Shiloh
Editor, Senior Moderator
Source: http://www.cidrap.umn.edu/news-perspective/2020/03/news-scan-mar-16-2020
News Scan for Mar 16, 2020
US measles cases low; Suboptimal procalcitonin testing
Filed Under:
Measles; Diagnostics
CDC reports small rise in US measles cases
As of Mar 2, the United States so far this year has recorded 12 measles cases from 7 jurisdictions, the Centers for Disease Control and Prevention (CDC) said in a Mar 12 monthly update. The totals reflect an increase of 7 cases and 2 jurisdictions since the CDC's last update on Feb 3.
The update didn't list the locations, but some cases are probably linked to a small outbreak reported in early February in Los Angeles County, California.
Cases this year are down sharply from the roughly 268 cases in 15 states reported at about this time in 2019, a year that marked the most measles cases in the United States since 1992. Most cases involved people who hadn't been vaccinated.
Mar 12 CDC measles update
Study warns of low sensitivity of procalcitonin for bacteremia
A study of inpatients at an academic medical center in Phoenix found that procalcitonin testing within 48 hours of admission demonstrated poor sensitivity for bacteremia, indicating that procalcitonin should not be routinely used to rule out systemic infections, researchers reported today in Open Forum Infectious Diseases.
The retrospective study looked at 332 patients admitted to the hospital from July 2018 through June 2019 with more than one positive blood culture within 24 hours of admission and procalcitonin testing within 48 hours. A low procalcitonin level, which is used by some antimicrobial stewardship programs as a guide to rule out bacterial infection and reduce the initiation and continuation of unnecessary antibiotic therapy, was defined as less than 0.5 micrograms per liter (?g/L). The primary objective of the study was to assess the sensitivity of procalcitonin for bacteremia and compare the characteristics of patients testing negative for bacterial infection with those of patients testing positive.
A total of 332 patients were included. The sensitivity of procalcitonin for bacteremia was 62% at the sepsis threshold of 0.5 ?g/L, 76% at a threshold of 0.25 ?g/L, and 92% at a threshold of 0.1 ?g/L. Of the 125 patients with low procalcitonin, 14% were initially admitted to the intensive care unit (ICU) and 9% required the use of vasopressors. In that same group, the top three organisms isolated were Staphylococcus aureus (39%), Escherichia coli (17%), and Klebsiella spp. (7%).
Although all patients received antibiotic therapy, compared with those patients with an elevated procalcitonin, patients with a low procalcitonin were significantly more likely to have delayed initiation of antibiotic therapy (3% vs 8%, P = 0.04), including among patients admitted to the ICU (1% vs 18%, P = 0.02).
"Antimicrobial stewardship programs should not use procalcitonin as a means of withholding potentially inappropriate antibiotic therapy in patients being admitted to the hospital," the authors of the study conclude.
Mar 16 Open Forum Infect Dis abstract
News Scan for Mar 16, 2020
US measles cases low; Suboptimal procalcitonin testing
Filed Under:
Measles; Diagnostics
CDC reports small rise in US measles cases
As of Mar 2, the United States so far this year has recorded 12 measles cases from 7 jurisdictions, the Centers for Disease Control and Prevention (CDC) said in a Mar 12 monthly update. The totals reflect an increase of 7 cases and 2 jurisdictions since the CDC's last update on Feb 3.
The update didn't list the locations, but some cases are probably linked to a small outbreak reported in early February in Los Angeles County, California.
Cases this year are down sharply from the roughly 268 cases in 15 states reported at about this time in 2019, a year that marked the most measles cases in the United States since 1992. Most cases involved people who hadn't been vaccinated.
Mar 12 CDC measles update
Study warns of low sensitivity of procalcitonin for bacteremia
A study of inpatients at an academic medical center in Phoenix found that procalcitonin testing within 48 hours of admission demonstrated poor sensitivity for bacteremia, indicating that procalcitonin should not be routinely used to rule out systemic infections, researchers reported today in Open Forum Infectious Diseases.
The retrospective study looked at 332 patients admitted to the hospital from July 2018 through June 2019 with more than one positive blood culture within 24 hours of admission and procalcitonin testing within 48 hours. A low procalcitonin level, which is used by some antimicrobial stewardship programs as a guide to rule out bacterial infection and reduce the initiation and continuation of unnecessary antibiotic therapy, was defined as less than 0.5 micrograms per liter (?g/L). The primary objective of the study was to assess the sensitivity of procalcitonin for bacteremia and compare the characteristics of patients testing negative for bacterial infection with those of patients testing positive.
A total of 332 patients were included. The sensitivity of procalcitonin for bacteremia was 62% at the sepsis threshold of 0.5 ?g/L, 76% at a threshold of 0.25 ?g/L, and 92% at a threshold of 0.1 ?g/L. Of the 125 patients with low procalcitonin, 14% were initially admitted to the intensive care unit (ICU) and 9% required the use of vasopressors. In that same group, the top three organisms isolated were Staphylococcus aureus (39%), Escherichia coli (17%), and Klebsiella spp. (7%).
Although all patients received antibiotic therapy, compared with those patients with an elevated procalcitonin, patients with a low procalcitonin were significantly more likely to have delayed initiation of antibiotic therapy (3% vs 8%, P = 0.04), including among patients admitted to the ICU (1% vs 18%, P = 0.02).
"Antimicrobial stewardship programs should not use procalcitonin as a means of withholding potentially inappropriate antibiotic therapy in patients being admitted to the hospital," the authors of the study conclude.
Mar 16 Open Forum Infect Dis abstract