Department of Clinical Laboratory, Cangzhou Central Hospital, No.16 Xinhua West Road, Cangzhou, 061001, Hebei, China.
Clinical Laboratory, Mengcun Hui Autonomous County Hospital, Chaoyang Dajie, Mengcun Hui Autonomous County, Cangzhou, 061400, Hebei, China.
Mol Cell Biochem. 2021 Jan;476(1):261-267. doi: 10.1007/s11010-020-03902-8. Epub 2020 Sep 29.
Hospital-acquired pneumonia (HAP) is one of the common infections in hospitalized patients. Early and prompt diagnosis of HAP is important because it aids in the appropriate selection of antibiotics and decreases the mortality and morbidity of patients. The investigation on serum procalcitonin (PCT) levels in pediatric patients is limited. Herein we aimed to evaluate the role of PCT in the early diagnosis of children with bacterial HAP. The study enrolled 264 children (< 14 years old) who were radiographically detected by pulmonary condensation chest X-rays. The HAP patients were stratified by patterns of microbiological detection of pathogens. Baseline white blood cell (WBC) count, neutrophil proportion, PCT, and C-reactive protein (CRP) were measured on admission. The laboratory findings and microbiological findings were analyzed and compared among groups. The median PCT concentration of patients with typical bacterial pathogens (3.95 ± 3.75 ng/mL) was significantly higher than the one of the patients with other pathogen types (median lower than 1.20 ng/mL). Correlation analysis indicated a significant correlation between PCT concentrations and the main inflammation makers including WBC count, neutrophil proportion, and CRP. PCT level was significantly decreased to 0.86 ± 1.46 ng/mL in post-treatment patients (p < 0.001). This cohort study with 264 pediatric HAP patients demonstrated the reliability of PCT level as a biomarker in patients with typical bacterial pathogens. Specifically, PCT cutoffs of 2 ng/mL accurately identified HAP children with typical bacterial pathogens. This finding suggested that PCT may serve as a reliable biomarker for the early diagnosis and treatment indicator of children with HAP.
医院获得性肺炎（HAP）是住院患者中常见的感染之一。早期和及时诊断 HAP 非常重要，因为这有助于选择适当的抗生素，并降低患者的死亡率和发病率。目前关于儿科患者血清降钙素原（PCT）水平的研究有限。本研究旨在评估 PCT 在儿童细菌性 HAP 早期诊断中的作用。该研究纳入了 264 名（<14 岁）通过肺部冷凝胸部 X 射线影像学检测的儿童患者。根据病原体微生物检测模式对 HAP 患者进行分层。入院时测量了白细胞（WBC）计数、中性粒细胞比例、PCT 和 C 反应蛋白（CRP）的基线水平。分析和比较了各组的实验室和微生物学结果。具有典型细菌病原体的患者 PCT 浓度中位数（3.95±3.75ng/mL）明显高于其他病原体类型患者（中位数低于 1.20ng/mL）。相关性分析表明，PCT 浓度与 WBC 计数、中性粒细胞比例和 CRP 等主要炎症标志物之间存在显著相关性。治疗后 PCT 水平显著下降至 0.86±1.46ng/mL（p<0.001）。这项纳入 264 名儿科 HAP 患者的队列研究证实了 PCT 水平作为典型细菌病原体患者生物标志物的可靠性。具体而言，2ng/mL 的 PCT 截断值可准确识别出具有典型细菌病原体的 HAP 儿童。这一发现表明，PCT 可能成为 HAP 儿童早期诊断和治疗指标的可靠生物标志物。
