Clinical utility of procalcitonin in febrile infants younger than 3 months of age visiting a pediatric emergency room: A retrospective single-center study
0
Citation
17
Reference
10
Related Paper
Abstract:
Abstract BackgroundFever in infants under 90 days of age is highly likely to be caused by a severe bacterial infection (SBI) and it accounts for a large number of patients visiting the pediatric emergency room. In order to predict the bacterial infection and reduce unnecessary treatment, the classic classification system is based on white blood cell (WBC) count, urinalysis, and x-ray, and it is modified and applied at each center by incorporating recently studied biomarkers such as c-reactive protein (CRP) or procalcitonin (PCT). This study analyzed the usefulness of PCT in predicting SBI when applied along with the existing classification system, including CRP, among infants less than 90 days old who visited with a fever at a single institution pediatric emergency center.MethodsWe retrospectively reviewed the medical records of patients younger than 3 months of age who presented with fever at the Seoul Asan Medical Center pediatric emergency room between July 2017 and October 2018.ResultsA total of 317 patients were analyzed, and 61 were diagnosed with SBI, among which urinary tract infection (UTI) accounted for the largest proportion (55/61, 90.2%). There were differences in WBC, neutrophil proportion, CRP, and PCT between the SBI group and the non-SBI group, and the AUC values of WBC, CRP, and PCT were 0.651, 0.804, and 0.746, respectively. When using the cut-off values of CRP and PCTs as 2.0 mg/dL and 0.3 ng/mL, respectively, the sensitivity and specificity for SBI were 49.2/89.5, and 54.1/87.5, respectively. WBC, CRP, and PCT were statistically significant for predicting SBI in multivariate analysis (odds ratios 1.066, 1.377, and 1.291, respectively). When the subjects were classified using the existing classification criteria, WBC and CRP, the positive predictive value (PPV) and negative predictive value (NPV) were 29.3% and 88.7%, respectively, and when PCT was added, the PPV and NPV were 30.7% and 92%, respectively, both increased.ConclusionPCT is useful for predicting SBI in children aged 3 months or less who visit the emergency room with a fever. It is useful as a single biomarker, and when used in conjunction with classic biomarkers, its diagnostic accuracy is further increased.Keywords:
Procalcitonin
White blood cell
Single Center
Medical record
OBJECTIVE To explore the values of serum Procalcitonin( PCT),Interleukin-6( IL-6). C-reactive protein( CRP) levels and White blood cell( WBC) count for diagnosis of children with sepsis. METHODS 89 of children who entered into PICU treatment. were divided into two groups: Sepsis group and Non-sepsis group. According to the diagnostic criteria of ACCP / SCM Conference,The PCT,IL-6,CRP and WBC level of the two groups were determined and compared with each other. RESULTS Compared to Non-sepsis group,Serum Procalcitonin,Interleukin-6,C-reactive protein levels of Sepsis group had significant difference( P 0. 05),and it was not significant difference of white blood cell levels. The specificity Sensitivity,Accuracy,Positive predictive value and Negative predictive value of PCT were higher than other projects. CONCLUSION WBC count was not be the diagnostic indicators of sepsis in children. Compared with WBC count,CRP and IL-6,PCT may reflect the most sensitive indicators of sepsis in children,PCT and IL-6 can be used as clinical assessment of sepsis in Children.
Procalcitonin
White blood cell
Cite
Citations (0)
Objective To study the procalcitonin in differential bacterial infection clinical value and observation of clinical effect.Methods In our hospital fees in 1000 patients,according to the diagnosis result,divided into the experimental group and the experimental group two.The experimental group is a bacterial infection of the patients,a total of 500 cases in experimental group;for a bacterial infection of the patients,a total of 500 cases,control group for my courtyard outpatient physical health of people,a total of 200 people.More patients in the experimental group and the control group of serum procalcitonin level,white blood cell count and C reactive protein expression level.Results In the experimental group and the control group in the white blood cell count,WBC comparison of serum procalcitonin levels comparison,C reactive protein expression level contrast,experimental group two and group a white blood cell count,WBC comparison of serum procalcitonin levels comparison,C reactive protein expression level of contrast,significant difference,P 0.05.But the experimental group and the experimental group two of the white blood cell count,WBC comparison of serum procalcitonin levels comparison,C reactive protein expression level contrast,no significant difference.The ROC curve area of serum procalcitonin levels of expression C reactive protein expression levels of white blood cell count,serum calcitonin was 0.92,C reactive protein 0.68,white blood cell count to 0.58.Serum procalcitonin than C reactive protein expression levels and white blood cell counts have improved diagnostic accuracy.Conclusions Serum procalcitonin in bacterial infection in the differential diagnosis with optimal sensitivity and specificity.
Procalcitonin
White blood cell
Erythrocyte sedimentation rate
Cite
Citations (0)
Objective To determine the correlations between predictive capability of conventional inflammatory marker white blood cell(WBC) count,and procalcitonin(PCT) with elevated levels of septic patients.Method Sixty-four patients were enrolled in the study.Serum concent rations of PCT,IL-6 were determined in 24 hours after clinical onset of sepsis or systemic inflammatory response syndrome.WBC count was also recorded.Results PCT was significantly correlated with serum IL-6 levels.The predictive capability was higher for PCT than WBC count.Conclusion Compared with white blood cell count,PCT may reflect the elevated levels of pro-inflammatory cytokines more reliably.
