Bedside Procalcitonin and C-Reactive Protein Tests in Children With Fever Without Localizing Signs of Infection Seen in a Referral Center

Galetto-Lacour, Annick; Zamora, Samuel Antonio; Gervaix, Alain

doi:10.1542/peds.112.5.1054

Cited by 210 publications

(165 citation statements)

References 34 publications

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“…This is higher in infants aged 0-28 days (9-28%) than those 2-3 months old (7.1%) [2][3][4][5][6][7][8][9]15,16]. We found the overall rate of SBI was high (38.4%) and our findings confirmed that SBI was seen more frequent in the neonatal period.…”

Section: Discussionsupporting

confidence: 80%

“…On the other hand, UTI was found higher and reported that 14-21.3 percent in febrile neonatesthat means UTI affects approximately 1 in 6 febrile neonates [2][3][4][5][6][7][8][9][10][11]18]. In our study, UTI incidence was found similarly the most common etiology of fever in neonatal period.…”

Section: Discussionsupporting

confidence: 47%

“…Rochester and Philadelphia protocols can be used for identification of Serious bacterial infections in older infants, but in neonatal period sensitivity of these protocols are low [7]. For this reason, it is reported that C-reactive protein (CRP), absolute neutrophil count and procalcitonin levels can be used in SBI determination in the first month of life [6][7][8][9]. Somestudies reported that the contribution of White blood cells count (WBC) in the identification of SBI is very low; thus,importance should be givenon CRP level over absolute neutrophil count and absolute band counts and WBC [4][5][6][7][8][9][10].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Etiology and Causative Pathogens of Febrile Neonates

Bülbül¹,

Bülbül²,

Ocak³

et al. 2018

Pediatric Infect Dis

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Background: Evaluation and treatment of febrile neonates varied widely among the different centers. The prevalence of serious bacterial infection (SBI) is high in neonates; thus, most experts would support the approach of a full sepsis evaluation and hospitalization. We aimed to evaluate the clinical and laboratory characteristics of febrile neonate less than 28 days of age and describe the incidence of SBI in febrile neonates.

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Section: Discussionsupporting

confidence: 80%

Section: Discussionsupporting

confidence: 47%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Etiology and Causative Pathogens of Febrile Neonates

Bülbül¹,

Bülbül²,

Ocak³

et al. 2018

Pediatric Infect Dis

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“…The prevalence of SBI in our study was 26.2% (39 out of 149 patients were positive for serious bacterial infection), Allen L. Hsiao et al (2) studied 429 infants out of which 44 (10.3%) patients were diagnosed with serious bacterial infection, in another study Pulliam PN et al (16) studied seventy-seven patients and they enrolled SBI in 18% of the patients and Annick Galetto-Lacour et al (17) studied 99 patients and noticed serious bacterial infection in 29%.…”

Section: Discussionsupporting

confidence: 44%

Estimate the Prevalence and Pattern of Serious Bacterial Infections (SBIS) in Febrile Young Infants

2016

IJSR

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2% of serious bacterial infection in our study was high, as our hospital is a tertiary care, referral centre for sick patients. Urinary tract infection was most common followed by pneumonia, then occult bacteremia and finally bacterial meningitis. Pneumonia in our study was 23.9% which was quite high, might be because of the fact that study happened at a colder place, which could be a risk factor for more lower airway diseases.

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“…dem CRP. Umgekehrt besitzt PCT einen hohen negativen pr ä diktiven Wert, d.h. niedrige PCT-Konzentrationen schlie ß en eine Infektion mit hoher Wahrscheinlichkeit aus [19,25] . So wurde zum Ausschluss einer Sepsis f ü r PCT bei einem Cut-Off von 0,2 ng/mL ein negativer pr ä-diktiver Wert von 99 % beschrieben [111] .…”

Section: Therapiesteuerungunclassified

Spielen CRP-Spiegel neben IL-6 und PCT noch eine Rolle für Patienten auf Intensivstationen?/Are circulating levels of CRP compared to IL-6 and PCT still relevant in intensive care unit patients?

