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63 CHAPTER SIX

64 6.2 RECOMMENDATIONS

1. There is urgent need for PCT to be included as part of investigation of patients with suspected sepsis in our environment.

2. There is need for dedicated Phlebotomist to obtain blood for culture and implementation of institutional policy on skin preparation and number of culture to be ordered.

3. There is need for continuous screening and surveillance for antibiotic resistance in the Pediatrics department of the hospital.

4. There is need for training and institution of strict infection control practices in the hospital.

5. There is urgent need for formulation of antibiotic guidelines as well as antibiotic policy.

6. Institution of antimicrobial stewardship program with inclusion of PCT in the hospital.

65 REFERENCES

1. World Health Organization (WHO). WHO report on infectious disease: overcoming antimicrobial resistance. Geneva: WHO, 2000.

2. Assicot M, Gendrel D, Carsin H, Raymond J, Guilbaud and Bohoun C. High serum procalcitonin concentrations in patients with sepsis and infection. Lancet 1993;

341(8844):515-518.

3. Le Moullec, J.M., Jullienne, A., Chenais, J., Lasmoles, F., Guliana, J.M., Milhaud, G., and Moukhtar, M.S. The complete sequence of human procalcitonin. FEBS Lett. 1984;

167(1): 93–97.

4. Casado-Flores J, Blanco-Quiros A, Asensio J, Arranz E, Garrote JA and Nieto M.

Serum procalcitonin in children with suspected sepsis: a comparison with C-reactive protein and neutrophil count. Pediatrics Critical Care Medicine. 2003; 4(2):190-195.

5. Dubos F, Korczowski B, Aygun DA, Martinot A, Prat C, Galetto-Lacour A, Casado-Flores J, Taskun E, Leclerc F, Rodrigo C, Gervaix A, Leroy S and Gendrel D . Serum procalcitonin level and other biological markers to distinguish between bacterial and aseptic meningitis in children: A European multicenter case cohort study. Archives of Pediatrics & Adolescent Medicine. 2008; 162:1157–1163.

6. Alkholi MU, Abd Al-monem N, Abd El-Azim AA, Sultan MH et al. Serum procalcitonin in viral and bacterial meningitis. Journal of Global Infectious Diseases.

2011;3(1): 14-18

66 7. Fernandez Lopez F, Cubells C. L., Garcia Garcia JJ and Pou F. Procalcitonin in

pediatric emergency departments for the early diagnosis of invasive bacterial infections in febrile infants: results of a multicenter study and utility of a rapid qualitative test for this marker. Pediatrics Infectious Disease Journal 2003;

22(10):895-903.

8. Maniaci V, Dauber A, Weiss S, Nylen E, Becker KL and Bachur R. Procalcitonin in young febrile infants for the detection of serious bacterial infections. Pediatrics 2008;

122(4):701-710.

9. Seligman R, Meisner M, Lisboa TO, Hertz FT, Filippin TB, Fachel JMG and Teixeira PJ. Decreases in procalcitonin and C-reactive protein are strong predictors of survival in ventilator-associated pneumonia. Critical Care 2006;10(5): R125.

10. Hatherill M, Shane MT, Turner C, Ratnavel N and Mtirdoch IA. Procalcitonin and cytokine levels: relationship to organ failure and mortality in pediatric septic shock.

Critical Care Medicine 2000; 28(7):2591-2594.

11. Adamik B, Kubler- Kielb J, Golebiowska B, Gaminan A and Kubler A. Effect of sepsis and cardiac surgery with cardiopulmonary bypass on plasma level of nitric oxide metabolites, neopterin, and procalcitonin: correlation with mortality and postoperative complications. Intensive Care Medicine 2000; 26(9): 1259-1267.

12. Christ-Crain M, Jaccard-Stolz D, Bingisser R, Gencay MM, Huber PR, Tamm M, and Muller B. Effect of procalcitonin-guided treatment on antibiotic use and outcome in lower respiratory tract infections: cluster randomised, single-blinded intervention trial.

