Dataset Information

Diagnostic test accuracy of point-of-care procalcitonin to diagnose serious bacterial infections in children.

ABSTRACT: BACKGROUND:The National Institute for Health and Care Excellence (NICE) have called for research into the role of biomarkers, and specifically procalcitonin (PCT), for the early diagnosis of serious bacterial infections (SBI) in children. The aim of this study was to compare the diagnostic test accuracy of C-reactive protein (CRP) and PCT for the diagnosis of SBI in children. METHODS:Data was collected prospectively from four UK emergency departments (ED) between November 2017 and June 2019. Consecutive children under 18 years of age with fever and features of possible sepsis and/or meningitis were eligible for inclusion. The index tests were PCT and CRP and the reference standard was the confirmation of SBI. RESULTS:213 children were included in the final analysis. 116 participants (54.5%) were male, and the median age was 2 years, 9 months. Parenteral antibiotics were given to 100 (46.9%), three (1.4%) were admitted to a paediatric intensive care unit and there were no deaths. There were ten (4.7%) confirmed SBI. The area under the curve for PCT and CRP for the detection of SBI was identical at 0.70. CONCLUSIONS:There was no difference in the performance of PCT and CRP for the recognition of SBI in this cohort. TRIAL REGISTRATION:Registered at https://www.clinicaltrials.gov (trial registration: NCT03378258 ) on the 19th of December 2017.

SUBMITTER: Waterfield T

PROVIDER: S-EPMC7576699 | biostudies-literature | 2020 Oct

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Diagnostic test accuracy of point-of-care procalcitonin to diagnose serious bacterial infections in children.

Waterfield Thomas T Maney Julie-Ann JA Lyttle Mark D MD McKenna James P JP Roland Damian D Corr Michael M Patenall Bethany B Shields Michael D MD Woolfall Kerry K Fairley Derek D

BMC pediatrics 20201021 1

<h4>Background</h4>The National Institute for Health and Care Excellence (NICE) have called for research into the role of biomarkers, and specifically procalcitonin (PCT), for the early diagnosis of serious bacterial infections (SBI) in children. The aim of this study was to compare the diagnostic test accuracy of C-reactive protein (CRP) and PCT for the diagnosis of SBI in children.<h4>Methods</h4>Data was collected prospectively from four UK emergency departments (ED) between November 2017 and ...[more]

PMID: 33087092

Similar Datasets

Project description:ObjectiveTo derive, cross validate, and externally validate a clinical prediction model that assesses the risks of different serious bacterial infections in children with fever at the emergency department.DesignProspective observational diagnostic study.SettingThree paediatric emergency care units: two in the Netherlands and one in the United Kingdom.ParticipantsChildren with fever, aged 1 month to 15 years, at three paediatric emergency care units: Rotterdam (n=1750) and the Hague (n=967), the Netherlands, and Coventry (n=487), United Kingdom. A prediction model was constructed using multivariable polytomous logistic regression analysis and included the predefined predictor variables age, duration of fever, tachycardia, temperature, tachypnoea, ill appearance, chest wall retractions, prolonged capillary refill time (>3 seconds), oxygen saturation <94%, and C reactive protein.Main outcome measuresPneumonia, other serious bacterial infections (SBIs, including septicaemia/meningitis, urinary tract infections, and others), and no SBIs.ResultsOxygen saturation <94% and presence of tachypnoea were important predictors of pneumonia. A raised C reactive protein level predicted the presence of both pneumonia and other SBIs, whereas chest wall retractions and oxygen saturation <94% were useful to rule out the presence of other SBIs. Discriminative ability (C statistic) to predict pneumonia was 0.81 (95% confidence interval 0.73 to 0.88); for other SBIs this was even better: 0.86 (0.79 to 0.92). Risk thresholds of 10% or more were useful to identify children with serious bacterial infections; risk thresholds less than 2.5% were useful to rule out the presence of serious bacterial infections. External validation showed good discrimination for the prediction of pneumonia (0.81, 0.69 to 0.93); discriminative ability for the prediction of other SBIs was lower (0.69, 0.53 to 0.86).ConclusionA validated prediction model, including clinical signs, symptoms, and C reactive protein level, was useful for estimating the likelihood of pneumonia and other SBIs in children with fever, such as septicaemia/meningitis and urinary tract infections.

Dataset Information

Diagnostic test accuracy of point-of-care procalcitonin to diagnose serious bacterial infections in children.

Publications

Diagnostic test accuracy of point-of-care procalcitonin to diagnose serious bacterial infections in children.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets