Comparison of serum PCT and CRP levels in patients infected by different pathogenic microorganisms: a systematic review and meta-analysis

To avoid the abuse and misuse of antibiotics, procalcitonin (PCT) and C-reactive protein (CRP) have been used as new approaches to identify different types of infection. Multiple databases were adopted to search relevant studies, and the articles that satisfied the inclusion criteria were included. Meta-analyses were conducted with Review Manager 5.0, and to estimate the quality of each article, risk of bias was assessed. Eight articles satisfied the inclusion criteria. The concentrations of both PCT and CRP in patients with bacterial infection were higher than those with non-bacterial infection. Both PCT and CRP levels in patients with G− bacterial infection were higher than in those with G+ bacterial infection and fungus infection. In the G+ bacterial infection group, a higher concentration of CRP was observed compared with fungus infection group, while the difference of PCT between G+ bacterial infection and fungus infection was not significant. Our study suggested that both PCT and CRP are helpful to a certain extent in detecting pneumonia caused by different types of infection.为规避抗生素的滥用与误用，降钙素原（procalcitonin, PCT）与C反应蛋白（C-reactive protein, CRP）已被用作鉴别不同类型感染的新型检测指标。本研究通过多数据库检索相关研究，纳入符合纳入标准的文献。采用Review Manager 5.0开展荟萃分析，并通过偏倚风险评估对每篇文献的研究质量进行评价。最终共有8篇文献符合纳入标准。细菌感染患者的降钙素原与C反应蛋白浓度均高于非细菌感染患者。革兰氏阴性（G−）细菌感染患者的降钙素原与C反应蛋白水平均高于革兰氏阳性（G+）细菌感染及真菌感染患者。在革兰氏阳性细菌感染组中，C反应蛋白浓度高于真菌感染组，但革兰氏阳性细菌感染与真菌感染患者的降钙素原浓度差异无统计学意义。本研究表明，降钙素原与C反应蛋白在一定程度上可辅助鉴别不同感染类型引发的肺炎。