Procalcitonin (PCT) is gaining currency as an identifier of life-threatening sepsis infection. To learn about its clinical uses in managing sepsis and bacterial infection, sign up for AACC’s webinar, Procalcitonin and other Biomarkers for the Management of Infections and Sepsis, on Dec. 14.
As a clinical pathologist and microbiologist, Stefan Riedel, MD, PhD, D(ABMM), FCAP, the webinar’s presenter, has had a longstanding interest in sepsis and its clinical diagnosis and management, which remains a challenge. Prompt recognition and diagnosis is critical for implementing appropriate interventions, yet clinical signs and symptoms such as systemic inflammatory response syndrome (SIRS) criteria are notoriously unreliable for rapidly identifying at-risk patients, Riedel, an associate professor of pathology at Harvard Medical School and associate medical director at Beth Israel Deaconess Medical Center’s clinical microbiology laboratories in Boston, told CLN Stat. “Traditionally, blood cultures have been considered the ‘gold-standard’ for the laboratory diagnosis of bacterial sepsis. However, studies have shown that blood cultures may be negative (i.e. have no growth) in up to 40% of all patients with sepsis,” he explained.
Riedel first became interested in PCT as a potential biomarker to aid in diagnosing sepsis after completing his fellowship training. He conducted several studies at at Johns Hopkins Bayview Medical Center in Baltimore and continued to expand this interest through collaborations with colleagues in other medical specialties. In his current position, Riedel has focused his sepsis research on biomarkers such as PCT, blood cultures, and other rapid methods to identify organisms.
Recent multicenter studies conducted in the United States and Europe have proven PCT’s utility in diagnosing sepsis and other infections, such as bacterial pneumonia. “In addition, these studies demonstrated the utility of PCT (serial PCT measurements) for the management of sepsis through antimicrobial stewardship programs,” Riedel said. Examples of these studies include the Monitoring Sepsis (MOSES) Study published in the journal Critical Care Medicine, and David N. Gilbert’s MD detailed review of the utility of PCT for diagnosis and management of sepsis, including evidence from various recent meta-analyses, in the journal Infectious Disease Clinics North America.
Clinical laboratories play a pivotal role in diagnosing and managing sepsis, Riedel emphasized. “While early recognition is critically important, the timely results of laboratory tests will provide critically important information to clinicians to confirm their clinical diagnosis. Moreover, rapid methods for detecting and identifying the pathogen (e.g. blood cultures and organism ID systems) are necessary to further guide appropriate selection of antibiotic therapy,” he said. Biomarkers such as PCT can further guide prognosis of sepsis, assessment of mortality risk, and duration of antibiotic therapy, including guidance for antimicrobial stewardship programs, Riedel added.
Right now, no specific point-of-care (POC) tests are available to diagnose sepsis rapidly. Advances have been made in rapid organism identification, but these technologies are laboratory-based, and include rapid identification methods from positive blood cultures (e.g. Biofire blood culture ID panel by Biofire Diagnostics), or organism detection directly from blood (e.g. T2-Candida panel by Biosystems). “Newer POC tests for biomarkers could potentially provide a faster turnaround time for results and therefore aid in recognizing and diagnosing sepsis,” Riedel suggested.
This webinar is intended for laboratory professionals, physicians and pathologists, hospital administrators, and other professionals working in the clinical laboratory testing industry. Sign up for the webinar to earn 1 ACCENT credit.