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Published on: September 28, 2016

[Diagnosis of nosocomial pneumonia: conventional and new indicators]

Pantelie Nicolcescu1, Florinel Bădulescu, Michael Schenker

  • 1Disciplina ATI, UMF Craiova.

Pneumologia (Bucharest, Romania)
|October 31, 2006
PubMed

Insights

Diagnosing nosocomial pneumonia (NP) is challenging. Procalcitonin (PCT) shows promise as a selective marker for bacterial inflammation, potentially aiding in NP diagnosis when values exceed 0.5 ng/mL.

Area of Science:

  • Infectious Diseases
  • Critical Care Medicine
  • Biomarkers

Background:

  • Nosocomial pneumonia (NP) diagnosis is complex, with current methods like clinical criteria and cultures often lacking specificity or sensitivity.
  • Traditional indicators such as fever and leukocytosis are inconsistent in NP diagnosis.
  • While Interleukin-1 (IL-1) and Tumor Necrosis Factor (TNF) have been studied, their direct role in NP incidence and outcome remains unclear.

Purpose of the Study:

  • To evaluate the diagnostic utility of Procalcitonin (PCT) as a biomarker for nosocomial pneumonia.
  • To differentiate PCT's role in bacterial inflammation compared to other inflammatory markers.
  • To establish a threshold for PCT indicative of acute infection in the context of NP.

Main Methods:

  • Review of existing literature on diagnostic markers for nosocomial pneumonia.
  • Analysis of studies investigating inflammatory cytokines like IL-1 and TNF in NP.
  • Examination of Procalcitonin (PCT) induction by bacterial inflammation and its presence in sepsis and MODS.

Main Results:

  • Clinical criteria and cultures for NP lack specificity, especially in ventilated patients.
  • Blood and pleural fluid cultures exhibit poor sensitivity for NP detection.
  • Procalcitonin (PCT) is selectively induced by bacterial inflammation and is elevated in sepsis and MODS.

Conclusions:

  • Procalcitonin (PCT) is a valuable marker for bacterial inflammation, distinguishing it from other inflammatory responses.
  • PCT levels above 0.5 ng/mL consistently indicate acute infection or septic inflammation.
  • PCT holds potential as a reliable diagnostic aid for nosocomial pneumonia.

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