The Lancet 2004; 363(9409):600-607.

67 13. Nobre V, Harbarth S, GrafjD, Rohner P and Pugin J. Use of procalcitonin to shorten

antibiotic treatment duration in septic patients. America Journal of Respiratory Critical Care Medicine 2008; 177(5):498-505.

14. Stolz D, Christ-Crain M, Bingisser R, Leuppi J, Miedinger D, Muller C, Huber P, Muller B, and Tamm M. Antibiotic treatment of exacerbations of COPD: a randomized, controlled trial comparing procalcitonin-guidance with standard therapy.

Chest 2007; 131(1):9-19.

15. Andreola B, Bressan S, Callegaro S, Liverani A, Mario P and Da Dalt L. Procalcitonin and C-reactive protein as diagnostic markers of severe bacterial infections in febrile infants and children in the emergency department. The Pediatrics Infectious Diseases Journal 2007; 26(8):672-677

16. Bouadma L, Luyt CE, Tubach F, Cracco C, Alvarez A, Schwebel C, Schortgen F, Lasocki S and Wolff J. Use of Procalcitonin to shorten ICU patients' exposure to antibiotics - the randomized controlled PRORATA trial: a multicenter randomized controlled trial. Lancet 2010; 375(9713):463-474.

17. Briel M, Schutz P, Muller B, Young J, Schild U, Nsubauwer C, Christ-Cain M, Heiner C and Periat P. Procalcitonin-guided antibiotic use vs a standard approach for acute respiratory tract infections in primary care. Archives of Internal Medicine 2008;

168(18): 2000-2007.

18. Ho M, Hsiung CA, Yu HT, Chi CL and Chang HJ. Changes before and after a policy to restrict antimicrobial usage in respiratory infection in Taiwan. International Journal of Antimicrobial Agents 2004; 23:438-445

68 19. Filippini M, Masiero G and Moschetti K. Socioeconomic determinants of regional

differences in outpatient antibiotic consumption: evidence from Switzerland. Health Policy 2006; 78(1): 77-92.

20. Gerard Y, Hober D, Petitjean S, Assicot M, Bohoun C, Mouton Y and Wattre P. High serum procalcitonin level in a 4- year old liver transplant recipient with disseminated candidiasis. Infection 1995; 23(5): 310-311.

21. Ortega M, Rovira M, Filella X, Almela M, Puig J, de la Bellacasa JP and Carreras E.

Prospective evaluation of procalcitonin in adults with febrile neutropenia after haematopoetic stem cell transplantation. British Journal of Hematology 2004; 126:

372-378.

22. Distefano G, Curreri R, Betta P, Romeo MG and Amato M. Procalcitonin serum levels in perinatal bacterial and fungal infection of preterm infants. Acta Paediatrica 2004;

93:216-219.

23. Davis TME, Assicot M, Bohuon C, St. John A, Li GQ and Anh TK. Serum procalcitonin concentrations in acute malaria. Transcactions of the Royal Society of Tropical Medicine and Hygiene 1994; 88(6):670–673.

24. Richard-Lenoble D, Tuong TH, Ferrer A, Lacombe C, Assicot M, Gendrel D, Bonhuon C and Kombila M. Changes in procalcitonin and interleukin 6 levels among treated African patients with different clinical forms of malaria. Transactions of Royal Society of Tropical Medicine and Hygiene 1997; 91(3):305–306.

25. Hollenstein U, Looareesuwan S, Aichelburg A, Thalhammer F, Stoiser B, Amradee S, Chullawichit S, El M and Burgman IH. Serum procalcitonin levels in severe Plasmodium falciparum malaria. American Journal Tropical Medicine Hygiene 1998;

59:860– 863.

69 26. Dorge H, Schondube FA, Dorge P, Seipelt R, Voss M and Messmer BJ. Procalcitonin

is a valuable prognostic marker in cardiac surgery but not specific for infection.

Thoracic Cardiovascular Surgeon 2003; 51(6):322-326.

