Procalcitonin for predicting catheter-associated bloodstream infection: A meta-analysis

Medicine (Baltimore). 2019 Dec;98(52):e18546. doi: 10.1097/MD.0000000000018546.

Abstract

Objective: The predictive accuracies of procalcitonin (PCT) in the diagnosis of catheter-associated bloodstream infection (CABSI) vary widely. This meta-analysis aimed to explore the predictive value of PCT for CABSI.

Methods: We searched PubMed, EMBase, Web of Science, ScienceDirect, Cochrane Library, and studies published up to 10 March 2019. Odds ratios (ORs) with 95% confidence intervals (95%CIs) were calculated to evaluate PCT predictive value using Stata 14.0 software.

Results: The meta-analysis was composed of 7 studies, consisting of 347 subjects. Pooled analysis demonstrated that a high PCT was significantly correlated with CABSI (pooled OR = 23.36, 95%CI 12.43-43.91, P < .001) and medium heterogenicity (I = 36.9%, P = .147). The pooled sensitivity and specificity were 85% (95%CI 0.76-0.91) and 89% (95%CI 0.68-0.97), respectively. Although Begg funnel plot (P = .007) indicated the presence of publication bias among the included studies, the stability of the pooled outcomes was verified by the trim-and-fill method. Furthermore, sensitivity analyses did not show important differences in effect estimation.

Conclusion: PCT is an effective predictor of CABSI. However, high-quality randomized controlled trials are needed to determine whether PCT could predict CABSI.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Biomarkers / blood
  • Catheter-Related Infections / blood*
  • Catheter-Related Infections / diagnosis
  • Humans
  • Predictive Value of Tests
  • Procalcitonin / blood*
  • Sepsis / blood*
  • Sepsis / diagnosis
  • Sepsis / etiology

Substances

  • Biomarkers
  • Procalcitonin