Korean J Pediatr Infect Dis.  2009 Dec;16(2):142-149.

Diagnostic Value of Serum Procalcitonin in Febrile Infants Under 6 Months of Age for the Detection of Bacterial Infections

• Kim NH
• Kim JH
• Lee TJ

Abstract

PURPOSE
The aim of this study was to determine the diagnostic value of serum procalcitonin (PCT) compared with that of C-reactive protein (CRP) and the total white blood cell count (WBC) in predicting bacterial infections in febrile infants <6 months of age.
METHODS
A prospective study was performed with infants <6 months of age who were admitted to the Department of Pediatrics with a fever of uncertain source between July and September 2008. Spinal taps were performed according to clinical symptoms and physical examination. Serum PCT levels were measured using an enzyme-linked fluorescent assay.
RESULTS
Seventy-one infants (mean age, 2.62 months) were studied. Twenty-six infants (36.6%) had urinary tract infections (UTIs), and 22 infants (31.0%) had viral meningitis. The remaining infants had acute pharyngitis (n=1), herpangina (n=1), upper respiratory tract infections (n=7), acute bronchiolitis (n=8), acute gastroenteritis (n=4), and bacteremia (n=2). The median WBC and CRP levels were significantly higher in infants with UTIs than in infants with viral meningitis. However, there were no differences in the median PCT levels between the groups (0.14 ng/mL vs. 0.11 ng/mL, P=0.419). The area under the receiver operating characteristic curve was 0.792 (95% CI, 0.65-0.896) for WBC, 0.77 (95% CI, 0.626-0.879) for CRP, and 0.568 (95% CI, 0.417-0.710) for PCT. An elevated WBC count (>11,920/microliter) and an increased CRP level (>1.06 mg/dL) were significant predictors of UTIs based on multiple logistic regression analysis.
CONCLUSION
Serum PCT concentrations should be interpreted with caution in infants <6 months of age with a fever of uncertain source.

Keyword

Procalcitonin; Infant; Bacterial infection

MeSH Terms

Bacteremia
Bacterial Infections
Bronchiolitis
C-Reactive Protein
Calcitonin
Fever
Gastroenteritis
Herpangina
Humans
Infant
Leukocyte Count
Logistic Models
Meningitis, Viral
Oligopeptides
Pediatrics
Pharyngitis
Physical Examination
Prospective Studies
Protein Precursors
Respiratory Tract Infections
ROC Curve
Spinal Puncture
Urinary Tract Infections
C-Reactive Protein
Calcitonin
Oligopeptides
Protein Precursors