• 1. Clinical Laboratory, the Fifth People's Hospital of Chengdu, Chengdu, Sichuan 611130, P. R. China;
  • 2. Intensive Care Unit, the Fifth People's Hospital of Chengdu, Chengdu, Sichuan 611130, P. R. China;
  • 3. Department of Respiratory Medicine, the Fifth People's Hospital of Chengdu, Chengdu, Sichuan 611130, P. R. China;
  • 4. Department of Rheumatism and Hematology;the Fifth People's Hospital of Chengdu, Chengdu, Sichuan 611130, P. R. China;
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Objective To assess the diagnostic value of procalcitonin (PCT) and/or (1,3)-β-D-glucan test (serum BG assay) for pulmonary infection. Methods We collected 1 027 cases randomly from January 24th, 2013 to January 25th, 2014. First, we accumulated isolates from these cases in sputum culture. Second, we compared PCT and sputum culture, serum BG assay and sputum culture, CT and serum BG assay. Then we accumulated these PCT and studied its distribution when PCT>0.5 ng/mL and when their sputum culture was positive. We also accumulated these serum BG assay results and studied its distribution when their sputum culture was positive for aspergillus or suggested aspergillus infection by CT. Finally, we estimated the significance of the combined use of PCT and serum BG assay for diagnosis of pulmonary infection. Results In these cases, pathogens were mainly multiple drug-resistant organisms and tuberculosis, or fungi. We found that PCT value presented a skew distribution in disease with a median of 2.06 ng/mL. Single PCT or combination of PCT and sputum culture had similar distribution. With sputum culture as the reference, PCT sensitivity was 41.2% and specificity was 66.4%. In the cases of sputum culture aspergillus and CT suggestion of aspergillus infection, serum BG assay value distribution was similar, and the median and average were both lower than cut-off. With sputum culture as the reference, serum BG assay sensitivity was 13.2% and specificity was 84.1%. In the 12 cases with positive sputum culture and serum BG assay, serum BG assay median was 112.91 pg/mL. With CT as the reference, serum BG assay sensitivity was 21.4% and specificity was 75.0%. In the 17 cases with the same sputum and blood culture result with the PCT median of 7.51 pg/mL, there were three cases whose PCT value was under the cutoff and three cases whose serum BG assay value was above the cutoff. In evaluation of the combination of PCT and serum BG assay, the analysis had yielded that we could neither diagnose pulmonary infection with both being positive, nor exclude the disease with both being negative. Conclusion With regard to PCT and serum BG assay, we should be prudent and wise and use it after reasonable evaluation and entire analysis.

Citation: LUXian-lei, LUOYu-peng, CAOZhi-yue, YANGJin, ZHUWen-lei, WANGPing, LIUBo, ZHUYong. Assessment of Diagnostic Value of Procalcitonin and/or (1,3)-β-D-glucan Test for Pulmonary Infection. West China Medical Journal, 2015, 30(2): 222-226. doi: 10.7507/1002-0179.20150069 Copy

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