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Published on: June 28, 2018
Biomarkers for Serious Bacterial Infections in Febrile Children
Luca Bernardi1, Gianluca Bossù1, Giulia Dal Canto1
1Pediatric Clinic, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy.
Insights
New biomarkers and machine learning show promise in diagnosing serious bacterial infections (SBI) in febrile children presenting to the emergency department (ED). Combining existing inflammatory markers like C-reactive protein (CRP) and procalcitonin may improve accuracy, but further research is needed for pediatric precision medicine.
Area of Science:
- Pediatric Emergency Medicine
- Clinical Biochemistry
- Immunology
Background:
- Febrile infections in children are a frequent reason for emergency department (ED) visits.
- Distinguishing viral from bacterial infections is crucial to prevent sepsis and complications.
- Traditional inflammatory biomarkers like C-reactive protein (CRP) and procalcitonin are commonly used.
Purpose of the Study:
- To review the latest evidence on biomarkers and predictive models for diagnosing serious bacterial infections (SBI) in febrile children.
- To explore the potential of novel biomarkers and machine learning in pediatric emergency settings.
Main Methods:
- Narrative literature review of recent evidence on biomarkers and predictor models for SBI in febrile children.
- Analysis of the role of inflammatory response, biochemical factors, and immunological pathways.
Main Results:
- CRP and procalcitonin remain key biomarkers for SBI diagnosis in pediatric EDs.
- Combining CRP and procalcitonin enhances their sensitivity and specificity.
- Machine learning tools, combined with clinical data, show potential for improving diagnostic accuracy and therapeutic targeting.
Conclusions:
- Combined use of CRP and procalcitonin is recommended for evaluating febrile children.
- Machine learning offers a novel approach to enhance SBI diagnosis accuracy in pediatric emergency care.
- Further validation in younger populations is necessary to establish the role of these new technologies in pediatric precision medicine.
Abstract:
Febrile infections in children are a common cause of presentation to the emergency department (ED). While viral infections are usually self-limiting, sometimes bacterial illnesses may lead to sepsis and severe complications. Inflammatory biomarkers such as C reactive protein (CRP) and procalcitonin are usually the first blood exams performed in the ED to differentiate bacterial and viral infections; nowadays, a better understanding of immunochemical pathways has led to the discovery of new and more specific biomarkers that could play a role in the emergency setting. The aim of this narrative review is to provide the most recent evidence on biomarkers and predictor models, combining them for serious bacterial infection (SBI) diagnosis in febrile children. Literature analysis shows that inflammatory response is a complex mechanism in which many biochemical and immunological factors contribute to the host response in SBI. CRP and procalcitonin still represent the most used biomarkers in the pediatric ED for the diagnosis of SBI. Their sensibility and sensitivity increase when combined, and for this reason, it is reasonable to take them both into consideration in the evaluation of febrile children. The potential of machine learning tools, which represent a real novelty in medical practice, in conjunction with routine clinical and biological information, may improve the accuracy of diagnosis and target therapeutic options in SBI. However, studies on this matter are not yet validated in younger populations, making their relevance in pediatric precision medicine still uncertain. More data from further research are needed to improve clinical practice and decision making using these new technologies.
