Is procalcitonin better than C-reactive protein for early diagnosis of bacterial pneumonia in children?
Early diagnosis of bacterial pneumonia plays a pivotal role in the management. We evaluated the diagnostic accuracy of procalcitonin (PCT) as compared with C-reactive protein (CRP) for the early diagnosis of bacterial pneumonia in children. In total, 92 children consisting of 46 patients of bacterial pneumonia were admitted in the Military hospital, Rawalpindi, Pakistan and equal number of controls were included. Patient's investigations were carried out at admission. PCT and CRP were analyzed on Vidas analyzer and Immulite 1000, respectively. Out of 46 pneumonia patients, 28 were male and 18 female, with a median age of 4 years. PCT levels were significantly high median (range) of 2.69 ng/ml (0.30-13.00) vs. 0.45 ng/ml (0.10-2.00) in controls. Serum CRP levels were moderately elevated with median (range) 6.5 mg/l (0.30-60) vs. 0.30 mg/l (0.30-5.0) in controls. The area under receiver characteristic curves for PCT and CRP were 0.89 (95% CI=0.83-0.96) and 0.79 (95% CI=0.70-0.88), respectively. In total, 38 patients were diagnosed to have bacterial pneumonia with PCT (sensitivity 83% at cutoff > or = 1 ng/ml) and 26 children with CRP (sensitivity 57% at cutoff > or = 6 mg/L). PCT has better diagnostic accuracy than CRP and can be utilized for early diagnosis of bacterial pneumonia in children.
Khan
Dilshad Ahmad
DA
Department of Pathology, Army Medical College, National University of Sciences and Technology, Rawalpindi, Pakistan. dilshad@nust.edu.pk
Rahman
Aisha
A
Khan
Farooq Ahmad
FA
D019540:Area Under Curve; D002097:C-Reactive Protein / Q000378:metabolism*; D002116:Calcitonin / Q000097:blood*; D015740:Calcitonin Gene-Related Peptide; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D018410:Pneumonia, Bacterial / Q000097:blood* / Q000175:diagnosis; D011237:Predictive Value of Tests; D011498:Protein Precursors / Q000097:blood*; D012372:ROC Curve; D012680:Sensitivity and Specificity; D018709:Statistics, Nonparametric
C000606589:CALCA protein, human; D011498:Protein Precursors; D002116:Calcitonin; D002097:C-Reactive Protein; D015740:Calcitonin Gene-Related Peptide