High Serum Procalcitonin Concentrations in Patients With Hemorrhagic Fever With Renal Syndrome Caused by Hantaan Virus

Overview

Journal Front Cell Infect Microbiol

Specialties Cell Biology
Infectious Diseases
Microbiology

Date 2018 Jun 6

PMID 29868489

Citations 10

Authors

Xiude Fan

Huan Deng

Jiao Sang

Na Li

Xiaoge Zhang

Qunying Han

Zhengwen Liu

Affiliations

Soon will be listed here.

Abstract

This study analyzed the significance of procalcitonin (PCT) in patients with hemorrhagic fever with renal syndrome (HFRS) caused by Hantaan virus. The demographics and clinical and laboratory data including PCT at hospital admission in 146 adults with HFRS were retrospectively analyzed. PCT level was significantly higher in severe patients ( = 72) than in mild patients ( = 74, < 0.001) and independently associated with disease severity (OR 2.544, 95% CI 1.330-4.868, = 0.005). PCT had an area under the receiver operating characteristic curve (AUC) value of 0.738 (95% CI 0.657-0.820, < 0.001) for predicting severity. PCT level was significantly increased in patients with bacterial infection ( = 87) compared with those without (n = 59, = 0.037) and associated with bacterial infection (OR 1.685, 95% CI 1.026-2.768, = 0.039). The AUC value of PCT for predicting bacterial infection was 0.618 (95% CI 0.524-0.711, = 0.016). PCT level was significantly elevated in non-survivors ( = 13) compared with survivors ( = 133, < 0.001) and independently associated with mortality (OR 1.075, 95% CI 1.003-1.152, = 0.041). The AUC value of PCT for predicting mortality was 0.819 (95% CI 0.724-0.914, < 0.001). PCT concentrations at admission would be predictive of disease severity, secondary bacterial infection and mortality in patients with HFRS caused by Hantaan virus.

Citing Articles

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References

Schmaljohn C, Hjelle B . Hantaviruses: a global disease problem. Emerg Infect Dis. 1997; 3(2):95-104. PMC: 2627612. DOI: 10.3201/eid0302.970202. View

Amour J, Birenbaum A, Langeron O, Le Manach Y, Bertrand M, Coriat P . Influence of renal dysfunction on the accuracy of procalcitonin for the diagnosis of postoperative infection after vascular surgery. Crit Care Med. 2008; 36(4):1147-54. DOI: 10.1097/CCM.0b013e3181692966. View

Avsic-Zupanc T, Saksida A, Korva M . Hantavirus infections. Clin Microbiol Infect. 2014; 21S:e6-e16. DOI: 10.1111/1469-0691.12291. View

Zhang Y, Zou Y, Fu Z, Plyusnin A . Hantavirus infections in humans and animals, China. Emerg Infect Dis. 2010; 16(8):1195-203. PMC: 3298307. DOI: 10.3201/eid1608.090470. View

Dandona P, Nix D, Wilson M, Aljada A, Love J, Assicot M . Procalcitonin increase after endotoxin injection in normal subjects. J Clin Endocrinol Metab. 1994; 79(6):1605-8. DOI: 10.1210/jcem.79.6.7989463. View

Nishikura T . Procalcitonin (PCT) production in a thyroidectomized patient. Intensive Care Med. 1999; 25(9):1031. DOI: 10.1007/s001340051006. View

Hoenigl M, Raggam R, Wagner J, Prueller F, Grisold A, Leitner E . Procalcitonin fails to predict bacteremia in SIRS patients: a cohort study. Int J Clin Pract. 2014; 68(10):1278-81. DOI: 10.1111/ijcp.12474. View

Peters C, Simpson G, Levy H . Spectrum of hantavirus infection: hemorrhagic fever with renal syndrome and hantavirus pulmonary syndrome. Annu Rev Med. 1999; 50:531-45. DOI: 10.1146/annurev.med.50.1.531. View

Jereb M, Lunacek N, Kotar T, Saksida A, Petrovec M, Avsic-Zupanc T . Procalcitonin in hantavirus infections. Scand J Clin Lab Invest. 2011; 71(4):287-91. DOI: 10.3109/00365513.2011.560675. View

10.

Arora R, Campbell J, Simon G, Sahni N . Does serum procalcitonin aid in the diagnosis of bloodstream infection regardless of whether patients exhibit the systemic inflammatory response syndrome?. Infection. 2016; 45(3):291-298. DOI: 10.1007/s15010-016-0965-0. View

11.

Jeeha R, Skinner D, de Vasconcellos K, Magula N . Serum procalcitonin levels predict acute kidney injury in critically ill patients. Nephrology (Carlton). 2017; 23(12):1090-1095. DOI: 10.1111/nep.13174. View

12.

Anand D, Das S, Bhargava S, Srivastava L, Garg A, Tyagi N . Procalcitonin as a rapid diagnostic biomarker to differentiate between culture-negative bacterial sepsis and systemic inflammatory response syndrome: a prospective, observational, cohort study. J Crit Care. 2014; 30(1):218.e7-12. DOI: 10.1016/j.jcrc.2014.08.017. View

13.

Linderholm M, Ahlm C, Settergren B, Waage A, Tarnvik A . Elevated plasma levels of tumor necrosis factor (TNF)-alpha, soluble TNF receptors, interleukin (IL)-6, and IL-10 in patients with hemorrhagic fever with renal syndrome. J Infect Dis. 1996; 173(1):38-43. DOI: 10.1093/infdis/173.1.38. View

14.

Zhao R, Zhu B, Guan D, Li R, Zhang G, Wu X . Diagnostic aspects for epidemic hemorrhagic fever in legal medical autopsy: report of 2 cases and review. Leg Med (Tokyo). 2009; 11 Suppl 1:S541-3. DOI: 10.1016/j.legalmed.2009.01.030. View

15.

Ma C, Wang Z, Li S, Xing Y, Wu R, Wei J . Analysis of an outbreak of hemorrhagic fever with renal syndrome in college students in Xi'an, China. Viruses. 2014; 6(2):507-15. PMC: 3939468. DOI: 10.3390/v6020507. View

16.

Ermonval M, Baychelier F, Tordo N . What Do We Know about How Hantaviruses Interact with Their Different Hosts?. Viruses. 2016; 8(8). PMC: 4997585. DOI: 10.3390/v8080223. View

17.

Wanner G, Keel M, Steckholzer U, Beier W, Stocker R, Ertel W . Relationship between procalcitonin plasma levels and severity of injury, sepsis, organ failure, and mortality in injured patients. Crit Care Med. 2000; 28(4):950-7. DOI: 10.1097/00003246-200004000-00007. View

18.

Vaheri A, Strandin T, Hepojoki J, Sironen T, Henttonen H, Makela S . Uncovering the mysteries of hantavirus infections. Nat Rev Microbiol. 2013; 11(8):539-50. DOI: 10.1038/nrmicro3066. View

19.

Nishikawa H, Shirano M, Kasamatsu Y, Morimura A, Iida K, Kishi T . Comparison between procalcitonin and C-reactive protein in predicting bacteremias and confounding factors: a case-control study. Clin Chem Lab Med. 2016; 55(7):1043-1052. DOI: 10.1515/cclm-2016-0705. View

20.

Kim Y, Lee S, Kim C, Heo S, Choi C, Kim J . Clinical and laboratory predictors of oliguric renal failure in haemorrhagic fever with renal syndrome caused by Hantaan virus. J Infect. 2006; 54(4):381-6. DOI: 10.1016/j.jinf.2006.07.006. View