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Utility of Procalcitonin as a Biomarker for Sepsis in Children
Kevin J Downes1,2,3,4, Julie C Fitzgerald5,6,3,7, Scott L Weiss5,6,7
1Department of Pediatrics, The University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA downeskj@email.chop.edu.
Insights
Procalcitonin is a key sepsis biomarker that aids in early detection, risk assessment, and antibiotic guidance, particularly in pediatric cases. This review explores its clinical utility and limitations in managing sepsis.
Area of Science:
- Critical care medicine
- Pediatric infectious diseases
- Biomarker research
Background:
- Sepsis is a life-threatening condition with high mortality, necessitating early diagnosis and treatment.
- Current diagnostic methods for sepsis have limitations in sensitivity and speed.
- Biomarkers are crucial for distinguishing bacterial infections and guiding clinical decisions.
Purpose of the Study:
- To review the role of procalcitonin as a sepsis biomarker.
- To discuss its application in early identification, risk stratification, and antibiotic stewardship.
- To focus on pediatric sepsis while acknowledging adult findings.
Main Methods:
- Literature review of procalcitonin in sepsis management.
- Analysis of studies focusing on adult and pediatric populations.
- Discussion of clinical utility and measurement challenges.
Main Results:
- Procalcitonin is a widely used biomarker for sepsis.
- It shows potential in identifying bacterial infections and guiding antimicrobial therapy.
- Its application in pediatric sepsis is a key focus, with specific challenges noted.
Conclusions:
- Procalcitonin plays a significant role in sepsis management, aiding diagnosis and treatment decisions.
- Further research and understanding of its limitations are essential for optimal use, especially in children.
- Effective use of procalcitonin can improve patient outcomes and antibiotic stewardship.
Abstract:
Sepsis is a complex process defined as life-threatening organ dysfunction caused by a dysregulated host response to infection. It is associated with significant morbidity and mortality rates in both adults and children, and emphasis has been placed on its early recognition and prompt provision of antimicrobials. Owing to limitations of current diagnostic tests (i.e., poor sensitivity and delayed results), significant research has been conducted to identify sepsis biomarkers. Ideally, a biomarker could reliably and rapidly distinguish bacterial infection from other, noninfectious causes of systemic inflammatory illness. In doing so, a sepsis biomarker could be used for earlier identification of sepsis, risk stratification/prognostication, and/or guidance of antibiotic decision-making. In this minireview, we review one of the most common clinically used sepsis biomarkers, procalcitonin, and its roles in sepsis management in these three areas. We highlight key findings in the adult literature but focus the bulk of this review on pediatric sepsis. The challenges and limitations of procalcitonin measurement in sepsis are also discussed.
