Omar Amr S, ElShawarby Amr, Singh Rajvir
Department of Cardiothoracic Surgery/Cardiac Anaesthesia & ICU Section, Heart Hospital, Hamad Medical Corporation, P.O. Box 3050, Doha, Qatar.
Faculty of Medicine, Beni Suef University, Beni Suef, Egypt.
J Clin Monit Comput. 2015 Dec;29(6):759-65. doi: 10.1007/s10877-015-9663-1. Epub 2015 Feb 1.
Several factors are implicated in the increased vulnerability of multiple trauma victims to infection, especially in intensive care units. The incidence of EVD related infections ranges from 5 to 20%. To assess the accuracy of serum procalcitonin (PCT) in predicting central nervous system (CNS) infection in patients with EVDs. Thirty-six adult patients with severe head trauma were enrolled in this prospective study, after exclusion of other causes of fever; patients were subjected to sampling of C-reactive protein (CRP), PCT, and cerebrospinal fluid (CSF) cultures every other day. Five patients developed ventriculostomy-related infections, and all had an elevated serum PCT concentration. Patients with negative CSF cultures had mean serum PCT <2.0 ng/ml, while patients with positive culture had early elevation of serum PCT with mean of 4.18 ng/ml, CRP did not show similar early changes. Patients who acquire CNS infection had prolonged length of stay in hospital and length of ventilation. In absence of other nosocomial infections, early high serum PCT concentrations appear to be a reliable indicator of bacterial CNS infection in patients with EVD.
多个因素与多发伤患者尤其是在重症监护病房中感染易感性增加有关。埃博拉病毒病（EVD）相关感染的发生率在5%至20%之间。为评估血清降钙素原（PCT）在预测埃博拉病毒病患者中枢神经系统（CNS）感染方面的准确性。本前瞻性研究纳入了36例重度颅脑外伤成年患者，排除其他发热原因后，患者每隔一天接受C反应蛋白（CRP）、PCT和脑脊液（CSF）培养采样。5例患者发生了与脑室造瘘相关的感染，且所有患者血清PCT浓度均升高。脑脊液培养阴性的患者血清PCT平均<2.0 ng/ml，而培养阳性的患者血清PCT早期升高，平均值为4.18 ng/ml，CRP未显示类似的早期变化。发生中枢神经系统感染的患者住院时间和通气时间延长。在没有其他医院感染的情况下，早期血清PCT浓度升高似乎是埃博拉病毒病患者细菌性中枢神经系统感染的可靠指标。