Boenisch

Fae

Drexel

et al. 2013

Laboratoriumsmedizin

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Zusammenfassung :In der Diagnostik von Infektionen und inflammatorischen Prozessen ist das C-reaktive Protein (CRP) einer der meistverwendeten Parameter, unter anderem aufgrund der geringen Kosten und der schnellen Verf ü gbarkeit. Im Zuge der letzten Jahre gewannen jedoch andere Entz ü ndungsparameter, wie zum Beispiel das Interleukin 6 (IL-6) oder Procalcitonin (PCT), zunehmend an Bedeutung. Obwohl diese Parameter im klinischen Alltag noch nicht ü berall etabliert sind, besitzen sie doch wesentliche Vorteile in der Diagnostik und im Verlaufsmonitoring von entz ü ndlichen Erkrankungen. Beispielsweise ist die Erkennung entz ü ndlicher Komplikationen auf Intensivstationen durch erh ö hte IL-6 Spiegel 24 bis 48 Stunden vor einer Erh ö hung des CRP m ö glich. Die deutliche Ü berlegenheit von PCT gegen ü ber CRP in der Diagnostik von bakteriellen Infektionen und Sepsis begr ü ndet sich in der h ö heren Spezifit ä t des PCT f ü r bakterielle Infektionen. Der PCT-Verlauf erm ö glicht daher eine bessere Beurteilung des Therapieerfolges und Krankheitsverlaufs des Patienten und liefert Hinweise auf eine gegebenenfalls erforderliche Therapieumstellung. Daraus ergibt sich die Frage, ob die Messung des CRPSpiegels durch IL-6 und/oder PCT ersetzt werden kann. In dieser Ü bersichtsarbeit wird die derzeitige Bedeutung von CRP im Verh ä ltnis zu den neueren Entz ü ndungsparametern in der Diagnostik von bakteriellen Infektionen, im therapeutischen Monitoring und in seiner Aussagekraft bez ü glich der Prognose des Patienten auf Intensivstationen dargestellt.Schl ü sselw ö rter: C-reaktive Protein (CRP); Entz ü ndungsmarker; Infektion; Intensivstation; Interleukin 6 (IL-6); Procalcitonin (PCT); Sepsis.Abstract : C-reactive protein (CRP) currently constitutes one of the most widely used parameters for the diagnosis of infections and inflammatory processes, due to simple methods and low costs. However, in recent years, other parameters, such as interleukin 6 (IL-6) and procalcitonin (PCT), have gained in importance. Although these parameters are presently not established everywhere in clinical routine, they provide significant advantages in the diagnosis and monitoring of inflammatory diseases. For instance, in intensive care, the increase in IL-6 levels may indicate inflammatory complications 24 to 48 h prior to the increase in circulating CRP levels. In contrast to CRP, PCT shows a higher specificity for bacterial infections, which facilitates the diagnosis of bacterial infections and sepsis. Therefore, PCT values provide a better evaluation of prognosis and therapeutic success and of a necessary change in therapy. These points raise the question whether CRP levels should at least in part be replaced by PCT and/or IL-6. Thus, this review seeks to examine the value of CRP in relation to PCT and IL-6 in the diagnosis of bacterial infections, in therapeutic monitoring, and regarding prognosis in critical care patients.

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Bedside Procalcitonin and C-Reactive Protein Tests in Children With Fever Without Localizing Signs of Infection Seen in a Referral Center

Abstract: PCT and CRP performed better than IL-6, WBC, and/or band count in predicting the occurrence of SBI. PCT and CRP bedside tests may be useful tools for emergency and private practice doctors and should be considered in the initial work-up of children with fever without source.

Cited by 210 publications

References 34 publications

Etiology and Causative Pathogens of Febrile Neonates

Etiology and Causative Pathogens of Febrile Neonates

Estimate the Prevalence and Pattern of Serious Bacterial Infections (SBIS) in Febrile Young Infants

Spielen CRP-Spiegel neben IL-6 und PCT noch eine Rolle für Patienten auf Intensivstationen?/Are circulating levels of CRP compared to IL-6 and PCT still relevant in intensive care unit patients?

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