Volume 2 Supplement 1

18th International Symposium on Intensive Care and Emergency Medicine

Open Access

Procalcitonin in paediatric sepsis

  • M Hatherill1,
  • SM Tibby1,
  • A Mclntyre1 and
  • IA Murdoch1
Critical Care19982(Suppl 1):P037

https://doi.org/10.1186/cc167

Published: 1 March 1998

Objective

To document the relationships between procalcitonin (PCT), C-reactive protein (CRP) and leucocyte count (WCC) in children with sepsis, and to compare their diagnostic value in septic shock.

Methods

PCT, CRP and WCC were measured on admission to the PICU in 146 children, median age 18 months (range 0.1-202), mortality 22/146 (15%). PCT was measured by immunoluminometric assay (BRAHMS Diagnostika, Berlin, Germany). Patients were categorized a priori according to clinical and laboratory data as having either septic shock (n = 51) [1], localized bacterial infection (n = 33), viral infection (n = 14) or as non-infected controls (n = 48). Data were analysed by Kruskal-Wallis ANOVA and Dunn's test for multiple comparisons.

Results

PCT was significantly higher in septic patients compared to localized infection, viral infection and controls respectively (all P < 0.001). Receiver operating curve analysis indicates PCT > 20 ng/ml as the best discriminator of septic shock with positive and negative predictive values of 87% and 89%. In contrast, CRP > 35 mg/l had positive and negative predictive values of 65% and 83%.

Conclusion

Procalcitonin is a better discriminator of systemic from localized bacterial infection than either CRP or leucocyte count.

Table

 

Septic

P

Local

P

Viral

P

Control

PCT

91.6 (22-323)

<0.001

7.2 (2-17)

NS

0.4 (0-0.8)

NS

0 (0-1.4)

CRP

86 (29-113)

NS

27 (10-94)

NS

10 (7-29)

NS

9 (7-16)

WCC

12.9 (5.7-18)

NS

9.7 (6.7-17.4)

NS

6.9 (4.5-10)

NS

13.5 (7.8-16.4)

PCT (ng/ml), CRP (mg/l) and WCC (× 109/l), median (interquartile range)

Authors’ Affiliations

(1)
Paediatric Intensive Care Unit, Guy's Hospital

References

  1. Saez-Llorens X, McCracken GH: Sepsis syndrome and septic shock in pediatrics: current concepts of terminology, pathophysiology, and management. J Pediatr. 1993, 123: 497-508. 10.1016/S0022-3476(05)80942-4.PubMedView ArticleGoogle Scholar

Copyright

© Current Science Ltd 1998

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