Department of Paediatrics and Child Health, Aga Khan University of Nairobi, P.O. Box 30270-00100, Nairobi, Kenya.
Health Services Unit, Kenya Medical Research Institute/Wellcome Trust Research Programme, P.O. Box 43640-00100, Nairobi, Kenya.
J Trop Pediatr. 2020 Feb 1;66(1):29-37. doi: 10.1093/tropej/fmz027.
Serum procalcitonin (PCT) was measured in 228 children aged 1 month to 15 years at an emergency department of a hospital located in an area without local malaria transmission in children with suspected infections; 21% (49) children had a clinical syndrome for suspected bacterial infections (Syndrome+ve). In children with Syndrome+ve criteria, 27/49 (55.1%) had PCT ≥0.5 µg/l but only 59/179 (32.9%) of those Syndrome-ve had abnormal PCT, χ2 = 8.0, p = 0.005; positive likelihood ratio = 2.0 [95% confidence interval (CI) 1.2-3.3]; negative likelihood ratio = 0.8 (95% CI 0.7-1.0). In patients with pneumonia, 9/15 (60%) with severe pneumonia had PCT ≥0.5 µg/l compared to 11/21 (52.4%) with non-severe pneumonia, χ2 = 0.2, p = 0.65. Children with clinical signs of pneumonia or clinical signs suggestive of bacterial infections fulfilling clinical syndromic definitions for suspected bacterial infections commonly have elevated PCT level. PCT levels are associated with disease severity and antibiotic trials guided by PCT levels may be needed where cultures are not available.
对 228 名年龄在 1 个月至 15 岁之间的疑似感染儿童在一家位于无疟疾本地传播地区医院的急诊科进行了血清降钙素原（PCT）检测；21%（49 名）儿童具有疑似细菌感染的临床综合征（综合征阳性）。在符合综合征阳性标准的儿童中，27/49（55.1%）的 PCT 值≥0.5μg/l，但只有 179/49（32.9%）的综合征阴性儿童的 PCT 值异常，χ2=8.0，p=0.005；阳性似然比=2.0（95%置信区间 1.2-3.3）；阴性似然比=0.8（95%置信区间 0.7-1.0）。在肺炎患者中，15 名严重肺炎患者中有 9 名（60%）PCT 值≥0.5μg/l，而非严重肺炎患者中有 21 名（52.4%），χ2=0.2，p=0.65。具有肺炎临床体征或提示细菌感染的临床体征且符合疑似细菌感染的临床综合征定义的儿童通常具有较高的 PCT 水平。PCT 水平与疾病严重程度相关，在无法进行培养的情况下，可能需要根据 PCT 水平进行抗生素试验。
