Postoperative serum pro-calcitonin and C-reactive protein levels in patients with orthopedic infections

Uckay, Ilker; Garzoni, Christian; Ferry, Tristan; Harbarth, Stéphan Juergen; Stern, Richard; Assal, Mathieu; Hoffmeyer, Pierre; Lew, Daniel Pablo; Bernard, Louis

doi:10.4414/smw.2010.13124

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Title		Postoperative serum pro-calcitonin and C-reactive protein levels in patients with orthopedic infections
Authors		Uckay, Ilker Garzoni, Christian Ferry, Tristan Harbarth, Stéphan Juergen Stern, Richard Assal, Mathieu Hoffmeyer, Pierre Lew, Daniel Pablo Bernard, Louis show all authors [1 - 9]
Published in		Schweizerische medizinische Wochenschrift. 2010, vol. 140, w13124
Abstract		QUESTIONS UNDER STUDY / PRINCIPLES: The value of postoperative pro-calcitonin (PCT) in the follow-up of patients with localised infections in the orthopaedic domain is unknown. METHODS: We conducted a retrospective study comparing postoperative ultra-sensitive serum PCT (upper normal level 0.25 microg/l) and C-reactive protein (CRP; upper normal level 10 mg/l) levels in adult patients with localised non-bacteremic orthopaedic infections. RESULTS: A total of 165 paired PCT and CRP samples were retrieved from 60 infected patients. PCT levels exceeded normal in only half of the patients and practically only on the first postoperative day, despite a clinically active infection in all cases. PCT values did not differ between patients with or without surgical re-interventions (36 patients; median 0.09 mg/l vs. 24 patients; median 0.08 microg/l; Wilcoxon-rank sum-test, p = 0.34). CRP was elevated in 54 patients (90%) with a maximum at day 2, and normalised by the tenth day. Both markers correlated poorly with each other (Kendall-tau-test 0.47). The cost for one analysis (phlebotomy by nurses, transport and laboratory) was US$70 for PCT and $20 for CRP. CONCLUSIONS: Postoperative serum PCT levels in orthopaedic infections were rarely elevated, even if patients continued to be infected. They quickly fell to within a normal range at day 2. PCT does not seem to be better than the less expensive CRP in the follow-up of these patients.
Keywords		Bacterial Infections/blood/etiology — C-Reactive Protein/analysis — Calcitonin/blood — Female — Humans — Male — Middle Aged — Orthopedic Procedures/adverse effects — Postoperative Period — Prosthesis-Related Infections/blood — Protein Precursors/*blood — Retrospective Studies — Soft Tissue Infections/blood/etiology
Identifiers		DOI: 10.4414/smw.2010.13124 PMID: 21104474
Full text		Article - Limited access to UNIGE
Structures		Faculté de médecine / Section de médecine clinique / Département de médecine Faculté de médecine / Section de médecine clinique / Département de chirurgie
Research groups		Chirurgie orthopédique et traumatologique (98) Epidémiologie et contrôle de la résistance aux antibiotiques (866) Glycopeptide résistance (28)
Citation (ISO format)		UCKAY, Ilker et al. Postoperative serum pro-calcitonin and C-reactive protein levels in patients with orthopedic infections. In: Schweizerische medizinische Wochenschrift, 2010, vol. 140, p. w13124. doi: 10.4414/smw.2010.13124 https://archive-ouverte.unige.ch/unige:20719