27. Sarbinowski R, Arvidsson S, Tylman M, Oresland T and Bengtsson A. Plasma concentrations of procalcitonin and systemic inflammatory response syndrome after colorectal surgery. Acta Anaestehesiologica Scandinavica 2005;49: 191-196.

28. Wanner GA, Keel M, Steckholzer U, Beier W, Stocke R and Ertel W. Relationship between procalcitonin plasma levels and severity of injury, sepsis, organ failure, and mortality in injured patients. Critical Care Medicine 2000; 28(4):950-957.

29. O'Neill WJ, Jordan MH, Lewis MS, Snider R, Mobre CF and Becker KL. Serum calcitonin may be a marker for inhalation injury in burns. Journal of Burn Care 1992;13: 605-616.

30. Becker KL, O'Neill WJ, Snider R, Nylen E, Moore CF, Jeng J, Silva OL, Lewis MS and Jordan MH. Hyperprocalcitoninemia in inhalation burn injury: a response of the pulmonary neuroendocrine cell? Anatomical Record 1993; 236:136-138.

31. von Heimburg D, Stieghorst W, Khorram-Sefat R and Pallua N. Procalcitonin - a sepsis parameter in severe burn injuries. Burns 1998; 24:745-750.

32. Chiesa C, Panero A, Rossi NA, Stegnago M, De Gusti M and Obsborn JF . Reliability of procalcitonin concentrations for the diagnosis of sepsis in critically ill neonates.

Clinical Infectious Diseases 1998, 269(3):664–672.

33. Gendrel D, Assicot M, Raymond J, Moulin F, Francoual C, Badoual J and Bohoun C.

Procalcitonin as a marker for the early diagnosis of neonatal bacterial infection.

Journal of Pediatrics 1996; 128(4):570–573.

70 34. Chauveau P, Level C, Lasseur C, Bonarek H, Peuchant E, Montaudon D, Vendrely B

and Combe C. C-reactive protein and procalcitonin as markers of mortality in hemodialysis patients: a 2-year prospective study. Journal of Renal Nutrition 2003;

13(2):137-143.

35. Herget-Rosenthal S, Klein T, Marggraf G, HirschT, Jakob HG and Philipp T.

Modulation and source of procalcitonin in reduced renal function and renal replacement therapy. Scandinavian Journal of Immunology 2005; 61:180-186.

36. Phillip Dellinger, Mitchell M. Levy, Andrew Rhodes, Djillali Annane, Herwig Gerlach, Steven M. Opal, et al. Surviving Sepsis Campaign: International Guidelines for Management of Severe Sepsis and Septic Shock. Critical Care Medicine, 2012;41(2):580-637

37. World Health Organisation Country Health System Fact Sheet(Nigeria), 2006

38. Onipede AO, Onayade AA, Elusiyan JB, Obiagunwa PO, Ogundare EO, Olaniran OO, Adeyemi LA and Oyelami OO. Invasive bacteria isolates from children with severe infections in a Nigerian hospital. Journal of infection in developing countries 2009;3(6):429-436.

39. Meremikwu MM, Nwachukwu CE, Asuquo AE, Okebe JU and Utsalo SJ. Bacterial isolates from blood cultures of children with suspected septicaemia in Calabar, Nigeria. BioMedCentral Infectious Diseases 2005;5: 110

40. Mokuolu AO, Ijiya N, Adesiyun OO. Neonatal septicemia in Ilorin: bacteria pathogens and antibiotic sensitivity pattern. African Journal of Medicine and Medical Science 2002; 31:127 – 130.

71 41. Rangel Fausto MS, Pittel D, Costigan M. The natural working of the systemic

inflammatory response syndrome (SIRS) Journal of The American Medical Association. 1995: 273; 117 – 123.

42. Kin HM, Park BS, Kim JI, et al. Crystal structure of the TLR4-MD-2 complex with bound endotoxin antagonist Eritoran. Cell 2007; 130: 906-917

43. Bannerman DD, Goldblum SE, Mechanisms of bacterial lipopolysaccharide induced endothelial apoptosis. American Journal Of Physiology and Lung Cell Molecular Physiology 2003: 360; 219-223

44. Hardaway R, William C, Vasquez Y. Disseminated intravascular coagulopathy in sepsis. Seminar Thrombosis Hemostasis 2001; 27: 577.

