Comparative study of procalcitonin versus c-reactive protein in the diagnosis of sepsis in children below 16 years-a single centre observational study

Abstract

Introduction: Given the limitation of non-specific nature of signs, symptoms and physical examination in diagnosing sepsis; especially in young children, a diagnostic marker that will aid in an early diagnosis is needed. Procalcitonin satisfies most of the criteria for smart biomarker of sepsis. The present study is done to compare procalcitonin (PCT) with C-reactive protein (CRP) as a diagnostic marker of sepsis in children. Materials & Methods: A prospective observational study was done in the Department of Paediatrics, ASRAM Medical College and Hospital, Eluru from July 2015 to June 2016. Children admitted to PICU during the above tenure are included in the study. Specific inclusion and exclusion criteria are formulated with a sample size of 100. Procalcitonin level is analyzed by enzyme linked immunoluminometric assay using Elecsys Brahms PCT kit.CRP analysis is done using immunoturbidometry which is a quantitative method. Results: Out of 100 children 72 have sepsis. The mean procalcitonin level in children with sepsis is 19.09 ± 24.53 ng/ml compared to 0.34 ± 0.49 ng/ml in children without sepsis. In comparing sepsis with asepsis, PCT (Cutoff value of 0.58ng/ml) have a better sensitivity (90.3%) and specificity (92.9%) than CRP (Cut off value of 0.7mg/dl) sensitivity of 87.5% and specificity of 57.1%. Conclusion: PCT offers better sensitivity and specificity than CRP, to differentiate sepsis from asepsis. In febrile children PCT is a better diagnostic marker of sepsis than CRP.

Neutrophil to lymphocyte ratio and platelet to lymphocyte ratio as markers of early sepsis and mortality in pediatric burns: a prospective evaluation

“…4,28 A few authors have shown PCT to be a more sensitive and specific marker for sepsis in children with burns than CRP. [29][30][31] However, both these parameters require enzyme backed assays for estimation, which are costly and may not be available in remote settings.…”