title: Diagnostic value of the Vesikari Scoring System for predicting the viral or bacterial pathogens in pediatric gastroenteritis.
abstract: OBJECTIVE
  To evaluate the diagnostic value of the Vesikari Scoring System (VSS) as an early predictor of pathogens in children with acute gastroenteritis (AG).
  
  
  METHODS
  In this retrospective study, the VSS score, absolute neutrophil count (ANC), and C-reactive protein (CRP) levels were analyzed in 107 hospitalized children with AG, aged 6 months to 17 years. Patients were divided into nonspecific, viral, and bacterial groups according to the pathogens detected using a multiplex polymerase chain reaction (PCR) test.
  
  
  RESULTS
  Patients in the bacterial group had significantly higher CRP values and VSS scores compared to those in the viral group and significantly higher VSS scores compared to those in the nonspecific group (P<0.05). Patients in the viral group had significantly higher VSS scores than those in the nonspecific group (P<0.05). Logistic regression analysis revealed that VSS was the most effective diagnostic tool for predicting the type of pathogen (P<0.05). The area under the receiver operating characteristics curve of VSS was significantly greater than that for ANC and CRP (P<0.05). At a cutoff point of 10 in the VSS, an acceptable diagnostic accuracy could be achieved for distinguishing between bacterial and viral pathogens in AG.
  
  
  CONCLUSIONS
  VSS can be considered a useful and reliable infectious marker for pediatric gastroenteritis. VSS may be a good early predictor of the type of pathogen, enabling development of a treatment plan before results from a stool culture or PCR test are available.
authors.affiliation: Department of Pediatrics, KEPCO Medical Center, Seoul, Korea.
authors.forename: Dong Ho
authors.initials: DH
authors.lastname: Shim
authors.affiliation: Department of Pediatrics, KEPCO Medical Center, Seoul, Korea.
authors.forename: Dong Yeon
authors.initials: DY
authors.lastname: Kim
authors.affiliation: Department of Pediatrics, KEPCO Medical Center, Seoul, Korea.
authors.forename: Ky Young
authors.initials: KY
authors.lastname: Cho
keywords: C-reactive protein; Child; Gastroenteritis; Neutrophils; Relative value scales