45. Proft T, Fraser JD: Bacterial super-antigens. Clinical Experiments Immunology 2003:

133: 299.

46. Ver Elst KM, Spapen ND, Nguyen DN, Garba C, Huyghens LP, Goma FK.. Cardiac troponins I and T are biological markers of left ventricular dysfunction in septic shock.

Clinical Chemistry 2000;46: 650-657.

47. Brealey D, Singer M, Multi-organ dysfunction in the critically ill: effects in different organs Journal of The Royal College Physicians London 2000; 34: 428-431.

48. Bick RL. Disseminated intravascular coagulation. Pathophysiological mechanisms and manifestation. Seminars Thrombosis Hemostasis. 1998; 24 :3-18

49. Musher D. Cutaneous and Soft tissue manifestation of sepsis due to gram negative enteric bacilli. Review Infectious Diseases 1999; 2: 854-866.

50. Hall KK and Lyman JA. Updated review of blood cultures contamination. Clinical Microbiology Review 2006;19:788-802

72 51. Weinbaum FI. Doing It Right the first time: Quality improvement and the

contamination of blood culture. Journal of Clinical Microbiology 1997; 35:563-565.

52. Chapnick EK. Technique for drawing of blood culture: is changing needles truly necessary? South African Medical Journal 1991; 34: 1197-1198.

53. Buttery JP. Blood culture in newborns and children optimizing: an everyday test.

Archives diseases child fetal neonatal ed. 2002: 37: 25-28.

54. NCCLS. Quality control for commercially prepared microbiological culture media- approved standard-third edition 2004. M22-A3

55. Cheeseborough M. District laboratory practice in tropical countries, Part 2. Cambridge University Press. 2006. 2nd edition, pp 96-128

56. Murray PR. Comparative evaluation of the Oxoid signal and Roche Septi check blood culture systems Journal of Clinical Microbiology 1988; 26: 2526-2530.

57. Cornish N. Reassessment of the incubation time in a controlled clinical comparison of the Bact/Alert bottle and standard anaerobic bottle used aerobically for the diagnosis of blood stream infections. Diagnosis Microbiology Infectious Diseases 1998; 32: 1-7.

58. Koneman’s Colour Atlas and Textbook of Diagnostic Microbiology, sixth edition, page 103-104.

59. Gabay C, Kushner I. Acute-phase proteins and other systemic responses to inflammation. N. Engl. J. Med.1999;340:448–454.

60. Uzzan B, Cohen R, Nicolas P, Cucherat M and Perret GY. Procalcitonin as a diagnostic test for sepsis in critically ill adults and after surgery or trauma: a systematic review and meta-analysis. Crit. Care Med.2006;34:1996–2003.

73 61. Weithamp JH, Aschner JL. Diagonostic use of C reactive protein in assessment of

neonatal sepsis. Pediatrics 2000;111:1092-1095

62. Tobias PS, Soldau K, Ulevitch RJ. Isolation of a lipopolysaccharide-binding acute phase reactant from rabbit serum. J. Exp. Med. 1986;164:777–793.

63. Wurfel MM, Kunitake ST, Lichenstein H, Kane JP, Wright SD. Lipopolysaccharide (LPS)-binding protein is carried on lipoproteins and acts as a cofactor in the neutralization of LPS. J. Exp. Med. 1994;180:1025–1035

64. Tobias PS, Mathison J, Mintz D, Lee JD, Kravchenko V, Kato K, et al. Participation of lipopolysaccharide-binding protein in lipopolysaccharide-dependent macrophage activation. Am. J. Respir. Cell Mol. Biol. 1992;7:239–245

65. Gaini S, Koldkjaer OG, Pedersen C, Pedersen SS. Procalcitonin, lipopolysaccharide-binding protein, interleukin-6 and C-reactive protein in community-acquired infections and sepsis: a prospective study. Crit. Care 2006;10:R53

66. Opal SM, Patrick JS, Jean-Louis V, Mark W, Stephen FC, John E, et al. Relationship between plasma levels of lipopolysaccharide (LPS) and LPS-binding protein in patients with severe sepsis and septic shock. J. Infect. Dis. 1999;180:1584–1589.

