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C-reactive protein in viral and bacterial gastroenteritis in childhood
G Borgnolo1, F Barbone, G Guidobaldi
1Paediatric Department, Monfalcone General Hospital, Italy.
Insights
C-reactive protein (CRP) levels can help distinguish bacterial from viral gastroenteritis in children. A CRP level of 12 mg/L or higher strongly suggests a bacterial infection, aiding in diagnosis.
Area of Science:
- Pediatrics
- Infectious Diseases
- Clinical Chemistry
Background:
- Differentiating bacterial from viral infections in children with gastroenteritis is crucial for appropriate treatment.
- C-reactive protein (CRP) is an acute-phase reactant often elevated in bacterial infections.
Purpose of the Study:
- To evaluate the utility of serum C-reactive protein (CRP) levels in distinguishing bacterial from viral gastroenteritis in children under 5 years of age.
- To determine the optimal CRP cutoff level for predicting bacterial gastroenteritis.
Main Methods:
- Serum samples were analyzed for C-reactive protein (CRP) levels in 53 children with bacterial gastroenteritis and 35 with viral gastroenteritis.
- CRP levels were compared across different infection types using various cutoff values (12 mg/L, 20 mg/L, 35 mg/L).
- Sensitivity and specificity were calculated for each CRP cutoff level.
Main Results:
- Children with bacterial gastroenteritis showed significantly higher CRP levels compared to those with viral infections.
- A CRP cutoff of >= 12 mg/L demonstrated the best balance of sensitivity (77%) and specificity (89%) for bacterial infections.
- Higher CRP cutoffs (>= 20 mg/L and >= 35 mg/L) offered higher specificity but lower sensitivity.
Conclusions:
- Serum C-reactive protein (CRP) determination is a valuable tool for predicting bacterial gastroenteritis in children.
- A CRP level of >= 12 mg/L is recommended as an effective threshold for identifying bacterial gastroenteritis in pediatric patients.
Abstract:
To differentiate bacterial from viral infections the level of C-reactive protein in serum samples was studied in three groups of children under 5 years of age with gastroenteritis. Of the 53 children with bacterial infection, 41 (77%) had C-reactive protein levels > or = 12 mg1 -1, 32 (66%) > or = 20 mgl-1 and 24 (45%) > or = 35 mgl-1. Of the 35 patients with viral infection, 4 (11%) had C-reactive protein levels > or = 12 mgl-1, 3 (9%) > or = 20 mgl-1 and 1 (3%) > or = 35 mgl-1. The best balance between sensitivity and specificity of C-reactive protein was obtained for a cut-off level > or = 12 mgl-1 (sensitivity 77%, specificity 89%) as compared to > or = 20 mgl-1 (sensitivity 58%, specificity 97%) and > or = 35 mgl-1 (sensitivity 44%, specificity 97%). Our results suggest that the determination of C-reactive protein values may be a useful tool for predicting bacterial gastroenteritis in children.