Bilavsky Efraim, Yarden-Bilavsky Havatzelet, Ashkenazi Shai, Amir Jacob
Department of Paediatrics C, Schneider Children's Medical Center of Israel, Petah Tiqva, Israel.
Acta Paediatr. 2009 Nov;98(11):1776-80. doi: 10.1111/j.1651-2227.2009.01469.x. Epub 2009 Aug 6.
To determine the potential predictive power of C-reactive protein (CRP) as a marker of serious bacterial infection (SBI) in hospitalized febrile infants aged < or =3 months.
Data on blood CRP levels were collected prospectively on admission for all infants aged < or =3 months who were hospitalized for fever from 2005 to 2008. The patients were divided into two groups by the presence or absence of findings of SBI.
A total of 892 infants met the inclusion criteria, of whom 102 had a SBI. Mean CRP level was significantly higher in the infants who had a bacterial infection than in those who did not (5.3 +/- 6.3 mg/dL vs. 1.3 +/- 2.2 mg/dL, p < 0.001). The area under the ROC curve (AUC) was 0.74 (95% CI: 0.67-0.80) for CRP compared to 0.70 (95% CI: 0.64-0.76) for white blood cell (WBC) count. When analyses were limited to predicting bacteremia or meningitis only, the AUCs for CRP and WBC were 0.81 (95% CI: 0.66-0.96) and 0.63 (95% CI: 0.42-0.83), respectively.
C-reactive protein is a valuable laboratory test in the assessment of febrile infants aged < or =3 months old and may serve as a better diagnostic marker of SBI than total WBC count.
确定C反应蛋白（CRP）作为3个月及以下住院发热婴儿严重细菌感染（SBI）标志物的潜在预测能力。
前瞻性收集2005年至2008年因发热住院的所有3个月及以下婴儿入院时的血CRP水平数据。根据是否存在SBI的检查结果将患者分为两组。
共有892名婴儿符合纳入标准，其中102名患有SBI。有细菌感染的婴儿的平均CRP水平显著高于未感染的婴儿（5.3±6.3mg/dL对1.3±2.2mg/dL，p<0.001）。CRP的ROC曲线下面积（AUC）为0.74（95%CI：0.67 - 0.80），而白细胞（WBC）计数的AUC为0.70（95%CI：0.64 - 0.76）。当分析仅限于预测菌血症或脑膜炎时，CRP和WBC的AUC分别为0.81（95%CI：0.66 - 0.96）和0.63（95%CI：0.42 - 0.83）。
C反应蛋白在评估3个月及以下发热婴儿时是一项有价值的实验室检查，并且可能是比总白细胞计数更好的SBI诊断标志物。
