Is serum procalcitonin a reliable diagnostic marker in children with acute respiratory tract infections? A retrospective analysis.

Details

Serval ID
serval:BIB_9E05FC65F189
Type
Article: article from journal or magazin.
Collection
Publications
Title
Is serum procalcitonin a reliable diagnostic marker in children with acute respiratory tract infections? A retrospective analysis.
Journal
European Journal of Pediatrics
Author(s)
Schützle H., Forster J., Superti-Furga A., Berner R.
ISSN
1432-1076 (Electronic)
ISSN-L
0340-6199
Publication state
Published
Issued date
2009
Volume
168
Number
9
Pages
1117-1124
Language
english
Abstract
Acute respiratory tract infections (ARI) in children are often treatedwith antibiotics even without evidence of bacterial infection. Serumprocalcitonin (PCT) is elevated in bacterial but not in viralinfections.We performed a retrospective analysis of children in the PID-ARI.netstudy on respiratory infections to address the question of whetherplasma PCT could potentially distinguish between bacterial infectionsrequiring antibiotic therapy and viral ARI. We analysed data on 327children who had been included in the German PID-ARI.net study and inwhom nasopharyngeal aspirates had been analysed with a 19-valentmultiplex reverse transcription-polymerase chain reaction-enzyme-linkedimmunosorbent assay for viral and atypical bacterial pathogens. SerumPCT was determined using a quantitative immunoassay (BRAHMS KryptorPCTsensitive, Henningsdorf, Germany). We then focussed specifically onthose children who were treated with antibiotics and therefore had beensuspected of having bacterial infection but who had a serum PCT levellower than 0.1 ng/ml.Out of 327 children, 132 had serum PCT levels below 0.1 ng/ml. Of these132, 38 children had been treated with antibiotics. After exclusion of26 patients (with critical illnesses, antibiotics on admission or forreasons other than ARI), 12 children remained for further evaluation.Of these 12 children, four had atypical pneumonia; four others hadpositive virus testing, and, in the last four, the aetiology of ARIremained unknown; evidence of bacterial infection could not be detectedin any.Taken the results of this retrospective analysis, serum PCT valuesbelow 0.1 ng/ml might be a marker to identify children with acuterespiratory tract infection in whom antibiotic treatment could bewithheld. However, only a prospective intervention trial will prove thegeneral safety of this limit.
Keywords
Anti-Bacterial Agents/therapeutic use, Calcitonin/blood, Child, Enzyme-Linked Immunosorbent Assay, Female, Humans, Male, Protein Precursors/blood, Respiratory Tract Infections/blood, Respiratory Tract Infections/diagnosis, Retrospective Studies, Severity of Illness Index
Pubmed
Web of science
Create date
14/03/2011 16:08
Last modification date
20/08/2019 15:04
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