Articles Vol. 65 No. CĐ 1 - Liên chi hội Phẫu thuật bàn tay 12/03/2024

2. PROCALCITONIN DYNAMICS ON PATIENTS WITH BACTERIAL PNEUMONIA

Dao Thi Loan1,2, Nguyen Si Tuan3,4,5,6, Nguyen Thi Ngoc Anh4,6, Pham Van Dung1,2
1 Thong Nhat General Hospital of Dong Nai Province
2 Bệnh viện đa khoa Thống Nhất tỉnh Đồng Nai
3 Thong Nhat General Hospital of Dong Nai Province;
4 Hong Bang International University
5 Bệnh viện đa khoa Thống Nhất tỉnh Đồng Nai;
6 Trường Đại học Quốc tế Hồng Bàng
DOI: 10.52163/yhc.v65iCD1.962
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Keywords
Procalcitonin (PCT) kinetics, multidrug-resistant bacterial pneumonia (P-MDR), nonmultidrug-resistant bacterial pneumonia (P-nMDR), PCT clearance time, antibiotic discontinuation.
Abstract

Proposes: Procalcitonin (PCT) is used to reduce the time of antibiotic use in patients with infections, especially in patients with sepsis. However, the role of PCT in patients with pneumonia caused by multidrug-resistant bacteria (P-MDR) has not been studied much, especially in Vietnam. Therefore, the project aimed to determine PCT kinetics in patients with bacterial pneumonia.

Research methods: Longitudinal study, we analyzed PCT dynamics in 121 patients with microbiological and clinical findings confirming bacterial pneumonia from January 2023 to October 2023.

Results: There were 65 patients with pneumonia caused by multidrug-resistant bacteria and 56 patients with pneumonia caused by non-multidrug-resistant bacteria (P-nMDR). The five most common agents causing bacterial pneumonia are Klebsiella pneumoniae (32.23%), Acinetobacter baumannii (26.45%), Pseudomonas aeruginosa (22.31%), Staphylococcus aureus (8.26%), and Escherichia coli (5.79%). The average PCT concentration in the P-MDR group was higher than in the P-nMDR group. PCT clearance time in the P-MDR group was 2.13 times slower than the P-nMDR group. 64.46% of patients who had not stopped using antibiotics at the time PCT was below 0.05 ng/ml.

Conclusions: The average PCT concentration in the P-MDR group was higher than in the P-nMDR group. PCT clearance time in the P-MDR group was slower than the P-nMDR group. It is necessary to conduct a randomized controlled clinical trial following this research to monitor PCT dynamics in patient groups such as COPD and bacterial pneumonia in 2024.

