Comparison of procalcitonin with C-reactive protein, interleukin 6 and interferon-alpha for differentiation of bacterial vs. viral infections

Autor: Catherine Royer, Hervé Lefèvre, Catherine Lacombe, Florence Moulin, Pierre Palmer, Mathie Lorrot, Claude Bohuon, Josette Raymond, Sylvie Guerin, Joël Coste, Sophie Ravilly, Dominique Gendrel
Rok vydání: 1999
Předmět:
Calcitonin
Microbiology (medical)
congenital
hereditary
and neonatal diseases and abnormalities

Adolescent
Calcitonin Gene-Related Peptide
medicine.medical_treatment
Alpha interferon
Sensitivity and Specificity
Procalcitonin
Predictive Value of Tests
parasitic diseases
Humans
Medicine
Protein Precursors
Child
Interleukin 6
Interferon alfa
Immunoassay
biology
medicine.diagnostic_test
Interleukin-6
business.industry
C-reactive protein
Infant
Interferon-alpha
Bacterial Infections
bacterial infections and mycoses
C-Reactive Protein
Infectious Diseases
Cytokine
ROC Curve
Virus Diseases
Child
Preschool

Luminescent Measurements
Pediatrics
Perinatology and Child Health

Immunology
biology.protein
Viral disease
Emergency Service
Hospital

business
Biomarkers
hormones
hormone substitutes
and hormone antagonists

medicine.drug
Zdroj: The Pediatric Infectious Disease Journal. 18:875-881
ISSN: 0891-3668
Popis: Procalcitonin (PCT) concentration increases in bacterial infections but remains low in viral infections and inflammatory diseases. The change is rapid and the molecule is stable, making it a potentially useful marker for distinguishing between bacterial and viral infections.PCT concentration was determined with an immunoluminometric assay on plasma collected at admission in 360 infants and children hospitalized for bacterial or viral infection. It was compared with C-reactive protein (CRP), interleukin 6 and interferon-alpha measured on the same sample.The mean PCT concentration was 46 microg/l (median, 17.8) in 46 children with septicemia or bacterial meningitis. PCT concentration was1 microg/l in 44 of 46 in this group and in 59 of 78 children with a localized bacterial infection who had a negative blood culture (sensitivity, 83%). PCT concentration was1 microg/l in 16 of 236 children with a viral infection (specificity, 93%). PCT concentration was low in 9 of 10 patients with inflammatory disease and fever. A CRP valueor =20 mg/l was observed in 61 of 236 patients (26%) with viral infection and in 105 of 124 patients (86%) with bacterial infection. IL-6 was100 pg/ml in 14% of patients infected with virus and in 53% with bacteria. A secretion of interferon-alpha was found in serum in 77% of viral infected patients and in 8.6% of bacterial infected patients.In this study a PCT value of 1 microg/l or greater had better specificity, sensitivity and predictive value than CRP, interleukin 6 and interferon-alpha in children for distinguishing between viral and bacterial infections. PCT values are higher in invasive bacterial infections, but the cutoff value of 1 microg/l indicates the severity of the disease in localized bacterial infection and helps to decide antibiotic treatment in emergency room. PCT may be useful in an emergency room for differentiation of bacterial vs. viral infections in children and for making decisions about antibiotic treatments.
Databáze: OpenAIRE