Procalcitonin
White blood cell
Blood count
Blood cell
Cite
Citations (0)
Objective To explore significances of differential clinically diagnosis of procalcitonin, C-reactive protein and white blood cell count in children with infectious pneumonia. Methods Ninety children with infantile pneumonia admitted by this hospital from October 2013 to April 2014 were selected into the observation group, 54 patients with pneumonia admitted by this hospital during such period were selected into the control group, calcitonin, procalcitonin, C-reactive protein and white blood cell count tests were applied on patients in two groups, and results were compared and analyzed. Results The(+) detection rate of CRP in the observation group was 47.78%, the(+) detection rate of WBC hit 38.87%,(+)detection rate of PCT hit 91.11%. The comparison x2 in three test index CRP, WBC and PCT hit 36.5287, 16.8201, and 109.3631, P 0.05 respectively, and the difference was statistically significant. Conclusion The monitoring on procalcitonin, C-reactive protein and white blood cell count is helpful to differential diagnosis on pediatric infectious pneumonia clinically, and dynamic testing is capable of promoting the diagnosis of bacterial pneumonia, being of high value of clinical use.
Procalcitonin
White blood cell
Bacterial pneumonia
Absolute neutrophil count
Cite
Citations (0)
In recent years, procalcitonin and C-reactive protein have been used as important indexes in the detection of inflammation. In order to analyze the combined detection of procalcitonin and C-reactive protein in infected patients, 57 subjects in the Clinical Laboratory of Zhengzhou Maternal and Child Health Hospital with a bacterial infection were selected as the observation group. Correspondingly, 57 non-infected subjects were selected for the control group. The procalcitonin and C-reactive protein levels in the included cases were analyzed and compared by extracting peripheral blood. The results showed that the two indexes of C-reactive protein (46.13±8.24 mg/L) and procalcitonin (6.61±3.45 ug/L) of the observation group were significantly higher than those of the control group (P less than 0.05). The positive rates of C-reactive protein (71.93%) and procalcitonin (91.23%) of the observation group were significantly higher than those of the control group (P less than0.05). Within the observation group, the C-reactive protein and procalcitonin levels in the infected patients after 2 and 3 days of treatment, decreased significantly (P less than 0.05). This study indicates that the combined detection of procalcitonin and C-reactive protein in patients with bacterial infections is effective and can be used in clinical settings.
Procalcitonin
Cite
Citations (3)
Objective To investigate diagnostic value of blood procalcitonin, white blood cell count, C reactive protein(CRP) in early infection after cardiac surgery in adults. Methods A total of 117 adult patients undergoing cardiopulmonary bypass heart operation in our hospital from October 2010 to December 2013 were selected as observation group, of which 39 with postoperative infection were enrolled as group A and 78 without postoperative infection were enrolled as group B. Meanwhile, 117 healthy persons were selected as the control group. All the people underwent serum procalcitonin detection, white blood cell count, C reactive protein detection. Changes of relevant indexes at different time points(preoperative, postoperative 1 d, postoperative 2 d, postoperative 3 d) were compared between groups. Relevant operation indications were analyzed in the observation group. Results Blood procalcitonin,white blood cell count and CRP 3 d after operation in the observation group were higher than those in the control group. Blood procalcitonin, white blood cell count and CRP at postoperative increased significantly in group B, reached the highest at postoperative 1 d, and decreased significantly at postoperative 2 d. Blood procalcitonin, white blood cell count, CRP at postoperative increased significantly in group A, reached the highest at postoperative 3 d, which were higher than group B at postoperative, postoperative 1 d, 2 d, 3 d. Serum procalcitonin in patients with moderate infection were higher than those with mild infection, and serum procalcitonin in patients with severe infection were higher than those with mild infection and moderate infection. Operation time, cardiopulmonary bypass time, blocking time in group A were significantly longer than group B(P0.05). Postoperative infection had significant positive correlation with blood procalcitonin, white blood cell count and CRP(P0.05). Conclusion Blood procalcitonin, white blood cell count, CRP can be used as effective indexes in the diagnosis of early infection after cardiac surgery in adults.
Procalcitonin
White blood cell
Venous blood
Complete blood count
Cite
Citations (0)
The aim of this study was to assess the clinical usefulness of blood procalcitonin (PCT) levels for the diagnosis and therapeutic monitoring of early-onset neonatal sepsis (EONS). PCT as well as C-reactive protein (CRP) levels and white blood cell (WBC) count were measured in venous blood from 57 infected and 72 uninfected neonates. Differences between groups for PCT, CRP, and WBC levels were significant. The threshold value on the receiver operating characteristic curve in the prediction of EONS was 5.33 ng/mL for PCT, 9.3 mg/L for CRP, and 14.9 × 109/L for WBC. There was no effect of antibiotic administered to the mother on PCT, CRP, and WBC levels in neonatal blood sampled before treatment of EONS. Evidently reduced PCT levels are observed after 2 days of treatment. The authors conclude that prenatal antibiotic therapy does not reduce the value of PCT levels in blood for the diagnosis of EONS.
