{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T21:04:08Z","timestamp":1792789448339,"version":"4.5.0"},"reference-count":44,"publisher":"MDPI AG","issue":"19","license":[{"start":{"date-parts":[[2023,9,24]],"date-time":"2023-09-24T00:00:00Z","timestamp":1695513600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"EU funding within the MUR PNRR Extended Partnership initiative on Emerging Infectious Diseases","award":["PE00000007"],"award-info":[{"award-number":["PE00000007"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: The aim of this study was to assess whether procalcitonin levels is a diagnostic tool capable of accurately identifying sepsis and ventilator-associated pneumonia (VAP) even in critically ill COVID-19 patients. Methods: In this retrospective, observational study, all critically ill COVID-19 patients who survived for \u22652 days in a single university hospital and had at least one serum procalcitonin (PCT) value and associated blood culture and\/or culture from a lower respiratory tract specimen available were eligible for the study. Results: Over the research period, 184 patients were recruited; 67 VAP\/BSI occurred, with an incidence rate of 21.82 episodes of VAP\/BSI (95% CI: 17.18\u201327.73) per 1000 patient-days among patients who were included. At the time of a positive microbiological culture, an average PCT level of 1.25\u20133.2 ng\/mL was found. Moreover, also in subjects without positive cultures, PCT was altered in 21.7% of determinations, with an average value of 1.04\u20135.5 ng\/mL. Both PCT and PCT-72 h were not linked to a diagnosis of VAP\/BSI in COVID-19 patients, according to the multivariable GEE models (aOR 1.13, 95% CI 0.51\u20132.52 for PCT; aOR 1.32, 95% CI 0.66\u20132.64 for PCT-72 h). Conclusion: Elevated PCT levels might not always indicate bacterial superinfections or coinfections in a severe COVID-19 setting.<\/jats:p>","DOI":"10.3390\/jcm12196171","type":"journal-article","created":{"date-parts":[[2023,9,24]],"date-time":"2023-09-24T10:48:31Z","timestamp":1695552511000},"page":"6171","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Reduced Reliability of Procalcitonin (PCT) as a Biomarker of Bacterial Superinfection: Concerns about PCT-Driven Antibiotic Stewardship in Critically Ill COVID-19 Patients\u2014Results from a Retrospective Observational Study in Intensive Care Units"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5921-3180","authenticated-orcid":false,"given":"Giancarlo","family":"Ceccarelli","sequence":"first","affiliation":[{"name":"Hospital Policlinico Umberto I, 00161 Rome, Italy"},{"name":"Department of Public Health and Infectious Diseases, University of Rome Sapienza, 00185 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3989-4964","authenticated-orcid":false,"given":"Francesco","family":"Alessandri","sequence":"additional","affiliation":[{"name":"Hospital Policlinico Umberto I, 00161 Rome, Italy"},{"name":"Department of Public Health and Infectious Diseases, University of Rome Sapienza, 00185 Rome, Italy"},{"name":"Intensive Care Unit, Department of General, Specialistic Surgery, University of Rome Sapienza, 00185 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4573-6025","authenticated-orcid":false,"given":"Giuseppe","family":"Migliara","sequence":"additional","affiliation":[{"name":"Hospital Policlinico Umberto I, 00161 Rome, Italy"},{"name":"Department of Public Health and Infectious Diseases, University of Rome Sapienza, 00185 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7873-7817","authenticated-orcid":false,"given":"Valentina","family":"Baccolini","sequence":"additional","affiliation":[{"name":"Hospital Policlinico Umberto I, 00161 Rome, Italy"},{"name":"Department of Public Health and Infectious Diseases, University of Rome Sapienza, 00185 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"Giordano","sequence":"additional","affiliation":[{"name":"Hospital Policlinico Umberto I, 00161 Rome, Italy"},{"name":"Department of Public Health and Infectious Diseases, University of Rome Sapienza, 00185 Rome, Italy"},{"name":"Intensive Care Unit, Department of General, Specialistic Surgery, University of Rome Sapienza, 00185 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gioacchino","family":"Galardo","sequence":"additional","affiliation":[{"name":"Hospital Policlinico Umberto I, 00161 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7299-5727","authenticated-orcid":false,"given":"Carolina","family":"Marzuillo","sequence":"additional","affiliation":[{"name":"Department of Public Health and Infectious Diseases, University of Rome Sapienza, 00185 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Corrado","family":"De Vito","sequence":"additional","affiliation":[{"name":"Department of Public Health and Infectious Diseases, University of Rome Sapienza, 00185 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3846-4620","authenticated-orcid":false,"given":"Alessandro","family":"Russo","sequence":"additional","affiliation":[{"name":"Infectious and Tropical Disease Unit, Department of Medical and Surgical Sciences, \u2018Magna Graecia\u2019 University of Catanzaro, 88100 Catanzaro, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Massimo","family":"Ciccozzi","sequence":"additional","affiliation":[{"name":"Unit of Medical Statistics and Molecular Epidemiology, University Campus Bio-Medico of Rome, 00128 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paolo","family":"Villari","sequence":"additional","affiliation":[{"name":"Department of Public Health and Infectious Diseases, University of Rome Sapienza, 00185 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2639-0281","authenticated-orcid":false,"given":"Mario","family":"Venditti","sequence":"additional","affiliation":[{"name":"Hospital Policlinico Umberto I, 00161 Rome, Italy"},{"name":"Department of Public Health and Infectious Diseases, University of Rome Sapienza, 00185 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1286-467X","authenticated-orcid":false,"given":"Claudio M.","family":"Mastroianni","sequence":"additional","affiliation":[{"name":"Hospital Policlinico Umberto I, 00161 Rome, Italy"},{"name":"Department of Public Health and Infectious Diseases, University of Rome Sapienza, 00185 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8076-1250","authenticated-orcid":false,"given":"Francesco","family":"Pugliese","sequence":"additional","affiliation":[{"name":"Hospital Policlinico Umberto I, 00161 Rome, Italy"},{"name":"Department of Public Health and Infectious Diseases, University of Rome Sapienza, 00185 Rome, Italy"},{"name":"Intensive Care Unit, Department of General, Specialistic Surgery, University of Rome Sapienza, 00185 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3571-5677","authenticated-orcid":false,"given":"Gabriella","family":"d\u2019Ettorre","sequence":"additional","affiliation":[{"name":"Hospital Policlinico Umberto I, 00161 Rome, Italy"},{"name":"Department of Public Health and Infectious Diseases, University of Rome Sapienza, 00185 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,9,24]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"dlac064","DOI":"10.1093\/jacamr\/dlac064","article-title":"Superinfections caused by carbapenem-resistant Enterobacterales in hospitalized patients with COVID-19, a multicentre observational study from Italy (CREVID Study)","volume":"4","author":"Falcone","year":"2022","journal-title":"JAC Antimicrob. 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