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. 2020 Oct 21;20(1):487.
doi: 10.1186/s12887-020-02385-2.

Diagnostic test accuracy of point-of-care procalcitonin to diagnose serious bacterial infections in children

Thomas Waterfield  1   2 , Julie-Ann Maney  3 , Mark D Lyttle  4   5 , James P McKenna  6 , Damian Roland  7   8 , Michael Corr  9 , Bethany Patenall  10 , Michael D Shields  11 , Kerry Woolfall  12 , Derek Fairley  11   6 ; Paediatric Emergency Research in the UK and Ireland (PERUKI)
Affiliations

Diagnostic test accuracy of point-of-care procalcitonin to diagnose serious bacterial infections in children

Thomas Waterfield et al. BMC Pediatr. .

Abstract

Background: The National Institute for Health and Care Excellence (NICE) have called for research into the role of biomarkers, and specifically procalcitonin (PCT), for the early diagnosis of serious bacterial infections (SBI) in children. The aim of this study was to compare the diagnostic test accuracy of C-reactive protein (CRP) and PCT for the diagnosis of SBI in children.

Methods: Data was collected prospectively from four UK emergency departments (ED) between November 2017 and June 2019. Consecutive children under 18 years of age with fever and features of possible sepsis and/or meningitis were eligible for inclusion. The index tests were PCT and CRP and the reference standard was the confirmation of SBI.

Results: 213 children were included in the final analysis. 116 participants (54.5%) were male, and the median age was 2 years, 9 months. Parenteral antibiotics were given to 100 (46.9%), three (1.4%) were admitted to a paediatric intensive care unit and there were no deaths. There were ten (4.7%) confirmed SBI. The area under the curve for PCT and CRP for the detection of SBI was identical at 0.70.

Conclusions: There was no difference in the performance of PCT and CRP for the recognition of SBI in this cohort.

Trial registration: Registered at https://www.clinicaltrials.gov (trial registration: NCT03378258 ) on the 19th of December 2017.

Keywords: Procalcitonin; bacterial infection; biomarkers; infection; paediatrics.

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Conflict of interest statement

JMcK Holds share options in HiberGene Diagnostics Ltd. TW has received an honorarium for speaking at educational events for Thermofisher.

Figures

Fig. 1
Fig. 1
Flow of participants through the study
See this image and copyright information in PMC

References

    1. Fever in under 5s: assessment and initial management NICE guideline [NG143] Published date: November 2019. Available fromhttps://www.nice.org.uk/guidance/ng143.
    1. Josko Markic. Biomarkers of sepsis in neonates and children. Signa Vitae. 2015. 10(2);1–9. 10.22514/SV102.122015.1.
    1. Samraj RS, Zingarelli B, Wong HR. Role of biomarkers in sepsis care. Shock. 2013;40(5):358–65. 10.1097/SHK.0b013e3182a66bd6. - PMC - PubMed
    1. Soares LV, Pedro P, Márcio S. Silva José Roberto Lapa e, Barbosa Arnaldo Prata, Salluh Jorge Ibrain Figueira. Use of biomarkers in pediatric sepsis: literature review. Rev. bras. ter. intensiva [Internet]. 2016 Dec [cited 2020 Aug 31]; 28(4): 472–82. Available from: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0103-507X2016000.... 10.5935/0103-507x.20160080. - PMC - PubMed
    1. Van Den Bruel A, Haj-Hassan T, Thompson M, et al. Diagnostic value of clinical features at presentation to identify serious infection in children in developed countries: a systematic review. Lancet. 2010;375:834–45. doi: 10.1016/S0140-6736(09)62000-6. - DOI - PubMed

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