C-Reactive Protein Levels in Children with Acute Bronchiolitis

Area of Science:

• Pediatrics
• Infectious Diseases
• Clinical Chemistry

Background:

• Acute bronchiolitis is a common pediatric respiratory infection.
• Elevated C-reactive protein (CRP) is often observed, but its correlation with bacterial coinfection is unclear.
• Understanding factors associated with high CRP can aid clinical decision-making.

Purpose of the Study:

• To investigate the relationship between CRP levels and bacterial coinfection in children with acute bronchiolitis.
• To identify clinical and laboratory factors associated with elevated CRP in this population.
• To assess antibiotic prescription patterns in acute bronchiolitis.

Main Methods:

• Retrospective analysis of 229 pediatric patients diagnosed with acute bronchiolitis.
• Measurement of CRP levels, detection of respiratory syncytial virus (RSV) and other viral pathogens.
• Assessment for bacterial coinfection, chest X-ray findings, and antibiotic use.
• Statistical analysis to correlate CRP levels with clinical factors and outcomes.

Main Results:

• A high proportion of patients (72.9%) had elevated CRP levels.
• Bacterial coinfection was confirmed in 17.6% of patients.
• Mean CRP was higher in RSV-negative patients compared to RSV-positive patients (P=0.042).
• High CRP was associated with older age (P<0.0001), fever (P<0.0001), cough (P=0.002), and lower hemoglobin (P<0.0001).
• Fever and hemoglobin level were independent factors associated with high CRP (P=0.016 and P=0.002, respectively).
• Antibiotics were prescribed to 78.1% of patients, despite a predominantly viral etiology.

Conclusions:

• Elevated CRP in acute bronchiolitis is common but does not reliably indicate bacterial coinfection.
• Clinical factors like fever and hemoglobin levels, rather than bacterial coinfection, are associated with high CRP.
• High rates of antibiotic prescription for viral bronchiolitis warrant review and potential de-escalation strategies.