Serum Procalcitonin Concentration in the Evaluation of Febrile Infants 2 to 60 Days of Age Pediatric Emergency Care, 05/08/2012

Woelker JU et al. – Procalcitonin concentration is a serological marker for identification of or exclusion of serious bacterial infections (SBIs) in infants aged 2 to 60days. The predictive value of procalcitonin (PCT) in combination with urinary white blood cell count may be clinically useful. A validation study is indicated.

• Infants 2 to 60days of age with rectal temperature 38°C were enrolled between May 2004 and March 2007.
• Blood was obtained from each, and PCT was assessed using BRAHMS PCT LIA method.
• Information for identification of low-risk infants using RC was obtained.
• Negative predictive value, sensitivity, specificity, and likelihood ratio of PCT were compared with the RC.
• In univariate analysis, the components of RC and PCT were considered.
• Variables holding a significant association with the absence of SBI were included in a backward stepwise logistic regression model with SBI as the dependent variable, creating new low risk criteria.

• One hundred fifty-five patients were enrolled.
• Thirteen (8.4%) had an SBI.
• Procalcitonin concentration at a cutoff value of 0.26ng/mL is similar in sensitivity (92%) and better in specificity (64%) than RC.
• A combination of urine white blood cell and PCT was the best model in the regression analysis.