[Investigation of the procalcitonin and microbiology test and antibiotics situation from our hospital].

Kotaro Fujii, Kuniko Yamada, Junko Sano, Dai Mashima, Hiroko Takeda
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Abstract

Procalcitonin (PCT) was first described as a sepsis-associated protein in 1993. PCT is increased in the blood at the time of infection by bacteria. Therefore, it is used as an auxiliary indicator of sepsis diagnosis. In addition, PCT is reduced quickly by antibiotics. And use as a stop or change marker is also expected. We have investigated the antimicrobial use and microbial testing of measurement patient and PCT running performance. Number of requests was 3,387 cases (inpatient 2,649 and outpatient 742 cases) for one year. It was subject to the 820 cases that had inspection request to July to October 2012. In 820 cases, 57 cases had exhibited a PCT >0.5 ng/ml and diagnosed with infectious diseases. In 57 cases, 44 cases (77%) were performed microbiology and blood culture. And only blood culture performed in 8 (14%), blood culture and microbiology is not performed for 5 cases (9%), In 21 (40%) cases of 52 cases performed the blood culture shown positive. Detecting bacteria accounted for more than half in 17 cases of Gram-negative bacilli. Also, it had exhibited a systemic inflammatory response syndrome (SIRS) in 18 cases. Antibiotics have been used in all cases regardless of implementation of the microbiology test. If sepsis is suspected, it is necessary for diagnosis is done correctly and quickly. Therefore, PCT has been suggested high usefulness by examining in the hospital. It is required that the reference identification and drug susceptibility results of the pathogenic bacterium combination of microbiology test and the PCT. We considered useful to PCT monitoring that as an indicator of antimicrobial agents change or shorten of antibiotic use period. Future, proactive use of clinical practice is expected.

[我院降钙素原、微生物学检测及抗生素使用情况调查]。
降钙素原(PCT)在1993年首次被描述为败血症相关蛋白。PCT在细菌感染时在血液中增加。因此,它被用作脓毒症诊断的辅助指标。此外,抗生素会迅速降低PCT。也可以用作停止或改变标记。我们调查了抗菌药物的使用和微生物测试的测量患者和PCT运行性能。全年就诊3387例(住院2649例,门诊742例)。截止到2012年7 ~ 10月,被要求进行检查的820件都属于这一范围。820例中,57例PCT >0.5 ng/ml,诊断为感染性疾病。57例中,44例(77%)行微生物学及血培养。仅行血培养8例(14%),未行血培养和微生物学培养5例(9%),52例中21例(40%)血培养阳性。革兰氏阴性杆菌17例中检出细菌占一半以上。此外,18例患者表现出全身性炎症反应综合征(SIRS)。在所有病例中都使用了抗生素,无论是否实施微生物学测试。如果怀疑脓毒症,有必要正确快速地进行诊断。因此,PCT在医院的检查显示出很高的实用性。病原菌的参考鉴定和药敏结果需要结合微生物学试验和PCT,我们认为作为抗菌药物变化或缩短抗生素使用周期的指标,对PCT监测有用。未来,临床实践有望积极使用。
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