Department of Infectious Diseases, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
Braz J Infect Dis. 2010 May-Jun;14(3):252-5.
Fever as a common presenting complaint in pediatric patients can be due to various causes. Differentiating bacterial infection from other causes is important because the prompt use of antibiotics is critical in bacterial infection. Traditional markers of infection such as BT and WBC count may be unspecific and culture may be late or absent. CRP and Procalcitonin (PCT) have been considered to evaluate the evolution of infections and sepsis in patients presenting with SIRS. Neopterin has also been proposed to aid in the diagnosis of bacterial infection. In this study, we compared the value of the serum PCT, neopterin level, and WBC count for predicting bacterial infection and outcome in children with fever.
158 pediatric (2-120-month-old) patients suspected to have acute bacterial infection, based on clinical judgment in which other causes of SIRS were ruled out were included in the study. WBC count with differential was determined and PCT and neopterin levels were measured.
PCT level was higher in bacterial infection and patients who were complicated or expired.
Rapid PCT test is superior to neopterin and WBC count for anticipating bacterial infection, especially in ED where prompt decision making is critical.
发热是儿科患者常见的主诉,可能由多种原因引起。区分细菌感染与其他原因很重要,因为及时使用抗生素对细菌感染至关重要。传统的感染标志物,如 BT 和白细胞计数,可能不具有特异性,且培养可能延迟或不存在。C 反应蛋白(CRP)和降钙素原(PCT)已被用于评估出现全身炎症反应综合征(SIRS)的患者感染和脓毒症的进展。新蝶呤也被提议用于辅助诊断细菌感染。在这项研究中,我们比较了血清 PCT、新蝶呤水平和白细胞计数对预测发热儿童细菌感染和结局的价值。
本研究纳入了 158 名(2-120 月龄)疑似急性细菌感染的儿科患者,这些患者基于临床判断,排除了其他 SIRS 原因。测定白细胞计数和分类,测量 PCT 和新蝶呤水平。
细菌感染和并发症或死亡患者的 PCT 水平更高。
快速 PCT 检测优于新蝶呤和白细胞计数,可预测细菌感染,特别是在 ED,需要快速决策。