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Procalcitonin and C-reactive protein may help to detect invasive bacterial infections in children who have fever
Gaëlle Hubert-Dibon1, Lou Danjou1, Cécile Feildel-Fournial1
1Pediatrics Emergency Department, University Hospital Nantes, Nantes, France.
Insights
Invasive bacterial infections are uncommon in febrile children without a source. Biomarkers like procalcitonin and C-reactive protein show promise in detecting these infections.
Area of Science:
- Pediatrics
- Infectious Diseases
- Clinical Diagnostics
Background:
- Fever without source is a common presentation in pediatric care.
- Accurate identification of bacterial infections is crucial for appropriate treatment.
Purpose of the Study:
- To evaluate the epidemiology of bacterial infections in children presenting with fever without source.
- To assess the performance of various biomarkers in identifying invasive bacterial infections.
Main Methods:
- Prospective cohort study conducted at a university hospital.
- Inclusion of 1060 children aged over six days and under five years with fever without source.
- Analysis of biomarker performance using receiver-operating characteristic curves.
Main Results:
- Low prevalence of invasive bacterial infections (1.0%) including bacterial meningitis and bacteremia.
- Urinary tract infections were diagnosed in 10.7% of children.
- Procalcitonin and C-reactive protein demonstrated superior performance over neutrophil and white blood cell counts in identifying invasive bacterial infections.
Conclusions:
- Invasive bacterial infections are infrequent in children with fever without source.
- Procalcitonin and C-reactive protein are valuable biomarkers for detecting invasive bacterial infections in this pediatric population.
Aim:
This study evaluated the epidemiology and performance of biomarkers for identifying bacterial infections in children who presented with fever without source.
Methods:
We conducted a prospective cohort study in the paediatric department at the University Hospital of Nantes, France, in 2016. Children older than six days and younger than five years of age were included.
Results:
A total of 1060 children (52.2% male) with fever without source were admitted, and the median age was 17 months (interquartile range: 6.6-24.3 months). Severe bacterial infections were diagnosed in 127 (11.9%) children and invasive bacterial infections in 11 (1.0%) children: four (0.3%) with bacterial meningitis and seven (0.6%) with bacteraemia. A further 114 (10.7%) had urinary tract infections. We explored the area under the receiver-operating characteristic curves for identifying invasive bacterial infections. The curves for procalcitonin and C-reactive protein assays were better than those for the absolute neutrophil counts and the white blood cell counts.
Conclusion:
This study found that there was a low prevalence of invasive bacterial infections in children who presented with fever without source. It also showed that procalcitonin and C-reactive protein may help to detect invasive bacterial infections in children who have fever without source.
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