Procalcitonin
White blood cell
Neonatal Sepsis
Venous blood
Antibiotic Therapy
Blood Culture
Cite
Citations (8)
Objective
To assess the early diagnostic value of white blood cell count (WBC), neutrophil percentage (NEU%), C-reactive protein (CRP) and procalcitonin (PCT) in blood bacterial infection.
Methods
Clinical data of 114 patients with bacterial blood stream infections(BSI group) and 247 patients without bloodstream infections (control group) admitted to Taiyuan Third People’s Hospitalin 2015 were retrospectively analyzed. The WBC, NEU%, CRP and PCT were measured in all patients. Receiver opearating characteristic curve (Roc) was used to evalute the accuracy of WBC, NEU%, CRP and PCT in the diagnosis of blood stream bacterial infectious.
Results
There were no significant differences in gender and age between two groups (χ2=0.7731, t=0.9900, both P>0.05). The WBC, NEU%, CRP and PCT levels in BSI group were significantly higher than those in control group (all P 0.05), while there was significant difference in PCT level (P<0.05). In diagnosis of bacteremia, the area under the ROC curve of PCT(0.827) was the largest, followed by CRP (0.721), NEU% (0.677) and WBC (0.593), the differences were statistically significant(Z=2.332, 3.355 and 3.786, P<0.05 or <0.01).
Conclusion
WBC, NEU%, CRP and PCT levels are of certain diagnostic value for bacterial bloodstream infections, particularly the PCT. In addition, PCT can predict G+ bacterial and G- bacterial infections.
Key words:
Bacterial infections; Bloodstream infections; Leukocyte count; C-reactive protein; Procalcitonin
Procalcitonin
White blood cell
Bacteremia
Blood stream
Bloodstream infection
Cite
Citations (0)
Objective To investigate the serum procalcitonin and C-reactive protein,white blood cell count to provide guidance based on diagnostic value in the diagnosis of bacterial infection,differential diagnosis and guide clinical use of antibiotics for bacterial infections.Methods In this study were collected from February 2008 to May 2012 during our hospital 46 cases of bacterial infectious diseases,48 cases of non-bacterial infectious diseases,and 40 healthy persons as the study,respectively,were detected by group of serum procalcitonin,C-reactive protein,white blood cell count level and compare the positive rate of each group.Results Bacterial infection group PCT,CRP,WBC count was significantly higher than the non-bacterial infection group and the healthy control group,the difference was statistically significant(P 0.05).Bacterial infection group PCT positive rate of 95.7%,was significantly higher than the non-bac terial infection group PCT positive rate(12.5%),the difference was extremely significant(P 0.01).Bacterial infection group,CRP positive rate of 100.0%,higher than the non-bacterial infection group PCT positive rate(87.5%),but the difference was not statistically significant(P 0.05).Bacterial infection group WBC positive rate was 93.5%,was significantly higher than non-bacterial infection group WBC-positive rate(4.2%),the difference was extremely significant(P 0.01).Conclusion Bacterial infection in patients with serum procalcitonin,C-reactive protein,white blood cell count was significantly higher than the non-bacterial infectious disease,bacterial infection of bacterial infection in patients with serum procalcitonin and C-reactive protein,white blood cell count testing,clinical early and accurate di agnosis,effective and reasonable treatment as soon as possible to obtain a good prognosis and provide a favorable refer ence.
Procalcitonin
White blood cell
Microbiological culture
Cite
Citations (0)
Objective To study the clinical value of procalcitonin(PCT) and C-reactive protein (CRP) on the diagnosis of bacterial pneumonia.Methods According to laboratory diagnostic results,210 cases of pneumonia were divided into three groups,viral group,bacteria and mycoplasma group,with 70 cases in each group.And in accordance with CURB score,the bacteria group was sub-divided into low-risk group,risk group and high-risk group.The levels of PCT,CRP,WBC (white blood cell count),NEUT(proportion of neutrophils) were compared.Results In bacterial group,the levels of CRP,PCT,WBC,NEUT were (62.57 ±16.55) mmol/L,(9.25 ± 5.17) μg/L,(13.59 ±3.04) × 109/L,0.87 ± 0.14,which were significantly higher than those in the mycoplasma group and viral group (P ＜ 0.05).In low-risk group,the levels of CRP,PCT,WBC were (22.37 ±4.55) mmol/L,(3.19 ± 0.99) μg/L,(10.22 ± 2.14) × 109/L,which were significantly lower than those in the risk group and high-risk groups(P ＜ 0.05).Conclusions By measuring the levels of procalcitonin,C-reactive protein and white blood cell count,bacterial pneumonia can be more accurately diagnosed,and it can reflect the severity of disease,so it is worthy promoting in clinic.
Key words:
Pneumonia; Bacterial pneumonia; Procalcitonin ; C-reactive protein; Leukocyte count
Procalcitonin
White blood cell
Bacterial pneumonia
Mycoplasma pneumonia
Cite
Citations (0)