Comparison between procalcitonin and C-reactive protein for early diagnosis of children with sepsis or septic shock.
OBJECTIVE
The objective of the paper is to examine the behavior of C-reactive protein (CRP) and procalcitonin (PCT) in the first 12 h of admission and verify which performs better to differentiate children with septic conditions.


METHODS
Septic children aged between 28 days and 14 years were divided into sepsis (SG; n = 46) and septic shock (SSG; n = 41) groups. CRP and PCT were measured at admission (T0) and 12 h later (T12 h). PCT results were classed as: 0.5 ng/ml = sepsis unlikely; >or=0.5 to <2 = sepsis possible; >or=2 to <10 = systemic inflammation; >or=10 = septic shock.


RESULTS
At T0, there was a higher frequency of SSG with PCT >10 compared to SG [SSG: 30 (73.1%) > SG: 14 (30.4%); P < 0.05]. Similar results were observed at T12 h. Pediatric Risk of Mortality I score was significantly higher for SSG patients with higher PCT than SG patients. CRP levels were not statistically different for groups and time points.


CONCLUSIONS
PCT was better than CRP for diagnosing sepsis and septic shock, mainly at admission, and is related to disease severity.
Fioretto
José R
JR
Pediatrics Department, Botucatu Medical School, Sao Paulo State University, São Paulo, Brazil. jrf@fmb.unesp.br
Martin
Joelma G
JG
Kurokawa
Cilmery S
CS
Carpi
Mário F
MF
Bonatto
Rossano C
RC
de Moraes
Marcos A
MA
Ricchetti
Sandra M Q
SM
D000293:Adolescent; D002097:C-Reactive Protein / Q000378:metabolism*; D002116:Calcitonin / Q000097:blood*; D015740:Calcitonin Gene-Related Peptide; D002648:Child; D002675:Child, Preschool; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D011446:Prospective Studies; D011498:Protein Precursors / Q000097:blood*; D018805:Sepsis / Q000097:blood / Q000175:diagnosis; D012772:Shock, Septic / Q000097:blood / Q000175:diagnosis
C000606589:CALCA protein, human; D011498:Protein Precursors; D002116:Calcitonin; D002097:C-Reactive Protein; D015740:Calcitonin Gene-Related Peptide