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The use of C-reactive protein in predicting bacterial co-Infection in children with bronchiolitis
Mohamad Fares1, Sawsan Mourad, Mariam Rajab
1Department of Pediatrics, Makassed General Hospital, Beirut, Lebanon.
Insights
C-reactive protein (CRP) effectively predicts bacterial co-infection in hospitalized infants with bronchiolitis. Elevated CRP levels can guide antibiotic use, reducing unnecessary treatments and hospital stays.
Area of Science:
- Pediatrics
- Infectious Diseases
- Clinical Chemistry
Background:
- Bronchiolitis is a common, potentially severe respiratory illness in young children.
- Viral lower respiratory tract infections increase the risk of secondary bacterial co-infections.
Purpose of the Study:
- To assess C-reactive protein (CRP) as a predictor of bacterial co-infection in hospitalized bronchiolitis patients.
- To correlate CRP levels with antibiotic treatment decisions.
Main Methods:
- Prospective study of 49 infants hospitalized with bronchiolitis.
- Collection of tracheal aspirate cultures and blood tests (CRP, white cell count, transaminases, blood sugar) on admission.
Main Results:
- Bacterial co-infection was confirmed in patients with positive tracheal aspirate cultures.
- A C-reactive protein (CRP) level ≥2 mg/dL indicated bacterial co-infection.
- Bacterial co-infection prolonged hospital stay by 2 days; other tested parameters were not predictive.
Conclusions:
- Bacterial co-infection is common in hospitalized infants with moderate to severe bronchiolitis.
- A C-reactive protein (CRP) level >1.1 mg/dL suggests bacterial co-infection.
- Microbiological investigation of tracheal aspirates is recommended to optimize antibiotic therapy and reduce hospital stay.
Background:
Bronchiolitis is a potentially life-threatening respiratory illness commonly affecting children who are less than two years of age. Patients with viral lower respiratory tract infection are at risk for co-bacterial infection.
Aim:
The aim of our study was to evaluate the use of C-reactive protein (CRP) in predicting bacterial co-infection in patients hospitalized for bronchiolitis and to correlate the results with the use of antibiotics.
Patients And Methods:
This is a prospective study that included patients diagnosed with bronchiolitis admitted to Makassed General Hospital in Beirut from October 2008 to April 2009. A tracheal aspirate culture was taken from all patients with bronchiolitis on admission to the hospital. Blood was drawn to test C-reactive protein level, white cell count, transaminases level, and blood sugar level.
Results:
Forty-nine patients were enrolled in the study and were divided into two groups. Group 1 included patients with positive tracheal aspirate culture and Group 2 included those with negative culture. All patients with a CRP level ≥2 mg/dL have had bacterial co-infection. White cell count, transaminases and blood sugar levels were not predictive for bacterial co-infection. The presence of bacterial co-infection increased the length of hospital stay in the first group by 2 days compared to those in the second group.
Conclusion:
Bacterial co-infection is frequent in infants with moderate to severe bronchiolitis and requires admission. Our data showed that a CRP level greater than 1.1 mg/dL raised suspicion for bacterial co-infection. Thus, a tracheal aspirate should be investigated microbiologically in all hospitalized patients in order to avoid unnecessary antimicrobial therapy and to shorten the duration of the hospital stay.
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