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Published on: February 14, 2019
New diagnostic biomarker in acute diarrhea due to bacterial infection in children
Hassan M Al-Asy1, Rasha M Gamal1, Ahmed M Abd Albaset1
1Pediatric Department, Tanta Faculty of Medicine, Tanta University, Egypt.
Insights
Soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) and procalcitonin (PCT) aid in diagnosing bacterial diarrhea in children. sTREM-1 shows higher accuracy than PCT for early bacterial infection detection.
Area of Science:
- Pediatrics
- Infectious Diseases
- Biomarkers
Background:
- Diarrhea is a significant cause of childhood illness and death.
- Distinguishing bacterial from non-bacterial diarrhea is challenging.
- Accurate diagnosis is crucial for effective treatment.
Purpose of the Study:
- To assess the diagnostic accuracy of sTREM-1 and PCT in identifying bacterial infections in children with acute diarrhea.
- To compare the efficacy of sTREM-1 and PCT as diagnostic markers.
Main Methods:
- A case-control study involving 40 children with bacterial diarrhea, 40 with non-bacterial diarrhea, and 30 healthy controls.
- Measurements included stool culture, CRP, serum PCT, and serum sTREM-1 levels.
- Diagnostic accuracy was evaluated using ROC curve analysis.
Main Results:
- Children with bacterial diarrhea showed significantly higher serum sTREM-1 and PCT levels compared to non-bacterial diarrhea and control groups.
- sTREM-1 demonstrated high sensitivity (93.7%) and specificity (94.3%) for bacterial diarrhea.
- sTREM-1 had a superior area under the ROC curve (0.94) compared to PCT.
Conclusions:
- Both PCT and sTREM-1 are valuable biomarkers for the early diagnosis of bacterial diarrhea in children.
- sTREM-1 exhibits superior diagnostic discriminatory power compared to PCT.
- These markers can aid clinicians in differentiating bacterial from non-bacterial causes of acute diarrhea.
Background And Objectives:
Diarrhea is a major cause of morbidity and mortality in children, and diarrhea may be due to infection that is bacterial or non-bacterial. Differentiation between diarrhea from a bacterial or non-bacterial infection is not a simple task, and no single method is present to differentiate between these causes of diarrhea.To evaluate the diagnostic accuracy of soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) and procalcitonin (PCT) in the diagnosis of acute diarrhea due to bacterial infection.
Patients And Methods:
Case control study of forty children with bacterial infection diarrhea diagnosed by stool culture and CRP, 40 children with acute non-bacterial infection diarrhea and 30 age- and sex-matched healthy controls. Stool cultures, serum CRP, PCT and serum sTREM-1 were measured in all children on admission.
Results:
Children with acute bacterial infection diarrhea had a significant increase in the serum sTREM-1 and PCT levels on admission compared to patients with nonbacterial infection diarrhea and controls (26.3667 ± 16.8184 ng/ml vs 7.2267 ± 6.4174 ng/ml vs 6.7367 ± 5.6479 ng/ml and 39.9933 ± 22.5260 ng/ml vs 1.8533 ± 1.7123 vs 0.2840 ± 0.1208 ng/ml, respectively; P < 0.05). sTREM-1 demonstrated significantly higher sensitivity (93.7%) and specificity (94.3%) in the prediction of bacterial infection as a cause of acute diarrhea in children with an area under the receiver operator characteristic (ROC) curve (95% CI) of 0.94 (0.84-0.99) at a cutoff value of 12.4 ng/ml.
Conclusions:
Both serum PCT and sTREM-1 are valuable in the early diagnosis of acute bacterial infection-induced diarrhea in children, and there was markedly higher diagnostic discriminatory power for sTREM-1.
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