ABSTRACT
Objective To investigate the variation of procalcitonin(PCT) in blood and tissue level of acute pancreatitis rats and probe its significant. Methods One hundred and two male Wistar rats were randomly divided into control group ( n = 6 ), lipopolysaccharide group ( LPS, n = 24 ), acute edematous pancreatitis (AEP) group ( n = 24), acute necrotizing pancreatitis (ANP) group ( n = 24), AN P + LPS group ( n = 24). Subcutaneous injection of cerulein was used for AEP induction, while ANP model was induced by retrograde injection of sodium taurocholate into the biliary and pancreatic duct. The rats were sacrificed at 3,6, 18 and 24 hours after model induction. Pancreatic tissue was harvested and the pathological scores were assessed. Levels of PCT in serum, liver, lung, spleen, pancreas, small intestine, large intestine tissue was harvested and tissue levels of PCT were determined. Results AEP and ANP models were established successfully. At 6 h, the serum levels of PCT in control group, LPS group, AEP group, ANP group and ANP +LPS group were (0.0144 ±0.0082) ng/ml, (0. 1722 ±0.0449) ng/ml,(0.4751 ±0.0572) ng/ml, (0.7070 ±0. 1040) ng/ml and ( 1. 1960 ±0.8644) ng/ml, respectively; and the difference was statistically significant (P < 0.05 ). PCT could be detected in liver, lung, spleen, pancreas, small intestine and large intestine tissue of normal rats. PCT levels in liver and pancreas of ANP group were not statistically different, but the PCT levels in lung, spleen, and large intestine tissue significantly decreased, and the corresponding values were (5.63 ±0.62) ng/ml vs. (6.85 ±0.46) mg/ml, (4.73 ±1.27) mg/ml vs. (6.88 ±0.37) ng/ml, (1.08 ±0.52) ng/ml vs. (4.12 ± 1.02) ng/ml (P <0.01 ). However, the PCT levels in small intestine significantly increased, which were (2.51 ±0.90) ng/ml vs (0.98 ±0. 12) ng/ml (P<0. 01). Conclusions Serum PCT level was associated with the severity of AP and infection; the changes of PCT levels in different tissues may be related with the changes of organ's function.
ABSTRACT
BACKGROUND: For an optimum treatment of infections, appropriate antimicrobials should be selected according to the results of antibiotic susceptibility test (AST). However, the present AST does not take into account of antimicrobial concentrations in tissues, although different tissues have different distribution of antimicrobials. Thereby we intended to evaluate the usefulness of interpreting antimicrobial susceptibility depending on tissue concentrations of antimicrobials. METHODS: Gram-negative bacilli isolated from clinical specimens at Yeungnam University Hospital during the period from January to July, 2006 were evaluated retrospectively. The data on blood concentration, half life and tissue distribution of antimicrobials with variable administration route and dosage were collected and arranged in the forms of previous reports. The diameters of the zone of inhibition from the disc diffusion method were converted to minimum inhibitory concentration (MIC) and the organism was regarded as resistant if the converted concentration was higher than the expected concentration in the tissue. RESULTS: Among the data reported as susceptible, antimicrobial concentrations in peritoneal fluid and bile showed a relatively good relationship with AST. But, aminoglycosides and carbenicllin concentrations in wounds and respiratory tissues were shown to be inadequate, thus resulting in a low bacteriologic cure. In cerebrospinal fluid, ciprofloxacin was less effective regardless of dosage. CONCLUSION: Antimicrobial concentration is variable in different tissues and more information on antimicrobial tissue distribution is needed for the appropriate treatment of infections. Reporting of MIC rather than AST with breakpoints should be considered for selection of antimicrobials. Therefore, an interpretation of AST in consideration of the tissue concentration would be more helpful for prevention of major errors and control of infections.