Effect of Viral Illness on Procalcitonin as a Predictor of Bacterial Infection in Febrile Infants

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Jared Kusma1,2, Quinney Fu1,2, Maheshwor Kafle1,2

  • 1Phoenix Children's Hospital, Phoenix, Arizona.

Hospital Pediatrics
|October 2, 2023
PubMed

Insights

Confirmed viral infections (CVI) in febrile infants reduce the sensitivity of procalcitonin (PCT) tests for detecting bacterial illness (BI). However, PCT specificity remains high, meaning it is still a reliable indicator when positive for BI in infants.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Clinical Chemistry

Background:

  • Febrile infants require accurate diagnosis of bacterial illness (BI).
  • Procalcitonin (PCT) is a biomarker used to assess bacterial infections.
  • The influence of concurrent viral infections (CVI) on PCT in infants with BI is not well understood.

Purpose of the Study:

  • To investigate the association between CVI and PCT levels in febrile infants with and without BI.
  • To evaluate PCT's effectiveness in predicting BI in infants who also have a CVI.

Main Methods:

  • Retrospective cohort study of febrile infants aged 8-60 days.
  • Comparison of PCT levels based on bacterial and viral test results.
  • Logistic regression analysis to assess PCT's predictive ability for BI.

Main Results:

  • Infants with both BI and CVI had lower PCT levels than those with BI alone.
  • The presence of CVI decreased PCT sensitivity for BI detection (44% vs. 68%).
  • PCT specificity for BI detection remained high (96% vs. 93%) even with CVI.

Conclusions:

  • CVI in febrile infants lowers PCT sensitivity for detecting bacterial illness.
  • PCT specificity for bacterial illness is minimally affected by concurrent viral infections.
  • Clinical interpretation of PCT in febrile infants should consider the potential impact of viral infections.
Abstract

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