67. Engel A, Mack E, Kern P, Kern WV. An analysis of interleukin-8, interleukin-6 and C-reactive protein serum concentrations to predict fever, gram-negative bacteremia and complicated infection in neutropenic cancer patients. Infection 1998;26:213–221 68. Becker, K., Mόller, B., Nylen, E., Cohen, R., Silva, O., and Snider, R. Calcitonin gene

family of peptides. In Becker K, ed. Principles and Practice of Endocrinology and Metabolism. Lippincott, Philadelphia. 2001 p520–534.

74 69. Becker, K.L., Nylén, E.S., White, J.C., Müller, B., and Snider, R.H., Jr. Procalcitonin

and the calcitonin gene family of peptides in inflammation, infection, and sepsis: a journey from calcitonin back to its precursors. Journal of Clinical Endocrinology and Metabolism 2004; 89(4):1512–1525.

70. Muller, B., White, J.C., Nylen, E., Snider, R.H., Becker, K.L., and Habener, J.F.

Ubiquitous expression of the calcitonin gene in multiple tissues in response to sepsis.

Journal of Clinical Endocrinology and Metabolism 2001; 86:396–404.

71. Whicher, J., Bienvenu, J., and Monneret, G. Procalcitonin as an acute phase marker.

Annals of Clinical Biochemistry 2001; 38:483–493.

72. Chastre, J., Luyt, C.E., Trouillet, J.L., and Combes, A. New diagnostic and prognostic markers of ventilator-associated pneumonia. Current Opinion in Critical Care 2006;

12(5):P446–451.

73. Nijsten, M.W., Olinga, P., The, T.H., de Vries. Procalcitonin behaves as a fast responding acute phase protein in vivo and in vitro. Critical Care Medicine 2000;

28(2):458–461.

74. Oberhoffer, M., Stonans, I., Russwurm S, Stonane E, Vogelsang H and Junker U.

Procalcitonin expression in human peripheral blood mononuclear cells and its modulation by lipopolysaccharides and sepsis-related cytokines in vitro. Journal of Laboratory and Clinical Medicine 1999;134: 49–55

75. Dandona P, Nix D, Wilson MF, Aljada A, Love J, Assicot M and Bohoun.

Procalcitonin increase after endotoxin injection in normal subjects. Journal of Clinical Endocrinology and Metabolism 1994; 79(6):1605-1608.

75 76. Brunkhorst FM, Heinz U and Forycki ZF. Kinetics of procalcitonin in iatrogenic

sepsis. Intensive Care Medicine 1998; 24(8):888-889.

77. www.procalcitonin.com Accessed 25/07/2012

78. Meisner M. Primary indications of Procalcitonin. In Procalcitonin-Biochemistry and Clinical Diagnosis. Uni-Med Verlag AG 2010:17.

79. Nigrovic LE, Kuppermann N and Malley R. Development and validation of a multivariable predictive model to distinguish bacterial from aseptic meningitis in children in the post-Haemophilus influenzae era. Pediatrics 2002; 110(4):712-719.

80. Maxson S, Lewno MJ and Schutze GE. Clinical usefulness of cerebrospinal fluid bacterial antigen studies. Journal of Pediatrics 1994; 125(2):235-238.

81. Sa´ez-Llorens X, McCracken GH Jr. Bacterial meningitis in children. Lancet 2003;

361(9375):2139-2148.

82. Tunkel AR, Hartman BJ, Kaplan SL, Kaufmann BA, Roos KL, Scheuld WM and Whitley RJ. Practice guidelines for the management of bacterial meningitis. Clinical Infectious Disease. 2004; 39(9):1267-1284.

