RRML - Diagnostic accuracy of three biomarkers in identifying serious bacterial infections in children younger than 36 months with fever without source

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Nr. 23(3)/2015 DOI:10.1515/rrlm-2015-0032

Diagnostic accuracy of three biomarkers in identifying serious bacterial infections in children younger than 36 months with fever without source

Diana Aniela Moldovan, Maria Despina Baghiu, Alina Balas, Emese Rozalia Fabian-Frast, Cristian Boeriu

Abstract:

Objectives: Our study aimed to evaluate and compare the accuracy of C-reactive protein, Procalcitonin and Interleukine-6 in identifying serious bacterial infections (SBI) in children with fever without source. Methods: 139 children, aged 7 days to 36 months, addressing the Emergency Department from a Romanian university hospital, were prospectively enrolled during 2013. C-reactive protein, Procalcitonin and Interleukin-6 were determined for every patient. SBI diagnosis was based on cultures results and chest radiographs. Results: 31 patients (22.3%) had SBI. C-reactive protein [AUC: 0.87 (95%CI: 0.81-0.92)] and Procalcitonin [AUC: 0.83 (95%CI: 0.76-0.89)] proved strong prediction value for SBI and performed better than Interleukin-6 [AUC: 0.77 (95%CI: 0.69-0.84)]. For the group of children with the duration of fever less than 8 hours, Interleukin-6 was the best predictor [AUC: 0.88 (0.76-0.95)]. Conclusions: Both C-reactive protein and Procalcitonin are strong and similar predictors for SBI, and Interleukin-6 might be a better SBI screening tool for children with shorter duration of fever.

Keywords: fever, children, C-reactive protein, Procalcitonin, Interleukin-6

Received: 31.3.2015
Accepted: 9.8.2015
Published: 10.9.2015

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