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Vol. 54. Núm. 1.
Páginas 69-73 (enero 2001)
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Vol. 54. Núm. 1.
Páginas 69-73 (enero 2001)
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Procalcitonina: un nuevo marcador de infección bacteriana
Procalcitonin. A new marker for bacterial infection
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J. Casado Floresa,
Autor para correspondencia
jcasadof@line_pro.es

Correspondencia: Servicio de Cuidados Intensivos Pediátricos. Hospital Universitario del Niño Jesús. Avda. Menéndez Pelayo, 65. 28009 Madrid
, A. Blanco Quirósb
a Servicio de Cuidados Intensivos Pediátricos. Hospital Universitario del Niño Jesús. Universidad Autónoma de Madrid
b Área de Pediatría. Universidad de Valladolid
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La procalcitonina (PCT) es un polipéptido sérico que se encuentra en el plasma en cantidades mínimas (, 0,5 ng/ml) y se eleva intensamente a las pocas horas de la administración de endotoxina en voluntarios humanos, así como en las infecciones bacterianas sistémicas graves (sepsis, shock séptico y meningitis).

La PCT aumenta moderadamente en las infecciones bacterianas localizadas (neumonía y pielonefritis) y no se modifica ni en las infecciones víricas, ni en la colonización bacteriana. El incremento de la PCT aparece en las infecciones bacterianas graves de los recién nacidos, lactantes, niños mayores y adultos, siendo en la actualidad el mejor marcador de infección bacteriana, mejor que la fórmula y recuento leucocitario, interleucinas o proteína C reactiva. Este último puede ser normal en la primera fase de la sepsis grave, y puede incrementarse también en algunas infecciones víricas.

Nosotros hemos comprobado en 54 niños con sepsis grave que los valores plasmáticos de PCT están correlacionados con el número de fármacos vasoactivos empleados para el soporte cardiocirculatorio.

La PCT puede determinarse de manera semicuantitativa en la cabecera del enfermo en cualquier momento y en cualquier hospital sin necesidad de aparatos de medida, utilizando un sencillo test, que permite en menos de 30 min discernir el tipo de infección y la indicación o no de antibioterapia.

Palabras clave:
rocalcitonina
Sepsis
Shock séptico
Meningitis
Infección bacteriana

Procalcitonin is a polypeptide present in the plasma of healthy subjects in minimal levels (, 0.5 ng/ml). Serum procalcitonin is markedly increased a few hours after the administration of endotoxin to human volunteers and in invasive bacterial infection (sepsis, septic shock, meningitis). Procalcitonin is moderately increased in local bacterial infection (pneumonia, pyelonephritis) and is unchanged in viral infections or bacterial colonization. Procalcitonin is increased in serious bacterial infections in neonates, children and adults and is currently the best diagnostic marker of severe bacterial infection, being better than leukocyte, interleukin or C-reactive protein counts. C-reactive protein levels can be normal in severe sepsis and some viral infections. We studied 54 children with sepsis in whom plasma procalcitonin levels showed a positive correlation with the vasoactive drugs necessary to maintain cardiovascular activity. The semiquantitative procalcitonin test is simple and easy to use at the bedside at any time and in any hospital as no instruments are required. Within 30 minutes, the test identifies the type of infection and whether antibiotics are indicated.

Key words:
rocalcitonin
Sepsis
Sepsis shock
Meningitis
Bacterial infection
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Copyright © 2001. Asociación Española de Pediatría
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