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KMID : 1100720210410040419
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Annals of Laboratory Medicine
2021 Volume.41 No. 4 p.419 ~ p.423
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Concordance of Three Automated Procalcitonin Immunoassays at Medical Decision Points
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Cho Hae-Weon
Kim Sun-Hee
Cho Yong-Geun
Jeong Seok-Hoon
Lee Sang-Guk
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Abstract
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Procalcitonin (PCT) is a useful bacterial infection biomarker with the potential for guiding antibiotic therapy. We evaluated the concordance of three automated PCT immunoassays: Kryptor (BRAHMS GmbH, Hennigsdorf, Germany), Atellica IM 1600 (Siemens Healthcare Diagnostics, Munich, Germany), and Cobas e801 (Roche Diagnostics, Mannheim, Germany). In 119 serum samples with a PCT concentration <5.00 μg/L, Kryptor (reference assay) was compared with the other two immunoassays by Spearman’s rank correlation, regression analysis, and concordance at two antibiotic stewardship medical decision points: 0.25 and 0.50 μg/L. The Atellica IM 1600 and Cobas e801 results showed high correlations with those of Kryptor, with correlation coefficient (ρ) values of 0.97 and 0.99, respectively. However, negative biases were observed in both immunoassays (slope/y-intercept: 0.75/?0.00 for Atellica IM 1600; 0.88/?0.01 for Cobas e801). Atellica IM 1600 and Cobas e801 demonstrated excellent concordance with Kryptor at both medical decision points, with linearly weighted κ values of 0.90 and 0.92, respectively, despite discrepancies, which were more prominent at the 0.25 μg/L medical decision point. Based on these biases and discrepancies, the alternate use of different PCT immunoassays in repeat examinations is inadvisable. Standardization is required before comparing the results of different PCT immunoassays.
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KEYWORD
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Procalcitonin, Standardization, Concordance, Immunoassay, Kryptor, Atellica IM 1600, Cobas e801
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