PCT indicator of bacterial and fungal infections

In the last 7 years, numerous studies have shown a correlation between PCT increase and bacterial or fungal infections. As PCT reacts very specifically to nonviral infections, it can be used to differentiate these from non-specific inflammation.

Interestingly enough, PCT correlates with the severity and activity of the infection. Assicot et al. [1] describe values up to 53 ng/ml in patients with severe systemic bacterial/fungal infections. Local bacterial/fungal infections resulted only in a moderate, or no, rise in PCT (0.3-1.5 ng/ml). In the case of an encapsulated process or infections limited to one organ - such as pneumonia or peritonitis - PCT levels were only slightly increased (1-3 ng/ml) [1]. The authors' own studies with heart, lung or liver transplant patients have confirmed these results (Tables 48.1 and 48.2). In liver transplant patients, PCT was found to reach slightly higher values (local infection: 2.2 ng/ml; systemic infection: 11.9 ng/ml) than in patients after heart or lung transplantation (local infection: 0.6 ng/ml; systemic infection: 10.5 ng/ml). PCT not only reacts sensitively to severe bacterial infections but also to those infections of parasites and fungi. As a consequence of the immunosuppressive therapy, transplanted patients often suffer from generalized fungal and opportunistic infections. In the authors' study, the maximal PCT values of 82 ng/ml were recorded in patients with Aspergillus sepsis. In the case of localized fungal infection - like candidiasis of the oral mucosa - PCT remained within normal limits.

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