title: The use of C-reactive protein in predicting bacterial co-Infection in children with bronchiolitis.
abstract: BACKGROUND
  Bronchiolitis is a potentially life-threatening respiratory illness commonly affecting children who are less than two years of age. Patients with viral lower respiratory tract infection are at risk for co-bacterial infection.
  
  
  OBJECTIVE
  The aim of our study was to evaluate the use of C-reactive protein (CRP) in predicting bacterial co-infection in patients hospitalized for bronchiolitis and to correlate the results with the use of antibiotics.
  
  
  METHODS
  This is a prospective study that included patients diagnosed with bronchiolitis admitted to Makassed General Hospital in Beirut from October 2008 to April 2009. A tracheal aspirate culture was taken from all patients with bronchiolitis on admission to the hospital. Blood was drawn to test C-reactive protein level, white cell count, transaminases level, and blood sugar level.
  
  
  RESULTS
  Forty-nine patients were enrolled in the study and were divided into two groups. Group 1 included patients with positive tracheal aspirate culture and Group 2 included those with negative culture. All patients with a CRP level ≥2 mg/dL have had bacterial co-infection. White cell count, transaminases and blood sugar levels were not predictive for bacterial co-infection. The presence of bacterial co-infection increased the length of hospital stay in the first group by 2 days compared to those in the second group.
  
  
  CONCLUSIONS
  Bacterial co-infection is frequent in infants with moderate to severe bronchiolitis and requires admission. Our data showed that a CRP level greater than 1.1 mg/dL raised suspicion for bacterial co-infection. Thus, a tracheal aspirate should be investigated microbiologically in all hospitalized patients in order to avoid unnecessary antimicrobial therapy and to shorten the duration of the hospital stay.
authors.affiliation: Department of Pediatrics, Makassed General Hospital, Beirut, Lebanon.
authors.forename: Mohamad
authors.initials: M
authors.lastname: Fares
authors.forename: Sawsan
authors.initials: S
authors.lastname: Mourad
authors.forename: Mariam
authors.initials: M
authors.lastname: Rajab
authors.forename: Nahida
authors.initials: N
authors.lastname: Rifai