References
[1]
Frank B, Evelyn T, Axel N et al., Effect Google Scholar
[2]
of sodium selenite administration and Google Scholar
[3]
procalcitonin-guided therapy on mortality in Google Scholar
[4]
patients with severe sepsis or septic shock: Google Scholar
[5]
a randomized clinical trial, JAMA internal Google Scholar
[6]
medicine, 176(9):1266-76, 2016. Google Scholar
[7]
Evelien de J, Jos AO, Albertus B et al., Efficacy Google Scholar
[8]
and safety of procalcitonin guidance in reducing Google Scholar
[9]
the duration of antibiotic treatment in critically Google Scholar
[10]
ill patients: a randomised, controlled, open-label Google Scholar
[11]
trial, The Lancet Infectious Diseases, 16(7):819- Google Scholar
[12]
, 2016. Google Scholar
[13]
Scott F, James B, Ryan F et al., Vital signs: Google Scholar
[14]
improving antibiotic use among hospitalized Google Scholar
[15]
patients, Morbidity and mortality weekly report, Google Scholar
[16]
(9):194, 2014. Google Scholar
[17]
Iván H, Eduardo P, Inés S et al., Kinetics of Google Scholar
[18]
procalcitonin in infections caused by multidrug Google Scholar
[19]
resistant bacteria, MEDICINA (Buenos Aires), Google Scholar
[20]
(6):599-605, 2020. Google Scholar
[21]
George K, Jean C, Mark HW, Antibiotic Google Scholar
[22]
strategies in the era of multidrug resistance, Google Scholar
[23]
Critical Care, 20(1):1-9, 2016. Google Scholar
[24]
Despoina K, Thiago L, Christian BB et al., Google Scholar
[25]
Spectrum of practice in the diagnosis of Google Scholar
[26]
nosocomial pneumonia in patients requiring Google Scholar
[27]
mechanical ventilation in European intensive Google Scholar
[28]
care units, Critical care medicine, 37(8):2360- Google Scholar
[29]
, 2009. Google Scholar
[30]
GB Liu, XQ Cui, ZB Wang et al., Detection Google Scholar
[31]
of serum procalcitonin and hypersensitive Google Scholar
[32]
C-reactive protein in patients with pneumonia Google Scholar
[33]
and sepsis, Journal of biological regulators Google Scholar
[34]
homeostatic agents, 32(5):1165-9, 2018. Google Scholar
[35]
Martin JL, Jennifer MF, Elizabeth D et al., The Google Scholar
[36]
antibiotic course has had its day, Bmj, 358, 2017. Google Scholar
[37]
Jason P, Wang JN, Kay CS et al., Characteristics Google Scholar
[38]
and outcomes of culture-negative versus Google Scholar
[39]
culture-positive severe sepsis, Critical care, Google Scholar
[40]
(5):1-12, 2013. Google Scholar
[41]
Chanu Rhee, Using procalcitonin to guide Google Scholar
[42]
antibiotic therapy. Open forum infectious Google Scholar
[43]
diseases; 2017: Oxford University Press US. Google Scholar
[44]
Chanu R, Michael KM, Thomas MF, Google Scholar
[45]
Procalcitonin use in lower respiratory tract Google Scholar
[46]
infections, Up-to-date [cited 2019 August 21] Google Scholar
[47]
Available from: URL: https://www upto-date Google Scholar
[48]
com/contents/procalcitonin-use-in-lower Google Scholar
[49]
respiratory-tract-infections, 2019. Google Scholar
[50]
Philipp S, Mirjam CC, Robert T et al., Effect Google Scholar
[51]
of procalcitonin-based guidelines vs standard Google Scholar
[52]
guidelines on antibiotic use in lower respiratory Google Scholar
[53]
tract infections: the ProHOSP randomized Google Scholar
[54]
controlled trial, Jama, 302(10):1059-66, 2009. Google Scholar
[55]
Philipp S, Yannick W, Ramon S et al., Effect Google Scholar
[56]
of procalcitonin-guided antibiotic treatment on Google Scholar
[57]
mortality in acute respiratory infections: a patient Google Scholar
[58]
level meta-analysis, The Lancet infectious Google Scholar
[59]
diseases, 18(1):95-107, 2018. Google Scholar
[60]
Nguyen Si-Tuan, Hua My Ngoc, Le Duy Google Scholar
[61]
Nhat et al., Genomic features, whole-genome Google Scholar
[62]
phylogenetic and comparative genomic analysis Google Scholar
[63]
of extreme-drug-resistant ventilator-associated Google Scholar
[64]
pneumonia Acinetobacter baumannii strain in Google Scholar
[65]
a Vietnam hospital, Infection, Genetics and Google Scholar
[66]
Evolution, 80:104178, 2020. Google Scholar
[67]
Nan Z, Dongmei Z, Yi H, Procalcitonin and Google Scholar
[68]
C-reactive protein perform better than the Google Scholar
[69]
neutrophil/lymphocyte count ratio in evaluating Google Scholar
[70]
hospital acquired pneumonia, BMC Pulmonary Google Scholar
[71]
Medicine, 20(1):1-10, 2020. Google Scholar