Procalcitonin to Detect Bacterial Infections in Critically Ill Pediatric Patients

Area of Science:

• Pediatric critical care medicine
• Infectious disease diagnostics
• Biomarker research

Background:

• The diagnostic utility of procalcitonin (PCT) for serious bacterial infections (SBI) in pediatric intensive care units (PICUs) remains unclear.
• Accurate diagnosis is crucial for timely treatment and appropriate antibiotic use in critically ill children.

Purpose of the Study:

• To evaluate the diagnostic performance of PCT in identifying SBI within a diverse PICU population.
• To determine an optimal PCT threshold for predicting SBI in this setting.

Main Methods:

• Retrospective cohort study of 75 pediatric patients admitted to the PICU between 2013 and 2015.
• Procalcitonin levels were measured within 48 hours of admission.
• Diagnostic accuracy was assessed using receiver operating characteristic (ROC) curves.

Main Results:

• Twenty-eight patients (37%) had SBI, with a median PCT of 6.48 ng/mL compared to 0.23 ng/mL in the non-infection group (P < .0001).
• PCT demonstrated good discriminatory ability for SBI (Area Under the Curve [AUC]-ROC = 0.83; P < .0001).
• An optimal PCT threshold of ≥1.28 ng/mL yielded a positive predictive value of 76.7% and a negative predictive value of 88.9%.

Conclusions:

• Procalcitonin is a valuable biomarker for predicting SBI in a heterogeneous PICU population.
• The findings suggest PCT can aid in judicious antibiotic use, potentially reducing unnecessary prescriptions.