Trial reportCritical care (London, England)2018
Influence of pathogen and focus of infection on procalcitonin values in sepsis patients with bacteremia or candidemia.
Trial report in Critical care (London, England), 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01187134 (Medical Education for Sepsis Source Control and Antibiotics), which is not on this map. Cited by 61 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Medical Education for Sepsis Source Control and Antibiotics
Who cites it
61 citing papers in PubMed, 2 syntheses or guidelines pooled it, 129 citations in OpenAlex.
- Diagnostic Accuracy of Procalcitonin Compared to C-Reactive Protein and Interleukin 6 in Recognizing Gram-Negative Bloodstream Infection: A Meta-Analytic Study.Disease markers · 2020Pooled it
- Procalcitonin levels in candidemia versus bacteremia: a systematic review.Critical care (London, England) · 2019Pooled it
- Influence of pathogen and focus of infection on procalcitonin values in sepsis patients with bacteremia or candidemia.Critical care (London, England) · 2018Trial
- Machine learning model based on clinical and imaging features for predicting fungal infections in children with leukemia.BMC pediatrics · 2026Article
- Association of procalcitonin levels with multidrug-resistant bloodstream infections: a prospective cohort study.BMC infectious diseases · 2026Article
- Procalcitonin kinetics in Gram-negative bloodstream infections and its value for infection management.Journal of medical microbiology · 2026Article
- Procalcitonin Levels in ICU Patients with SARS-CoV-2-Associated Viral Sepsis.Journal of clinical medicine · 2026Article
- Article
- High procalcitonin in Gram-negative urosepsis: indicator of immune modulation rather than poor outcome.World journal of urology · 2026Article
- Diagnostic utility of procalcitonin in determining Gram-negative and Gram-positive bacterial bloodstream infections: a single-centre study from South India.Frontiers in medicine · 2026Article
- Fatal Panton-Valentine leukocidin-positive MSSA toxic shock syndrome: a call for rapid virulence detection and optimized antimicrobial therapy.Frontiers in cellular and infection microbiology · 2026Article
- Management of mould pneumonia in resource-limited settings in Asia: A Delphi-based consensus statement by the Asia Fungal Working Group.Medical mycology · 2025Article
- A novel nomogram for the early identification of coinfections in elderly patients with coronavirus disease 2019.Virology journal · 2025Observational
- A Knowledge-Enhanced Platform (MetaSepsisKnowHub) for Retrieval Augmented Generation-Based Sepsis Heterogeneity and Personalized Management: Development Study.Journal of medical Internet research · 2025Article
- Use of procalcitonin in therapeutic decisions in the pediatric intensive care unit.Annals of intensive care · 2025Review
- Diagnostic value of contrast-enhanced ultrasound combined with serum procalcitonin in tuberculous lymph nodes and metastatic lymph nodes.Clinics (Sao Paulo, Brazil) · 2025Article
- Persistently high plasma procalcitonin levels despite successful treatment of tuberculous pleuritis and tuberculous lymphadenitis patients.Scientific reports · 2024Article
- Changes of Procalcitonin Kinetics According to Renal Clearance in Critically Ill Patients with Primary Gram-Negative Bloodstream Infections.Infectious diseases & clinical microbiology · 2024Article
- Article
- The Diagnostic Accuracy of Procalcitonin and Its Combination with Other Biomarkers for Candidemia in Critically Ill Patients.Journal of clinical medicine · 2024Article
1 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
7 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundThis study aimed to evaluate the accuracy of procalcitonin (PCT) serum concentrations to diagnose Gram-negative bacteremia and the association of PCT serum concentrations with more specific pathogens and the focus of infection.
methodsSecondary analysis of the prospectively collected patient-level dataset from a cluster randomized quality improvement trial was performed. The trial included sepsis patients with organ dysfunction treated in the participating intensive care units from 2011 to 2015. Test performance for the prediction of Gram-negative bacteremia was assessed by receiver operating curve analysis. Independent effects of specific pathogen groups and foci of infection on PCT concentrations were assessed by linear logistic regression models.
resultsBlood cultures (BC) and PCT concentrations had been taken in 4858 of 6561 documented patients. PCT was significantly higher in Gram-negative bacteremia compared to Gram-positive bacteremia or candidemia (p < 0.001). The area under the curve was 0.72 (95% confidence interval 0.71-0.74) for the prediction of Gram-negative bacteremia compared to all other blood culture results including negative blood cultures. The optimized cutoff value was 10 ng/ml (sensitivity 69%, specificity 35%). PCT differed significantly between specific groups of pathogens (p < 0.001) with highest concentrations in Escherichia coli, Streptococcus species and other Enterobacteriaceae. PCT was highest in urogenital followed by abdominal infection and lowest in respiratory infection (p < 0.001). In a linear regression model, Streptococci, E. coli and other Enterobacteriaceae detected from BC were associated with three times higher PCT values. Urogenital or abdominal foci of infection were associated with twofold increased PCT values independent of the pathogen.
conclusionsSerum PCT concentrations are higher in patients with Gram-negative bacteremia than in patients with Gram-positive bacteremia or candidemia. However, the discriminatory power of this difference is too low to guide therapeutic decisions. Variations in PCT serum concentrations are not determined solely by Gram-negative or Gram-positive bacteria but are also affected by distinct groups of pathogens and different foci of infection.
trial registrationClinicalTrials.gov, NCT01187134 . Registered on 23 August 2010.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.