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. 2017 Jun;4(2):75-80.
doi: 10.1016/j.ijpam.2016.12.004. Epub 2017 Feb 13.

New diagnostic biomarker in acute diarrhea due to bacterial infection in children

Hassan M Al-Asy  1 , Rasha M Gamal  1 , Ahmed M Abd Albaset  1 , Mohammed G Elsanosy  1 , Maali M Mabrouk  2
Affiliations

New diagnostic biomarker in acute diarrhea due to bacterial infection in children

Hassan M Al-Asy et al. Int J Pediatr Adolesc Med. 2017 Jun.

Abstract

Background and objectives: Diarrhea is a major cause of morbidity and mortality in children, and diarrhea may be due to infection that is bacterial or non-bacterial. Differentiation between diarrhea from a bacterial or non-bacterial infection is not a simple task, and no single method is present to differentiate between these causes of diarrhea.To evaluate the diagnostic accuracy of soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) and procalcitonin (PCT) in the diagnosis of acute diarrhea due to bacterial infection.

Patients and methods: Case control study of forty children with bacterial infection diarrhea diagnosed by stool culture and CRP, 40 children with acute non-bacterial infection diarrhea and 30 age- and sex-matched healthy controls. Stool cultures, serum CRP, PCT and serum sTREM-1 were measured in all children on admission.

Results: Children with acute bacterial infection diarrhea had a significant increase in the serum sTREM-1 and PCT levels on admission compared to patients with nonbacterial infection diarrhea and controls (26.3667 ± 16.8184 ng/ml vs 7.2267 ± 6.4174 ng/ml vs 6.7367 ± 5.6479 ng/ml and 39.9933 ± 22.5260 ng/ml vs 1.8533 ± 1.7123 vs 0.2840 ± 0.1208 ng/ml, respectively; P < 0.05). sTREM-1 demonstrated significantly higher sensitivity (93.7%) and specificity (94.3%) in the prediction of bacterial infection as a cause of acute diarrhea in children with an area under the receiver operator characteristic (ROC) curve (95% CI) of 0.94 (0.84-0.99) at a cutoff value of 12.4 ng/ml.

Conclusions: Both serum PCT and sTREM-1 are valuable in the early diagnosis of acute bacterial infection-induced diarrhea in children, and there was markedly higher diagnostic discriminatory power for sTREM-1.

Keywords: Diarrhea; Procalcitonin (PCT); Soluble tregering expression on myeloid receptor type 1 (s TREM 1).

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Figures

Fig. 1
Figure 1
Receiver operating characteristic (ROC) curves comparing the baseline C-reactive protein (CRP), procalcitonin (PCT) and soluble triggering receptor expressed on myeloid cells-1 (sTREM-1).
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