Korean J Pediatr.  2018 Sep;61(9):285-290. 10.3345/kjp.2017.06170.

Usefulness of the procalcitonin test in young febrile infants between 1 and 3 months of age

• Lee IS
• Park YJ
• Jin MH
• Park JY
• Lee HJ
• Kim SH
• Lee JS
• Kim CH
• Kim YD
• Lee JH

• KMID: 2422367
• DOI: http://doi.org/10.3345/kjp.2017.06170

Abstract

PURPOSE
To study the usefulness of the procalcitonin (PCT) test in young febrile infants between 1 and 3 months of age.
METHODS
We evaluated the medical records of 336 febrile infants between 1 and 3 months of age who visited the Emergency Department or outpatient department of Samsung Changwon Hospital from May 2015 to February 2017, and analyzed the clinical characteristics between infants in the serious bacterial infection (SBI) group and non-SBI group.
RESULTS
Among the 336 infants, 38 (11.3%) had definitive SBI (bacteremia, n=3; meningitis, n=1; urinary tract infection, n=34). The mean PCT (6.4±11.9 ng/mL) and C-reactive protein (CRP) level (3.8±2.6 mg/dL), and the absolute neutrophil count (ANC) (6,984±4,675) for patients in the SBI group were significantly higher than those for patients in the non-SBI group (PCT, 0.3±1.2 ng/mL; CRP, 1.3±1.6 mg/dL; ANC, 4,888±3,661). PCT had lower sensitivity (43.6%), but higher specificity (92.6%) and accuracy (86.9%) than CRP (92.3%, 25.3%, and 33.0%) for identifying SBI. The area under the receiver operating characteristic curves (AUCs) for definitive SBI were PCT 77.0%, CRP 80.8%, WBC 56.8%, ANC 67.8%, and PLT 48.1%. The AUCs for definitive SBI were PCT+CRP 85.4%, PCT+WBC 77.2%, PCT+ANC 81.3%, CRP+WBC 80.1%, and CRP+ANC 81.6%.
CONCLUSION
Our results suggest that the PCT test or a combination of PCT and CRP tests is a more accurate and specific biomarker to detect and rule out SBIs.

Keyword

Infant; Fever; Procalcitonin

MeSH Terms

Area Under Curve
Bacterial Infections
C-Reactive Protein
Emergency Service, Hospital
Fever
Gyeongsangnam-do
Humans
Infant*
Medical Records
Meningitis
Neutrophils
Outpatients
ROC Curve
Sensitivity and Specificity
Urinary Tract Infections
C-Reactive Protein