World Sepsis Day – Focus on Procalcitonin
Sepsis: When Infection Turns Into an Emergency
September 13th is World Sepsis Day — a day to focus global attention on the fight against this life-threatening condition.
Sepsis is not simply “blood poisoning.” It’s a life-threatening overreaction of the body’s immune system to an infection. This uncontrolled, dysregulated response can, in just a few hours, lead to multi-organ failure, shock, and death.
According to WHO data, there were 48.9 million cases of sepsis and 11 million sepsis-related deaths worldwide in 2020 — nearly 20% of all global deaths. Almost half (20 million) occurred in children under 5 years of age [1,2]. In 2024, WHO reiterated the urgent need for early recognition and integrated care for sepsis patients[1].
Spotting the Warning Signs
Sepsis doesn’t always start with dramatic symptoms — in fact, it can look deceptively mild at first. What may seem like “just the flu” can, in a matter of hours, progress to a life-threatening condition.
WHO lists the most common early signs as:
Fever or chills,
Rapid breathing or shortness of breath,
Rapid heartbeat,
Confusion or disorientation,
Clammy or sweaty skin, which may signal circulatory compromise.
Even a single warning sign, especially after a recent infection, should prompt urgent medical evaluation. Early recognition and prompt treatment can be lifesaving.
Why Procalcitonin?
Procalcitonin (PCT) is a biomarker that rises rapidly in bacterial infections and sepsis. Measuring PCT helps clinicians distinguish bacterial from viral infections and supports informed, evidence-based decisions on starting or discontinuing antibiotics. Its dynamic profile makes it a valuable tool: levels rise within 4–6 hours, peak at 12–24 hours, and fall with a half-life of ~24 hours; with effective treatment, levels typically decrease by about 50% per day [4–6]. Multiple studies show also that PCT has significantly better diagnostic accuracy for sepsis compared with CRP in many clinical settings, though performance varies depending on population (ICU vs. ward), etiology, and cut-off values [7].
When to Order PCT?
Mainly while bacterial infection with risk of sepsis is suspected (fever or hypothermia, tachycardia, tachypnea, and/or organ dysfunction such as hypotension, hypoxemia, oliguria, altered mental status).
Differentiating etiology (bacterial vs. viral).
How to interpret PCT results
There’s no single cut-off for all patients. Many protocols consider:
≤0.25 ng/ml in mild respiratory infections,
≤0.5 ng/ml in more severe infections,
≥80% decline from peak value for stopping antibiotics — always together with clinical judgment [4,11,13–15].
Important considerations
PCT can be elevated after trauma, surgery, burns, or shock (false positives).
Early infections may still have low PCT; repeat testing every 24–48 h improves reliability [4,13].
Prevention still matters
While not all sepsis can be prevented, risk can be reduced by:
Staying up to date with vaccinations (meningococci, pneumococci, Haemophilus influenzae type B),
Practising good hygiene,
Maintaining a balanced diet and physical activity,
Managing chronic conditions and seeking timely care for infections.
PCT Testing with the AURYX 90 Immunoassay System*
Sepsis remains a global health emergency, where every hour counts and early recognition is crucial to saving lives. Procalcitonin testing plays a key role in guiding timely and accurate decisions — now made faster and more reliable with the AURYX 90 Immunoassay System.
The AURYX 90 provides an efficient solution for PCT testing: this fully automated analyzer, based on ECLIA technology, delivers up to 86 tests per hour and produces first results within minutes. Equipped with dedicated reagents, including the AURYX 90 PCT Reagent Kit, it offers laboratories a reliable and rapid method for sepsis diagnostics. In clinical practice, AURYX 90 supports healthcare professionals in detecting sepsis earlier and making life-saving therapeutic decisions in a race against time.
*Data on files (Labeling).
References
1. World Health Organization. Sepsis Fact Sheet. WHO, 2024.
2. Rudd KE, et al. Global, regional, and national sepsis incidence and mortality, 1990–2017: analysis for the Global Burden of Disease Study. Lancet. 2020;395(10219):200–211.
3. Singer M, et al. The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA. 2016;315(8):801–810.
4. ADLM (AACC Academy). Clinical Use of Procalcitonin. 2023 Guidance Document.
5. Samsudin I, Vasikaran SD. Clinical Utility and Measurement of Procalcitonin. Clin Biochem Rev. 2017;38(2):59–68.
6. Becker KL, et al. Procalcitonin in sepsis and systemic inflammation: a harmful biomarker and a therapeutic target. Br J Pharmacol. 2010;159(2):253–264.
7. Zaki HA, et al. Diagnostic accuracy of procalcitonin for sepsis: systematic review and meta-analysis. Syst Rev. 2024;13:1–17.
8. Evans L, et al. Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock 2021. Crit Care Med. 2021;49(11):e1063–e1143.
9. Schuetz P, et al. Current evidence for procalcitonin-guided antibiotic stewardship. Lancet Infect Dis. 2018;18(1):95–107.
10. Wirz Y, et al. Effect of procalcitonin-guided antibiotic treatment on clinical outcomes in ICU patients with sepsis. Crit Care Med. 2018;46(6):890–899.
11. Schuetz P, et al. Procalcitonin to initiate or discontinue antibiotics in acute respiratory tract infections. Cochrane Database Syst Rev. 2017;Issue 10:CD007498.
12. Gregoriano C, et al. Procalcitonin-guided antibiotic treatment in patients with cancer: an individual patient data meta-analysis. BMC Cancer. 2024;24:109.
13. Mott T. Procalcitonin stewardship: clinical thresholds for stopping antibiotics. Fed Pract. 2023;40(2):74–79.
14. Park DW, et al. Implementation of procalcitonin testing in antibiotic stewardship. Infect Chemother. 2022;54(2):242–254.
15. Meisner M. Update on procalcitonin measurements. Ann Lab Med. 2014;34(4):263–273.
Contact
PZ Cormay S.A.
Puławska 303
02-785 Warsaw
Poland