C reactive protein and procalcitonin as diagnostic markers of sepsis in febrile infants and children

Objective. The aim of this study was to estimate significance of determining C-reactive protein and procalcitonin for diagnosis of sepsis in febrile children. Methods. Data from medical history of 82 children (30 days to 16 years) who had been admitted into Intensive Care Unit of Pediatric Clinic, Clinical Centre 'Kragujevac', Kragujevac, were used in the study. The children were divided into two groups according to specific criteria for defining sepsis. Immediately after admission, we monitored erythrocyte sedimentation rate (ESR), leukocyte count, Creactive protein and procalcitonin, in different time intervals and their values were analyzed as indicators of disease control and success of the antibiotic therapy. Results. Sepsis was diagnosed in 47 (57.32%), localized respiratory and urinary tract infections in 35 (42.68%), and aseptic meningitis in 4 children. In the sepsis group the values of analyzed parameters were statistically higher than those in the control group, which showed similar values in both groups. The most sensitive parameter for diagnosis of sepsis was procalcitonin (sensitivity 87.2%), while ESR showed the least sensitivity (57.4%). The area under ROC curve for C-reactive protein was 0.699. Cut-off value for Creactive protein was 47.25 mg/l (sensitivity 76.6%, specificity 53.7%). The area under ROC curve for procalcitonin was 0.824. Cut-off value for procalcitonin was 2.69 ng/ml (sensitivity 87.2%, specificity 84.3%). The values of Creactive protein and procalcitonin decreased only after 24-48h with adequate initial antibiotic therapy. Conclusion. Procalcitonin and C-reactive protein are respectable indicators of sepsis in febrile children.