Correlation between locally versus centrally processed serum procalcitonin during emergency department research evaluation of febrile infants aged 0–60 days

Introduction: Procalcitonin (PCT) is a useful biomarker in the initial evaluation of febrile infants for serious bacterial infections (SBIs). However, PCT is not always available locally and must at times be frozen and shipped to a reference laboratory for research studies. We sought to compare PCT...

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Main Authors: Cosby G. Arnold, Prashant Mahajan, Russell K. Banks, John M. VanBuren, Nam K. Tran, Octavio Ramilo, Nathan Kuppermann
Format: Article
Language:English
Published: Elsevier 2024-03-01
Series:Practical Laboratory Medicine
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S2352551724000374
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author Cosby G. Arnold
Prashant Mahajan
Russell K. Banks
John M. VanBuren
Nam K. Tran
Octavio Ramilo
Nathan Kuppermann
author_facet Cosby G. Arnold
Prashant Mahajan
Russell K. Banks
John M. VanBuren
Nam K. Tran
Octavio Ramilo
Nathan Kuppermann
author_sort Cosby G. Arnold
collection DOAJ
description Introduction: Procalcitonin (PCT) is a useful biomarker in the initial evaluation of febrile infants for serious bacterial infections (SBIs). However, PCT is not always available locally and must at times be frozen and shipped to a reference laboratory for research studies. We sought to compare PCT measured locally versus centrally at a reference laboratory during a research study. Materials and methods: This was a secondary analysis of a multicenter study of febrile infants ≤60 days evaluated for SBIs from June 2016 to April 2019. A PCT cutoff value of 0.5 ng/mL was used to stratify infants at low-versus high-risk of SBIs. Statistical analyses consisted of Spearman's correlation, Bland-Altman difference plotting, Passing-Bablok regression, Deming regression, and Fisher's exact testing at the 0.5 ng/mL threshold. Results: 241 febrile infants had PCT levels measured both locally and at the reference laboratory. PCT levels measured locally on 5 different platforms and from the frozen research samples demonstrated strong Spearman's correlation (ρ = 0.83) and had similar mean PCT values with an average relative difference of 0.02%. Eleven infants with SBIs had PCT values < 0.5 ng/mL in both the clinical and research samples. Six other infants had differences in SBI prediction based on PCT values at the 0.5 ng/mL threshold between the clinical and research platforms. Conclusions: We found no significant differences in detection of febrile infants at high risk for SBI based on locally (on multiple platforms) versus centrally processed PCT. Testing at a central reference laboratory after freezing and shipping is an accurate and reliable alternative for research studies or when rapid turnaround is not required.
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spelling doaj.art-44f869e37aa1428ab3c6d19e6b5f69a22024-03-28T06:38:15ZengElsevierPractical Laboratory Medicine2352-55172024-03-0139e00391Correlation between locally versus centrally processed serum procalcitonin during emergency department research evaluation of febrile infants aged 0–60 daysCosby G. Arnold0Prashant Mahajan1Russell K. Banks2John M. VanBuren3Nam K. Tran4Octavio Ramilo5Nathan Kuppermann6Department of Emergency Medicine, University of California, Davis, School of Medicine, 2315 Stockton Blvd, PSSB Ste 2100, Sacramento, CA, 95817, USA; Corresponding author.Departments of Emergency Medicine and Pediatrics, University of Michigan Medical School, 1540 East Hospital Drive, CW 2-737, SPC 4260, Ann Arbor, MI, 48109-4260, USAUniversity of Utah Data Coordinating Center, 295 Chipeta Way, Salt Lake City, UT, 84108, USAUniversity of Utah Data Coordinating Center, 295 Chipeta Way, Salt Lake City, UT, 84108, USADepartment of Pathology and Laboratory Medicine, University of California, Davis, School of Medicine, 4400 V Street, Sacramento, CA, 95817, USADepartment of Infectious Diseases, MS 320, Room E8050, St. Jude Children's Research Hospital, 262 Danny Thomas Place, Memphis, TN, 38105, USADepartments of Emergency Medicine and Pediatrics, University of California, Davis, School of Medicine, 2315 Stockton Blvd, PSSB Ste 2100, Sacramento, CA, 95817, USAIntroduction: Procalcitonin (PCT) is a useful biomarker in the initial evaluation of febrile infants for serious bacterial infections (SBIs). However, PCT is not always available locally and must at times be frozen and shipped to a reference laboratory for research studies. We sought to compare PCT measured locally versus centrally at a reference laboratory during a research study. Materials and methods: This was a secondary analysis of a multicenter study of febrile infants ≤60 days evaluated for SBIs from June 2016 to April 2019. A PCT cutoff value of 0.5 ng/mL was used to stratify infants at low-versus high-risk of SBIs. Statistical analyses consisted of Spearman's correlation, Bland-Altman difference plotting, Passing-Bablok regression, Deming regression, and Fisher's exact testing at the 0.5 ng/mL threshold. Results: 241 febrile infants had PCT levels measured both locally and at the reference laboratory. PCT levels measured locally on 5 different platforms and from the frozen research samples demonstrated strong Spearman's correlation (ρ = 0.83) and had similar mean PCT values with an average relative difference of 0.02%. Eleven infants with SBIs had PCT values < 0.5 ng/mL in both the clinical and research samples. Six other infants had differences in SBI prediction based on PCT values at the 0.5 ng/mL threshold between the clinical and research platforms. Conclusions: We found no significant differences in detection of febrile infants at high risk for SBI based on locally (on multiple platforms) versus centrally processed PCT. Testing at a central reference laboratory after freezing and shipping is an accurate and reliable alternative for research studies or when rapid turnaround is not required.http://www.sciencedirect.com/science/article/pii/S2352551724000374ProcalcitoninBiomarkersSerious bacterial infectionInfectious diseaseInterlaboratory performanceFebrile infant
spellingShingle Cosby G. Arnold
Prashant Mahajan
Russell K. Banks
John M. VanBuren
Nam K. Tran
Octavio Ramilo
Nathan Kuppermann
Correlation between locally versus centrally processed serum procalcitonin during emergency department research evaluation of febrile infants aged 0–60 days
Practical Laboratory Medicine
Procalcitonin
Biomarkers
Serious bacterial infection
Infectious disease
Interlaboratory performance
Febrile infant
title Correlation between locally versus centrally processed serum procalcitonin during emergency department research evaluation of febrile infants aged 0–60 days
title_full Correlation between locally versus centrally processed serum procalcitonin during emergency department research evaluation of febrile infants aged 0–60 days
title_fullStr Correlation between locally versus centrally processed serum procalcitonin during emergency department research evaluation of febrile infants aged 0–60 days
title_full_unstemmed Correlation between locally versus centrally processed serum procalcitonin during emergency department research evaluation of febrile infants aged 0–60 days
title_short Correlation between locally versus centrally processed serum procalcitonin during emergency department research evaluation of febrile infants aged 0–60 days
title_sort correlation between locally versus centrally processed serum procalcitonin during emergency department research evaluation of febrile infants aged 0 60 days
topic Procalcitonin
Biomarkers
Serious bacterial infection
Infectious disease
Interlaboratory performance
Febrile infant
url http://www.sciencedirect.com/science/article/pii/S2352551724000374
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