83. Gendrel D, Raymond J, Assicot M, Molllin F, Iniguez JL, Lebon P and Bohuon C.

Measurement of procalcitonin levels in children with bacterial and viral meningitis.

Clinical Infectious Diseases 1997; 24: 1240-1242.

84. Mills GD, Lala HM, Oehley MR, Craig AM, Thornley CN, Nesdale A, Manikkam NE and Reeve P. Elevated procalcitonin as a diagnostic marker in meningococcal disease.

European Journal of Clinical Microbiology and Infectious Disease 2006; 25: 501-509.

76 85. Casado-Flores J, Blanco-Quiros A, Montserrat, Asensio J and Fernandez C. Prognostic

utility of the semi- quantitative procalcitonin test, neutrophil count and C- reactive protein in meningococcal infection in children. European Journal of Pediatrics. 2006;

165:26-29.

86. Carrol ED, Newland P, Riordan FAI, Thomson APJ, Curtis N and Hart CA.

Procalcitonin as a diagnostic marker of meningococcal disease in children presenting with fever and a rash. Archives of Diseases in Childhood 2002; 86:282-285.

87. Marc E, Menager C, Moulin F, Stos B, Chalumeau M, Guerin S Lebon P, Brunet F, Raymond J and Gendrel D. Procalcitonin and viral meningitis: reducing unneccessary antibiotic treatments by routine analysis during an outbreak. Archives of Pediatrics 2002; 9(4):358-364.

88. Gendrel D, Raymond J, Coste J, Moulin F, Lorrot M, Guerrin S, Ravilly S, Lefevre H, Roger C, Laconbe C, Palmer P and Bohuon C . Comparison of procalcitonin with C-reactive protein, interleukin 6 and interferon alpha for differentiation of bacterial vs.

viral infections. Pediatrics Infectious Diseases Journal 1999; 18(10):875–881.

89. Matesanz JL, Fernandez E, Fernandez JM and Viejo G. Plasma procalcitonin and C-reactive protein concentrations in pediatric patient with Epstein-Barr virus infection.

Clinical Chemistry 2003; 49(12):2103-2104.

90. Resch B, Gusenleitner W and Muller W. Procalcitonin, interleukin-6, C-reactive protein and leukocyte counts in infants with bronchiolitis. The Pediatric Infectious Disease Journal 2003; 22(5):476.

91. Rangel-Frausto MS, Pittet D, Costigan M, Hwang T, Davis C and Wenzel RP. The natural history of the systemic inflammatory response syndrome (SIRS). Journal of American Medical Association1998; 273(2):117-123.

77 92. Schuetz P, Mueller B and Trampuz A. Serum procalcitonin for discrimination of blood

contamination from bloodstream infection due to coagulase-negative staphylococci.

Infection 2007; 35(5): 352-355.

93. Chirouze C, Schuhmacher H, Rabaud C, Gil H, Khayat N, Estavoyer JM, May T and Hoen B . Low serum procalcitonin level accurately predicts the absence of bacteremia in adult patient with acute fever. Clinical Infectious Diseases 2002; 35(2): 156-161.

94. Caterino JM, Scheatzle MD, Forbes ML and D'Antonio JA. Bacteremic elder emergency department patients procalcitonin and white count. Academics of Emergency Medicine 2004; 11 (4):393-396.

95. Brodska H, Malickova K, Adamkova V, Benakova H, St’astna MM and Zima T.

Significantly higher procalcitonin levels could differentiate gram negative sepsis from gram positive and fungal sepsis. Clinical and Experimental Medicine 2012;05:10238 96. Pierre Emmanuel C, Sylvain L, Serge A, Jean-Pierre Q, Jean-Marc D, Sebastien P,

Niels-Oliver O and Bernard B. Serum procalcitonin elevation in critically ill patients at the onset of bacteremia caused by either gram negative or gram positive bacteria.

