The role of procalcitonin in the identification of invasive fungal infection—a systemic review and meta-analysis

• Published in: Diagnostic microbiology and infectious disease Vol. 76; no. 4; pp. 464 - 469
• Main Authors: Dou, Yu-Hong, Du, Ji-Kun, Liu, He-Lu, Shong, Xiao-Dong
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.08.2013
• Subjects: Adult; Bacterial Infections - blood; Bacterial Infections - diagnosis; Bacterial sepsis; Calcitonin - blood; Calcitonin Gene-Related Peptide; Candidiasis, Invasive - blood; Candidiasis, Invasive - diagnosis; Databases, Bibliographic; Diagnosis, Differential; Humans; Infant, Newborn; Infectious Disease; Internal Medicine; Invasive fungal infection; Invasive Pulmonary Aspergillosis - blood; Invasive Pulmonary Aspergillosis - diagnosis; Likelihood Functions; Predictive Value of Tests; Procalcitonin; Protein Precursors - blood; Invasive fungal infection; Bacterial sepsis; Procalcitonin
• ISSN: 0732-8893; 1879-0070
• DOI: 10.1016/j.diagmicrobio.2013.04.023

Abstract We aimed to summarize evidence on the accuracy of procalcitonin (PCT) test in differentiating fungal infection from other causes of infection. We searched electronic database for original researches that reported diagnostic performance of PCT alone or compare with other biomarkers to diagnose invasive fungal infection (IFI). We included 8 qualifying studies studying 474 episodes of suspected fungal infection with 155 (32.7%) probable or proven IFIs. Four studies compared IFI to bacterial sepsis, in which the pooled positive likelihood ratios and negative likelihood ratios were 4.65 (95% confidence interval [CI], 2.46–8.79) and 0.15 (95% CI, 0.05–0.41), respectively. Another 4 studies compared IFI to uninfected individuals, in which the pooled positive likelihood ratios and negative likelihood ratios were 4.01 (95% CI, 2.04–7.88) and 0.23 (0.07–0.77), respectively. The existing literature suggests good diagnostic accuracy for the PCT test for discrimination between IFIs and bacterial infection or noninfectious conditions. Given the high heterogeneity, medical decisions should be based on both PCT test results and clinical findings.