Background: Bacterial peritonitis is serious disease and remains a diagnostic challenge for clinicians. Many studies have highlighted the potential usefulness of procalcitonin (PCT) for identification of bacterial peritonitis, however, the overall diagnostic value of PCT remains unclear. Therefore, we performed a meta-analysis to assess the accuracy of PCT for detection of bacterial peritonitis.
Methods: We performed a systematic searched in MEDLINE, EMBASE, SCOPUS, China Biology Medicine Database (CBM), China National Knowledge Infrastructure Database (CNKI) and Cochrane databases for trials that evaluated the diagnostic role of PCT for bacterial peritonitis. Sensitivity, specificity and other measures of accuracy of PCT were pooled using bivariate random effects models.
Results: Eighteen studies involving 1827 patients were included in the present meta-analysis. The pooled sensitivity and specificity of serum PCT for the diagnosis bacterial peritonitis were 0.83 (95% CI: 0.76-0.89) and 0.92 (95% CI: 0.87-0.96), respectively. The positive likelihood ratio was 11.06 (95% CI: 6.31-19.38), negative likelihood ratio was 0.18 (95% CI: 0.12-0.27) and diagnostic odds ratio (DOR) was 61.52 (95% CI: 27.58-137.21). The area under the receiver operating characteristic curve (AUROC) was 0.94. Use of a common PCT cut-off value could improve the DOR to 75.32 and the AUROC to 0.95. Analysis of the seven studies that measured serum C-reactive protein (CRP) indicated that PCT was more accurate than CRP for the diagnosis of bacterial peritonitis.
Conclusions: Our results indicate that PCT determination is a relatively sensitive and specific test for the diagnosis of bacterial peritonitis. However, with regard to methodological limitations and significant heterogeneity, medical decisions should be based on both clinical findings and PCT test results.
The increasing occurrence of infections caused by multidrug-resistant (MDR) bacteria drives the need for new antibacterial drugs. Due to the current lack of antibiotic discovery and development, new strategies to fight MDR bacteria are urgently needed. Efforts to develop new antibiotic adjuvants to increase the effectiveness of existing antibiotics and design delivery systems are essential to address this issue.
The combination of aztreonam (ATM) and avibactam (AVI) is an attractive option to treat infections caused by extended spectrum β-lactamase plus NDM-1-producing . Since ATM activity was shown to be severely impacted by an increase in the inoculum size , we wondered whether ATM-AVI activity could be impaired in high-inoculum infections. We analyzed the impact of the inoculum size on ATM-AVI activity and in a murine model of peritonitis due to susceptible CFT073-pTOPO and its isogenic derivatives producing NDM-1 ( CFT073-NDM1) and CTX-M-15 plus NDM-1 ( CFT073-CTXM15-NDM1).
A significant increase in multidrug-resistant Methicillin-resistant Staphylococcus aureus (MRSA) infections has made it crucial to explore new antimicrobial drugs and strategies. Emerging evidence suggests that the bile acid metabolite isoallolithocholic acid (isoallo-LCA) may contribute to reducing the risk of infection among centenarians. However, its precise role remains somewhat ambiguous and necessitates further investigation.