BioMed Central Infectious Diseases 2008;8:38 (Accessed 04/07/2013)

97. Brunkhorst FM, Al-Nawas B, Krummenauer F, Forycki ZF and Shaw PM.

Procalcitonin, C-reactive protein and APACHE II score for risk evaluation in patients with severe pneumonia. Clinical Microbiology Infection 2002; 8(2):93-100.

98. Hedlund J and Hansson LO. Procalcitonin and C-reactive protein levels in community-acquired pneumonia: correlation with etiology and prognosis. Infection 2000;

28(2):68-73.

78 99. Moulin F, Raymond J, Lorrot M, Marc E, Coste J, Iniguez JL, Kalifa G, Bohuon C and

Gendrel D. Procalcitonin in children admitted to hospital with community-acquired pneumonia. Archives of Diseases in Childhood 2001; 84(4):332-336.

100. Prat C, Dominguez J, Rodrigo C, Gimenez M, Azuara M, Jimenez O, Gali N and Ausina V. Procalcitonin, C-reactive protein and leukocyte count in children with Iower respirratory tract infection. Pediatrics Infectious Diseases Journal 2003; 22(11):963- 967.

101. Toikka P, Irjala K, Uven T, Virkki R, Mertsola J, Leinonen M, et al. Serum procalcitonin, C-reactive protein and interleukin -6 for distinguishing bacterial and viral pneumonia in children. Pediatr Infect Dis J 2000; 19:598-602

102. Korppi M, Remcs S, Heiskanen-Kosma T and Ruuskanen O. Serum procalcitonin concentrations in bacterial pneumonia in children: a negative result in primary healthcare settings. Pediatric Pulmonology 2003; 35(1):56-61.

103. Kruger S, Ewig S, Marre R, Papassotriou J, Richter J, Von Baun H, Suthorp N and Welte T. Procalcitonin predicts patients at low risk of death from community-acquired pneumonia across all CRB-65 classes. European Respiratory Journal 2008; 31(2):349-355.

104. Huang DT, Weissfeld LA, Kellum JA, Yealy DM, Kong L, Martino M, Angus DC and GenIMS investigators. Risk prediction with procalcitonin and clinical rules in community-acquired pneumonia. Annals of Emergency Medicine 2008; 52(1): 48-58.

105. Franzin L and Cabodi D. Legionella Pneumonia and Serum Procalcitonin. Current Microbiology 2005; 50(1):43- 46.

79 106. Jereb M and Kotar T. Usefulness of procalcitonin to differentiate typical from atypical

community-acquired pneumonia. Wien KlinWochenschr 2006; 118(5-6):170-174.

107. Kandemir O, Uluba B, Polat G, Sezer C, Camdeviren H and Kaya A. Elevation of procalcitonin level in patients with pulmonary tuberculosis and in medical staff with close patient contact. Archives of Medical Research 2003; 34(4):311-314.

108. Baylan O, Balkan A, Inal A, Kisa O,Albay A, Doganci L and Acikel CH. The predictive value of serum pro calcitonin levels in adult patients with active pulmonary tuberculosis. Japanese Journal of Infectious Diseases 2006;59(3):164-167

109. Cakir E, Deniz O, Ozcan O, Tozkoparan E, Yaman H, Akgul EO, Bilgi C, Bilgic H, Ekiz K and Erbil MK. Pleural fluid and serum procalcitonin as diagnostic tools in tuberculosis pleurisy. Clinical Biochemistry 2004;38(3):234-238

110. Stolz D, Smyrnios N, EggimannP, Pargger H, Thakkar N, Siegemund M, Marsch S, Rakic J, Mueller B and Tamm M. Procalcitonin for reduced antibiotic exposure in ventilator-associated pneumonia - a randomized study. European Respiratory Journal 2009; 34(6):1364-1375.

111. Boussekey N, Leroy 0, Alfandari S, Devos P, Georges H, Guery B. Procalcitonin kinetics in the prognosis of severe community-acquired pneumonia. Intensive Care Medicine 2006; 32(3):469-472.

