The diagnostic and antibiotics reference values of procalcitonin for intracranial infection after craniotomy.

The diagnostic and antibiotics reference values of procalcitonin for intracranial infection after craniotomy.

World Neurosurg. 2018 Dec 11;:

Authors: Zhu L, Dong L, Li Y, Zhang H, Wang X, Liu X, Teng Z, Xia B, Zhang P

Abstract
OBJECTIVE: To evaluate the values of CSF and serum PCT for the diagnosis of intracranial infection after craniotomy and the relationship between them, and explore the PCT value about the application in the clinical antibiotics guidance.
METHODS: Reviewing the incidence of intracranial infection in 21 craniotomy patients from the Subei People Hospital of Northern Jiangsu Province. CSF samples and venous blood were collected for the analysis. Diagnostic parameters were calculated via the ROC curves, and inflammatory indicators were analyzed before and after the application of antibiotics in the infection group.32 non-infection patients were recruited for the same measurements as control.
RESULTS: CSF and serum PCT levels in the infection group were higher than that in non-infection group (P values<0.05), and the diagnostic efficiency of CSF PCT(AUC=0.86, DOR=41.40) was superior than serum PCT (AUC=0.66, DOR=3.40). The diagnostic efficiency was more powerful when serial test was used (specificity=0.99, PLR=37.10, DOR=54.45). All the inflammatory indicators decreased after the application of antibiotics except the CSF protein (P=0.129), and no obvious correlation was seen between CSF and serum PCT. Dynamic change of PCT can be used as a reference for adjusting antibiotics. CSF PCT can also be used as an indicator to identify intracranial gram-negative bacteria infection.
CONCLUSIONS: CSF PCT is a good marker for intracranial infection. It could be used as a method to help confirm intracranial infection and provide guidance for the clinical antibiotics when combined with serum PCT.

PMID: 30550873 [PubMed - as supplied by publisher]

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