Procalcitonin as a Marker of Serious Bacterial Infections in Febrile Children Younger Than 3 Years Old
| Autor: | Xinguang Chen, Nirupama Kannikeswaran, Nathan Kuppermann, Rachel M. Stanley, Mary Grzybowski, Prashant Mahajan, Bonita Singal, Dominic A. Borgialli, Elizabeth Duffy, John D. Hoyle |
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| Rok vydání: | 2014 |
| Předmět: |
Calcitonin
Male medicine.medical_specialty Fever Calcitonin Gene-Related Peptide Bacteremia Procalcitonin Leukocyte Count Pneumonia Bacterial Humans Medicine Prospective Studies Protein Precursors Gynecology Extramural business.industry Infant Newborn Infant General Medicine Cross-Sectional Studies Logistic Models ROC Curve Multicenter study Child Preschool Multivariate Analysis Urinary Tract Infections Emergency Medicine Female Emergency Service Hospital business Biomarkers |
| Zdroj: | Academic Emergency Medicine. 21:171-179 |
| ISSN: | 1069-6563 |
| DOI: | 10.1111/acem.12316 |
| Popis: | Objectives There is no perfectly sensitive or specific test for identifying young, febrile infants and children with occult serious bacterial infections (SBIs). Studies of procalcitonin (PCT), a 116-amino-acid precursor of the hormone calcitonin, have demonstrated its potential as an acute-phase biomarker for SBI. The objective of this study was to compare performance of serum PCT with traditional screening tests for detecting SBIs in young febrile infants and children. Methods This was a prospective, multicenter study on a convenience sample from May 2004 to December 2005. The study was conducted in four emergency departments (EDs): one pediatric ED and three EDs with pediatric units, all with academic faculty on staff. A total of 226 febrile children 36 months old or younger who presented to the four participating EDs and were evaluated for SBI by blood, urine, and/or cerebral spinal fluid (CSF) cultures were included. Results The test characteristics (with 95% confidence intervals [CIs]) of the white blood cell (WBC) counts including neutrophil and band counts were compared with PCT for identifying SBI. Thirty children had SBIs (13.3%, 95% CI = 8.85 to 17.70). Four (13.3%) had bacteremia (including one with meningitis), 18 (60.0%) had urinary tract infections (UTIs), and eight (26.6%) had pneumonia. Children with SBIs had higher WBC counts (18.6 × 109 ± 8.6 × 109 cells/L vs. 11.5 × 109 ± 5.3 × 109 cells/L, p |
| Databáze: | OpenAIRE |
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