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[Value of procalcitonin for infants with bronchiolitis in an emergency department]
M Desmarest1, C Aupiais2, J Le Gal1
1Service d'accueil des urgences pédiatriques, hôpital Robert-Debré, AP-HP, 48, boulevard Sérurier, 75019 Paris, France.
Insights
Procalcitonin (PCT) levels in infants with bronchiolitis did not predict pneumonia on X-ray. Higher PCT was associated with increased antibiotic use, though this link needs further study.
Area of Science:
- Pediatric Emergency Medicine
- Infectious Disease Biomarkers
- Respiratory Illnesses
Background:
- Limited research exists on procalcitonin (PCT) in infant bronchiolitis.
- Understanding PCT's role can aid in clinical decision-making for pediatric respiratory infections.
Purpose of the Study:
- To characterize infants diagnosed with bronchiolitis in the emergency department who underwent PCT testing.
- To compare clinical, biological, and radiological features based on PCT levels.
Main Methods:
- Retrospective analysis of 136 infants with bronchiolitis and PCT tests (2014-2014).
- Comparison of clinical and biological data between infants with PCT <1 g/L and ≥1 g/L.
- Assessment of chest X-ray findings in relation to PCT levels.
Main Results:
- Infants with high PCT (≥1 g/L) exhibited higher temperatures, C-reactive protein, and neutrophil counts.
- No significant difference in alveolar condensation on chest X-ray between high and low PCT groups.
- A substantially lower percentage of infants in the low-PCT group received antibiotics (14.7% vs. 65%).
Conclusions:
- Procalcitonin levels ≥1 g/L do not reliably predict alveolar condensation in infants with bronchiolitis.
- PCT levels appear correlated with antibiotic prescription practices in this population.
- Further research is needed to confirm the association between PCT and antibiotic use due to study design limitations.
Context:
Very few studies have evaluated the role of procalcitonin (PCT) in infants with bronchiolitis.
Aims:
To describe infants who had both a diagnosis of bronchiolitis at the emergency department and a blood test including PCT, and to compare the characteristics of children according to the PCT value.
Methods:
Infants admitted to the Pediatric Emergency Department between 1 January 2014 and 31 December 2014 who had a diagnosis of bronchiolitis and a blood test including PCT were included. The clinical, biological, and radiological characteristics of the infants with PCT <1 or ≥1g/L were compared.
Results:
One hundred thirty six infants were included. Patients with high PCT (n=20) had a higher temperature (38.5°C, IQR=37.8-38.6 vs. 37.5°C, IQR=37.1-38.2; P<0.01), C-reactive protein (50mg/L, IQR=25-83 vs. 5mg/L, IQR=0-19; P<0.01), and neutrophils (7.8×109/L, IQR=6.0-8.5 vs 4.5×109/L, IQR=2.9-6.6; P<0.01) higher than patients with low PCT (n=116). Presence on the chest x-ray of alveolar condensation did not differ between the two PCT groups. Infants coming from the low-PCT group received fewer antibiotics (14.7% vs 65%; P<0.01).
Conclusion:
In a Pediatric Emergency Department, PCT with a value of 1 or more cannot predict the presence of alveolar condensation on the chest x-ray. It seems to be associated with the antibiotics prescription, even if this could not be proved because of the design of the study.
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