Clinical Predictors and Biomarkers in Children With Sepsis and Bacterial Meningitis.

Autor:	Castagno E; From the Department of Pediatric Emergency, Regina Margherita Children's Hospital - A.O.U. Città della Salute e della Scienza di Torino, Turin, Italy., Aguzzi S; From the Department of Pediatric Emergency, Regina Margherita Children's Hospital - A.O.U. Città della Salute e della Scienza di Torino, Turin, Italy., Rossi L; Division of Pediatrics and Neonatology, P.O. Ciriè, ASL-TO4, Ciriè (TO), Italy., Gallo R; Pediatric Department, E. Agnelli Hospital, Pinerolo (TO), Italy., Carpino A; Department of Public Health and Pediatrics, University of Turin, Turin, Italy., Ricceri F; Department of Clinical and Biological Sciences, University of Turin, Orbassano (TO), Italy., Urbino AF; From the Department of Pediatric Emergency, Regina Margherita Children's Hospital - A.O.U. Città della Salute e della Scienza di Torino, Turin, Italy., Bondone C; From the Department of Pediatric Emergency, Regina Margherita Children's Hospital - A.O.U. Città della Salute e della Scienza di Torino, Turin, Italy.
Jazyk:	angličtina
Zdroj:	Pediatric emergency care [Pediatr Emerg Care] 2023 May 01; Vol. 39 (5), pp. 311-317. Date of Electronic Publication: 2023 Jan 30.
DOI:	10.1097/PEC.0000000000002865
Abstrakt:	Objectives: Sepsis and meningitis in children may present with different clinical features and a wide range of values of inflammatory markers. The aim of this study was to identify the prognostic value of clinical features and biomarkers in children with sepsis and bacterial meningitis in the emergency department (ED). Methods: We carried out a single-center, retrospective, observational study on 194 children aged 0 to 14 years with sepsis and bacterial meningitis admitted to the pediatric ED of a tertiary children's hospital through 12 years. Results: Among epidemiological and early clinical features, age older than 12 months, capillary refill time greater than 3 seconds, and oxygen blood saturation lower than 90% were significantly associated with unfavorable outcomes, along with neurological signs ( P < 0.05). Among laboratory tests, only procalcitonin was an accurate and early prognostic biomarker for sepsis and bacterial meningitis in the ED, both on admission and after 24 hours. Procalcitonin cut-off value on admission for short-term complications was 19.6 ng/mL, whereas the cut-off values for long-term sequelae were 19.6 ng/mL on admission and 41.9 ng/mL after 24 hours, respectively. The cut-off values for mortality were 18.9 ng/mL on admission and 62.4 ng/mL at 24 hours. Conclusions: Procalcitonin, along with clinical evaluation, can guide the identification of children at higher risk of morbidity and mortality, allowing the most appropriate monitoring and treatment. Competing Interests: Disclosure: The authors declare no conflict of interest. (Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.)
Databáze:	MEDLINE
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