Korean J Pediatr.  2016 Mar;59(3):126-131. 10.3345/kjp.2016.59.3.126.

Diagnostic value of the Vesikari Scoring System for predicting the viral or bacterial pathogens in pediatric gastroenteritis

• Shim DH
• Kim DY
• Cho KY

• KMID: 2163056
• DOI: http://doi.org/10.3345/kjp.2016.59.3.126

Abstract

PURPOSE
To evaluate the diagnostic value of the Vesikari Scoring System (VSS) as an early predictor of pathogens in children with acute gastroenteritis (AG).
METHODS
In this retrospective study, the VSS score, absolute neutrophil count (ANC), and C-reactive protein (CRP) levels were analyzed in 107 hospitalized children with AG, aged 6 months to 17 years. Patients were divided into nonspecific, viral, and bacterial groups according to the pathogens detected using a multiplex polymerase chain reaction (PCR) test.
RESULTS
Patients in the bacterial group had significantly higher CRP values and VSS scores compared to those in the viral group and significantly higher VSS scores compared to those in the nonspecific group (P<0.05). Patients in the viral group had significantly higher VSS scores than those in the nonspecific group (P<0.05). Logistic regression analysis revealed that VSS was the most effective diagnostic tool for predicting the type of pathogen (P<0.05). The area under the receiver operating characteristics curve of VSS was significantly greater than that for ANC and CRP (P<0.05). At a cutoff point of 10 in the VSS, an acceptable diagnostic accuracy could be achieved for distinguishing between bacterial and viral pathogens in AG.
CONCLUSION
VSS can be considered a useful and reliable infectious marker for pediatric gastroenteritis. VSS may be a good early predictor of the type of pathogen, enabling development of a treatment plan before results from a stool culture or PCR test are available.

Keyword

Child; Gastroenteritis; Relative value scales; Neutrophils; C-reactive protein

MeSH Terms

C-Reactive Protein
Child
Child, Hospitalized
Gastroenteritis*
Humans
Logistic Models
Multiplex Polymerase Chain Reaction
Neutrophils
Polymerase Chain Reaction
Relative Value Scales
Retrospective Studies
ROC Curve
C-Reactive Protein