Calcitonin Gene-Related Peptide for Identifying Pediatric Bacterial Musculoskeletal Infections: A Prospective,...

Area of Science:

• Biochemistry
• Pediatric Infectious Diseases
• Biomarker Discovery

Background:

• Bacterial musculoskeletal infections (MSKIs) present diagnostic challenges in children.
• Accurate and timely diagnosis is crucial for effective treatment and patient outcomes.

Purpose of the Study:

• To compare the diagnostic accuracy of calcitonin gene-related peptide (CGRP) with procalcitonin (PCT) for identifying MSKIs in pediatric patients.
• To investigate the correlation between serum CGRP and PCT levels in children evaluated for MSKIs.

Main Methods:

• A prospective cohort study included 200 pediatric patients (≤21 years) evaluated for MSKIs across three emergency departments.
• Serum CGRP and PCT levels were measured.
• Diagnostic accuracy was assessed using the area under the receiver operating characteristic curve (AUC), and correlation was evaluated using the Spearman rank coefficient.

Main Results:

• Of 200 patients, 33 (17%) had a confirmed MSKI.
• Median serum CGRP levels did not significantly differ between patients with and without MSKI.
• Procalcitonin (PCT) levels were significantly higher in patients with MSKI compared to those without.
• CGRP and PCT levels showed no significant correlation (Spearman coefficient: -0.01).
• CGRP exhibited lower diagnostic accuracy (AUC: 0.57) compared to PCT (AUC: 0.78).

Conclusions:

• Calcitonin gene-related peptide (CGRP) is not a reliable biomarker for diagnosing pediatric musculoskeletal infections (MSKIs).
• Procalcitonin (PCT) demonstrated superior diagnostic accuracy compared to CGRP.
• The study underscores the need for novel biomarkers to improve the diagnosis of pediatric MSKIs.