展鵬zh_HK
dc.date.accessioned2012-11-01T02:50:31Z-
dc.date.available2012-11-01T02:50:31Z-
dc.date.issued2012en_US
dc.identifier.urihttp://hdl.handle.net/10722/173735-
dc.descriptionThesis (P. Dip.)--University of Hong Kong, 2012.en_US
dc.description"This work is submitted to Faculty of Medicine of the University of Hong Kong in partial fulfillment of the requirements for the Postgraduate Diploma in Infectious Diseases, PDipID (HK)."en_US
dc.descriptionIncludes bibliographical references (p. 33-38).en_US
dc.description.abstractIntroduction Procalcitonin (PCT) was one of the recently described bio-markers in rapid diagnosis of severe sepsis. However, the reported sensitivity and specificity of PCT varied among studies and the results of Oriental population was scanty. The objective of this study was to determine the usefulness of serum procalcitonin level of the Oriental intensive care unit patients in diagnosis of nosocomial infection Materials and methods This was a retrospective observational single-arm cohort review study, which was conducted in a mixed medico-surgical Intensive Care Unit (ICU) of a regional public hospital (United Christian Hospital) in Hong Kong SAR, China between 1st January, 2009 and 30th June, 2009, to determine the blood procalcitonin level at early diagnosis (and differentiation) in patients with SIRS and hospital-acquired sepsis, in comparison with other parameters and markers. Results Total 33 patients were recruited in this study. The mean age was 61 years old with nearly 1:1 male to female ratio. The commonest offending organism and involved system in nosocomial sepsis in ICU in this cohort was Gram negative micro-organisms and respiratory tract respectively. The positive likelihood ratios (LR) of nosocomial sepsis in ICU were 4.242 (P = 0.032), 5.711 (P = 0.016) and 8.550 (P = 0.023) with PCT > 0.1 ng/ml, PCT > 0.5 ng/ml and PCT > 5 ng/ml respectively. Good discriminative power of PCT as a test in diagnosing severe sepsis and septicaemia in ICU (AUC of ROC-curve 0.78-0.90) was also demonstrated. In patients with severe sepsis, at serum PCT cut-off point 1.23 ng/ml, the sensitivity and specificity was 89.5% and 71.4% respectively. Conclusion Our study demonstrated the consistent usefulness of PCT, including in diagnosis of severe nosocomial sepsis and septicaemia in oriental ICU patients.en_US
dc.languageengen_US
dc.publisherThe University of Hong Kong (Pokfulam, Hong Kong)en_US
dc.rightsCreative Commons: Attribution 3.0 Hong Kong Licenseen_US
dc.rightsThe author retains all proprietary rights, (such as patent rights) and the right to use in future works.en_US
dc.subject.lcshNosocomial infections -- Diagnosis.en_US
dc.subject.lcshCalcitonin -- Diagnostic use.en_US
dc.titleRetrospective observational study of procalcitonin in oriental intensive care unit patients with suspected nosocomial infectionen_HK
dc.typePG_Thesisen_US
dc.identifier.hkulb4832035en_US
dc.description.thesisnamePostgraduate Diploma in Infectious Diseasesen_US
dc.description.thesislevelPostgraduate diplomaen_US
dc.description.thesisdisciplineMicrobiologyen_US
dc.description.naturepublished_or_final_versionen_US

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