PCT (procalcitonin)

A biomarker to aid in the diagnosis of sepsis

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Infection (PCT, CRP) Myocardial infarction (TnI, CKBM, Myo) Heart failure (NT-proBNP) Pregnancy (ßhCG) Venous thromboembolism (D-dimer)

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Fast results
Early detection of sepsis
Better monitoring of disease progression

PCT testing in the emergency department

Many patients arrive at the emergency department with a local infection or, in some cases, develop an infection after major trauma or surgery.

Sepsis is defined as life-threatening organ dysfunction caused by a dysregulated host response to infection [1]. Sepsis is the number 1 cause of death in hospitals [2].

Sepsis can be difficult to identify, particularly in the initial stages, and it presents a considerable diagnostic challenge to the emergency department and intensive care clinicians.

Procalcitonin (PCT) is released in larger amounts in response to infection, thereby acting as a risk indicator for sepsis.

Immunoassay biomarkers

CRP (C-reactive protein)

D-dimer

PCT (Procalcitonin)

Troponin I

βhCG (Human chorionic gonadotropin)

NT-proBNP

PCT - a biomarker to aid in the diagnosis of sepsis

Procalcitonin (PCT) is a 116–amino acid polypeptide prohormone of calcitonin.

PCT is synthesized primarily by the C-cells of the thyroid gland, and to a lesser extent in the neuroendocrine tissue of other organs such as the lungs and intestines. Normal procalcitonin levels in the blood are very low [3].

However, production can be stimulated in almost every organ by inflammatory cytokines and especially bacterial endotoxins present e.g., during sepsis, causing high amounts of PCT to be released in the blood. This allows PCT levels to be used as a biomarker of sepsis. The higher the level of PCT, the greater the likelihood of systemic infection and sepsis [3].

More information on PCT in the diagnosis of sepsis

The mortality rates associated with sepsis remains higher than prostate cancer, breast cancer, and HIV/AIDS combined [4], despite strict guidelines for the implementation of early and effective therapies which have improved the chance of survival [5].

Radiometer’s rapid, acute care AQT90 FLEX PCT test, an in vitro diagnostic assay for the quantitative determination of PCT in EDTA or lithium-heparin whole blood or plasma specimens, is an important tool for acute and intensive care professionals, aiding the early detection of sepsis. This enables clinicians to start antibiotic treatment undelayed.

PCT has the potential advantage of earlier disease diagnosis and better monitoring of disease progression. Early diagnosis and treatment are critical for survival rates [6].

Testing PCT on the AQT90 FLEX analyzer

Radiometer’s AQT90 FLEX immunoassay analyzer is a benchtop analyzer that brings rapid biomarker assessment capabilities right to the patient’s bedside. The AQT90 FLEX delivers PCT results in less than 21 minutes, aiding the clinicians in the work-up of critically ill patients at risk for sepsis [7].

Its closed tube system makes PCT testing easy: the operator simply inserts the sample tube into the tube holder in the sample port and the analyzer performs all assay steps automatically. There is no need for sample preparation.

Learn more about the AQT90 FLEX analyzer

Key benefits of PCT on the AQT90 FLEX analyzer

No blood exposure: closed system
No sample or assay preparation
Specimen types: Venous whole blood and plasma samples
PCT assays in general have shown excellent agreement with blood culture
Great correlation with other commercially available PCT assays

PCT assay specifics

Turnaround time:

21 min.

CV % (plasma): Within-lab CV % at conc. 0.092 μg/L: 12.5%

95th percentile*: < 0.12 μg/L for whole blood and 0.087 μg/L for plasma

Traceability: Harmonized to correlate with results of the B∙R∙A∙H∙M∙S PCT® sensitive KRYPTOR® assay

* These values should only be used as an example. Each laboratory should establish its own decision threshold level.

Note on trademarks

B·R·A·H·M·S PCT® and B·R·A·H·M·S® are registered trademarks of B·R·A·H·M·S GmbH; KRYPTOR® is a registered trademark of Cisbio Bioassays; all other trademarks belong to their respective owners.

References

1. Singer M, et al. The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA 2016
2. Rudd et al. Global, regional, and national sepsis incidence and mortality, 1990 -2017: analysis for the Global Burden of Disease Study. The Lancet Volume 395, Issue 10219, 18 -24 January 2020; 200-211.
3. Sartelli M, et al. The role of procalcitonin inreducing antibiotics across the surgical pathway. World Journal of Emergency Surgery. 2021
4. Vincent JL. Increasing awareness of sepsis: World Sepsis Day. Crit Care 2012
5. Levy MM, Dellinger RP, Townsend SR, et al. The Surviving Sepsis Campaign: results of an international guideline-based performance improvement program targeting severe sepsis. Intensive Care Med 2010
6. Riedel S, et al. Procalcitonin as a Marker for the Detection of Bacteremia and Sepsis in the Emergency Department. Am J Clin Pathol 2011
7. Li et al. Determining procalcitonin at point-of-care; A method comparison study of four commercial PCT assays. Practical Laboratory Medicine 2021; 25.