Procalcitonin


Abbrev Code:PCAL   
Order Code:LAB5727Order Name:Procalcitonin
Synonyms:PCT
Methodology:Roche: Electrochemiluminescence immunoassay (ECLIA)
Vista: ELISA
CPT Codes: 84145 x1, 84145 x1
Turnaround Time:Performed and reported 24 hours/day.
Associated Links:

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Collection Instructions

Specimen:Blood
Optimal Volume:3.0 mL
Minimum\Peds Volume:1.0 mL
Collection Instructions:Chemistry Tests Containers Chart
Causes for Rejection:Hemolysis, icterus and lipemia, greater than moderate. Samples that have undergone multiple freeze-thaw cycles.


Processing and Shipping

Specimen Processing:Centrifuge and aliquot 1.5 mL, 0.4 mL minimum. Store in refrigerator.
Shipping Instructions:Ship at refrigerated temperature.
Stability:Roche: 24 hours at room temperature; 48 hours refrigerated; 12 months frozen. Freeze only once.
Vidas: 4 hours at room temperature; 48 hour refrigerated.
Test Performed at or Referral Lab Chemistry  (Roche-Grand Itasca, Roche-Lakes, Roche-Northland, Roche-Range, Roche-Ridges, Roche-Southdale, Roche-St. John's, Roche-UMMC East, UMMC West Bank, Woodwinds)


Interpretive

Critical Range:Greater than or equal to 5.00 ng/mL
Reference Range:Less than 5 ng/mL

Interpretation Guidelines
  Interpretation Recommendations
<0.05 ng/mL Normal Very low risk of bacterial infection. Strongly discourage antibiotics.
0.05-0.24 ng/mL Low risk of systemic
infection. Local bacterial infection possible. 		Assess other clinical features of infection. Discourage antibiotics.
0.25-0.49 ng/mL Possible early systemic infection or localized infection Encourage antibiotics only in correct clinical context. Consider obtaining blood cultures or other relevant cultures. Recheck PCT in 6-12 hours to ensure baseline low level. If repeat PCT is rising, consider early systemic infection and consider starting antibotics.
0.50-1.99 ng/mL Moderate risk of systemic infection. Recommend antibiotics. Evaluate culture results and clinical features to target antibacterial therapy. Obtain blood cultures and other relevant cultures if not done. If empiric antibiotics were started, recheck PCT in 2 days to guide antibiotic de-escalation. Discontinue or de-escalate antibiotics when PCT concentration is <80% of peak or abs PCT <0.5. If empiric antibiotics were NOT started, recheck PCT in 6-12 hours to re-evaluate need for antibiotics.
2.00-9.99 g/mL High risk for progression to severe sepsis. Strongly recommend initiating or continuing antibiotics. Evaluate culture results and clinical features to target antibacterial therapy. Obtain blood cultures and other relevant cultures if not done. Repeat PCT in 2 days to guide antibiotic de-escalation. Consider de-escalating antibiotics when PCT concentration is <80% or peak or abs PCT < 0.05.
≥ 10 ng/mL Very high likelihood of severe sepsis or septic shock. Strongly recommend initiating or continuing antibiotics. Evaluate culture results and clinical features to target antibacterial therapy. Obtain blood cultures and other relevant cultures if not done. Repeat PCT in 2 days to guide antibiotic de-escalation. Consider de-escalating antibiotics when PCT concentration is <80% of peak or abs PCT < 1.
   
Use:Useful in the diagnosis of systemic bacterial infection and sepsis and optimization of antibiotic therapy. Procalcitonin (PCT) is a calcitonin precursor produced during periods of heightened inflammation. PCT production is particularly pronounced in the presence of bacterial infection. High PCT levels might indicate severe infection, and low and/or decreasing levels might assist in deciding the most appropriate time to discontinue antimicrobial therapy.


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