112. Micek ST, Ward S, Fraser VJ, Kollef MH. A randomized controlled trial of an antibiotic discontinuation policy for clinically suspected ventilator-associated pneumonia. Chest 2004; 125(5):1791-1799.

80 113. Chastre J, WolffM, Fagon JY, Chevret S, Thomas F, Wermert D, Clementi E,

Gonzalez J, Jusserand D, Asfar P, Fieux F and Aubas S . Comparison of 8 vs l5 days of antibiotic therapy for ventilator-associated pneumonia in adults: a randomized trial.

Journal of American Medical Association 2003;290(19):2588-2598

114. Kocazeybek B, Kucukoglu S and Oner YA. Procalcitonin and C-reactive protein in infective endocarditis: correlation with etiology and prognosis. Chemotherapy 2003;

49(1-2):76-84.

115. Mueller C, Huber P, Laifer G, Muller B and Perruchoud. AP. Procalcitonin and the early diagnosis of infective endocarditis. Circulation 2004; 109: 1707–1710.

116. Thia KT, Chan E, Ling KL, Ng WY, Jacob E, Ooi CJ. Role of Procalcitonin in infectious gastroenteritis and inflammatory bowel disease. Digestive Diseases and Sciences 2008; 53(11):2960-2968.

117. Korczowski B, Szybist W. Serum procalcitonin and C-reactive protein in children with diarrhea of various etiologies. Acta Paediatrica 2004; 93(2):169-173.

118. Neana M, Carr R. Promising stratagies for reducing the burden of neonatal sepsis.

Archives diseases child fetal neonatal ed 2000:83:151-153

119. Jones SR, Carley S and Harrison M. An introduction to power and sample size estimation. Emergency Medicine Journal 2003;20:453-458

120. Performance standards for Antimicrobial susceptibility testing; Twenty-first informational supplement M100 – S21 Wayne PA 2011: Clinical and laboratory standards institute.

121. Zahedpasha Y, AhmadpourKacho M, Hajiahmadi M, Haghshenas M. Procalcitonin as a marker of neonatal sepsis. Iran J Paediatr 2009;19:117-22.

81 122. Monneret G, Labaune JM, Isaac C. Procalcitonin and C-reactive protein levels in

neonatal infections. Acta Paediatr 1997;86:209-12.

123. Sucilathangam G., Amuthavalli K., Velvizhi G., Ashihabegum M.A., Jeyamurugan T., Palaniappan N. Early Diagnostic Markers for Neonatal Sepsis: Comparing Procalcitonin (PCT) and C-reactive protein (CRP). Journal of Clinical and Diagnostic Research. 2012;6(4): 627-631

124. Boo NY, Nor Azlina AA, Rohana J. Usefulness of a semi-quantitative procalcitonin test kit for the early diagnosis of neonatal sepsis. Singapore Med J 2008;49:204-08.

125. Kyung-Eun K and Jin-Yeong H. Evaluation of the Clinical Performance of an Automated Procalcitonin Assay for the Quantitative Detection of Bloodstream Infection. Korean J Lab Med 2010;30:153-159

126. Stefan Riedel, Johan H. Melendez, Amanda T. An, Janet E. Rosenbaum and Jonathan M. Zenilman. Procalcitonin as a Marker for the Detection of Bacteremia and Sepsis in the Emergency Department. Am J Clin Path 2011; 135:182-189

127. Charles PE, Dalle F, Aho S, Quenot JP, Doise JM, Aube H et al. Serum procalcitonin measurement contribution to the early diagnosis of candidemia in critically ill patients.

Intensive Care Med. 2006;32(10):1577-83.

128. Carol ED, Thomason AP, Hart CA. Procalcitonin as a marker of sepsis. Int J Antimicrob Agents 2002;20:1‐9.

129. H. Giamarellou, E. J. Giamarellos-Bourboulis, P. Repoussis, L. Galani, N.

Anagnostopoulos, P. Grecka et al. Potential use of procalcitonin as a diagnostic criterion in febrile neutropenia: experience from a multicentre study. Clin Microbiol Infect 2004; 10: 628–633