Sepsis and the B·R·A·H·M·S Procalcitonin (PCT) AssayWhen seconds count, accurate results can make the difference between life and death.

Sepsis is a life-threatening condition that arises when the body’s response to an infection injures its own tissues and organs.¹ If not recognized and treated quickly with appropriate antibiotics and supportive measures, sepsis can rapidly evolve into septic shock.

• Approximately 25% of patients with sepsis will develop septic shock, and up to 80% of patients with septic shock will die.²

What is PCT?

• When bacterial infection is present, PCT is released from virtually every type of organ and tissue in the body.
• Increasing serum PCT concentrations indicate increased severity of infection and a worse prognosis for the patient.

Procalcitonin (PCT) is a biomarker widely used to assess risk in the setting of bacterial infection for progression to severe sepsis and septic shock in conjunction with other laboratory findings and clinical assessment. Procalcitonin can be used as an aid in identification of patients at lower or higher risk of 28-day mortality after diagnosis with severe sepsis due to bacterial coinfection. It has also been shown to be a valuable tool in the current COVID-19 pandemic, including as a recommended test for potential clinical significance in recognizing bacterial (super) infection.^3,4

There is a definite clinical need for earlier detection of sepsis. When seconds count, accurate results can make the difference between life and death.

Challenges

• Identifying patients with sepsis early, when treatment is most likely to be effective.
• Knowing if the antibiotics applied are appropriate and effective.
• Predicting which patients are at the greatest risk of a poor outcome and require closer monitoring and care.
• Reducing high costs associated with treating patients with severe sepsis and septic shock.
• Differentiating sepsis from other inflammatory diseases, trauma, and other conditions whose clinical picture (signs, symptoms, and laboratory findings) is similar to sepsis.
• Reducing unnecessary antibiotic use and its associated costs and side effects.

Solution: The Atellica® IM B·R·A·H·M·S PCT Assay

• Helps achieve early sepsis risk assessment to help improve patient outcomes, including reduced morbidity and mortality with the ability to make confident decisions in minutes.
• Gain confidence when guiding antibiotic therapy with an assay that has optimal precision across the measurable range.
• Deliver reliable results from a proven, trusted technology that demonstrates high agreement with the B·R·A·H·M·S PCT sensitive KRYPTOR assay.

Interpretation of results: risk assessment for progression to severe sepsis and septic shock
Data support the following interpretative risk assessment criteria on first day of ICU admission:^8,9

• PCT>2.0 ng/mL: Associated with a high risk for progression to severe sepsis and/or septic shock.
• PCT<0.5 ng/mL: Associated with a low risk for progression to severe sepsis and/or septic shock.

Note: PCT levels < 0.5 ng/mL do not exclude an infection, because localized infections (without systemic signs) may also be associated with such low levels. If the PCT measurement is done very early after the systemic infection process has started (usually < 6 hours), these values may still be low.

The Surviving Sepsis Campaign, an initiative of the European Society of Intensive Care Medicine and the U.S. Society of Critical Care Medicine, was developed to improve the management, diagnosis, and treatment of sepsis, and to reduce the mortality rate from severe sepsis worldwide. The most recent evidence-based guidelines were published in 2016.¹⁰

Resources available from the campaign include: 

• Resuscitation and sepsis management bundles: evidence-based guidelines for the management of severe sepsis and septic shock.
• Guidelines and instructions for implementing the campaign at medical facilities.
• Information for healthcare professionals.
• Information for the general public, patients, and their families.
• Educational opportunities.