Role of procalcitonin in diagnosis of community acquired pneumonia in Children
Abstract Background The role of serum Procalcitonin (PCT) in adults in diagnosis of Community acquired pneumonia (CAP) is well established, however, role in pediatric CAP remains controversial. Objectives The objective of this study was to investigate the utility of serum procalcitonin in differenti...
| Main Authors: | , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2022-04-01
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| Series: | BMC Pediatrics |
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| Online Access: | https://doi.org/10.1186/s12887-022-03286-2 |
| _version_ | 1818278973650501632 |
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| author | Vinod H. Ratageri Puspha Panigatti Aparna Mukherjee Rashmi R. Das Jagdish Prasad Goyal Javeed Iqbal Bhat Bhadresh Vyas Rakesh Lodha Deepak Singhal Prawin Kumar Kuldeep Singh Samarendra Mahapatro Bashir Ahmad Charoo S. K. Kabra K. R. Jat |
| author_facet | Vinod H. Ratageri Puspha Panigatti Aparna Mukherjee Rashmi R. Das Jagdish Prasad Goyal Javeed Iqbal Bhat Bhadresh Vyas Rakesh Lodha Deepak Singhal Prawin Kumar Kuldeep Singh Samarendra Mahapatro Bashir Ahmad Charoo S. K. Kabra K. R. Jat |
| author_sort | Vinod H. Ratageri |
| collection | DOAJ |
| description | Abstract Background The role of serum Procalcitonin (PCT) in adults in diagnosis of Community acquired pneumonia (CAP) is well established, however, role in pediatric CAP remains controversial. Objectives The objective of this study was to investigate the utility of serum procalcitonin in differentiating bacterial community-acquired lower respiratory tract infection from non-bacterial respiratory infection in children; radiologically confirmed pneumonia was used as the reference. In addition, we assessed the utility of adding the PCT assay to the clinical criteria for diagnosis of pneumonia. Study design Subanalysis of a larger prospective,multicentriccohort study. Participants Children, 2 months to 59 months of age, attending paediatric OPD of 5 urban tertiary care hospitals, suffering from acute respiratory infection (ARI). Intervention Detailed clinical history and examination findings of enrolled children were recorded on predesigned case record form. Samples for PCT were obtained at admission and were measured centrally at the end of the study except for one site using VIDAS® B.R.A.H.M.S PCT kit (Biomerieux SA, France). Outcomes Sensitivity and specificity of procalcitonin for diagnosis of radiologically confirmed pneumonia. Results Serum Procalcitonin was measured in 370 patients; median (IQR) age of these children being 12 (7, 22) months, 235 (63.5%) were boys. The median (IQR) serum procalcitonin concentration was 0.1(0.05, 0.4) ng/mL.Sensitivity and specificity of raised PCT (> 0.5 ng/mL) for pneumonia as per any CXR abnormalities were 29.7% and87.5%,(P < 0.001) respectively. Raised PCT was also significantly associated with consolidation (34.5%,79.2%,P < 0.02)and pleural effusion(54.6%,79%,P < 001). Adding PCT to the existing clinical criteria of WHO did not improve the sensitivity for diagnosis of pneumonia. PCT was significantly higher in children with severe pneumonia. Conclusion Positive PCT (> 0.5 ng/mL) is significantly associated with radiographic pneumonia but not with pneumonia based on WHO criteria.However, it can act as a surrogate marker for severe pneumonia. |
| first_indexed | 2024-12-12T23:25:57Z |
| format | Article |
| id | doaj.art-a2557c1f38644948b58f6a03c46a719e |
| institution | Directory Open Access Journal |
| issn | 1471-2431 |
| language | English |
| last_indexed | 2024-12-12T23:25:57Z |
| publishDate | 2022-04-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Pediatrics |
| spelling | doaj.art-a2557c1f38644948b58f6a03c46a719e2022-12-22T00:08:05ZengBMCBMC Pediatrics1471-24312022-04-012211910.1186/s12887-022-03286-2Role of procalcitonin in diagnosis of community acquired pneumonia in ChildrenVinod H. Ratageri0Puspha Panigatti1Aparna Mukherjee2Rashmi R. Das3Jagdish Prasad Goyal4Javeed Iqbal Bhat5Bhadresh Vyas6Rakesh Lodha7Deepak Singhal8Prawin Kumar9Kuldeep Singh10Samarendra Mahapatro11Bashir Ahmad Charoo12S. K. Kabra13K. R. Jat14Department of Pediatrics, Karnataka Institute of Medical SciencesDepartment of Pediatrics, Karnataka Institute of Medical SciencesDepartment of Pediatrics, All India Institute of Medical SciencesDepartment of Pediatrics, All India Institute of Medical SciencesDepartment of Pediatrics, All India Institute of Medical SciencesDepartment of Pediatrics, Sher I Kashmir Institute of Medical SciencesDepartment of Pediatrics, MP Shah Medical CollegeDepartment of Pediatrics, All India Institute of Medical SciencesDepartment of Pediatrics, All India Institute of Medical SciencesDepartment of Pediatrics, All India Institute of Medical SciencesDepartment of Pediatrics, All India Institute of Medical SciencesDepartment of Pediatrics, All India Institute of Medical SciencesDepartment of Pediatrics, Sher I Kashmir Institute of Medical SciencesDepartment of Pediatrics, All India Institute of Medical SciencesDepartment of Pediatrics, All India Institute of Medical SciencesAbstract Background The role of serum Procalcitonin (PCT) in adults in diagnosis of Community acquired pneumonia (CAP) is well established, however, role in pediatric CAP remains controversial. Objectives The objective of this study was to investigate the utility of serum procalcitonin in differentiating bacterial community-acquired lower respiratory tract infection from non-bacterial respiratory infection in children; radiologically confirmed pneumonia was used as the reference. In addition, we assessed the utility of adding the PCT assay to the clinical criteria for diagnosis of pneumonia. Study design Subanalysis of a larger prospective,multicentriccohort study. Participants Children, 2 months to 59 months of age, attending paediatric OPD of 5 urban tertiary care hospitals, suffering from acute respiratory infection (ARI). Intervention Detailed clinical history and examination findings of enrolled children were recorded on predesigned case record form. Samples for PCT were obtained at admission and were measured centrally at the end of the study except for one site using VIDAS® B.R.A.H.M.S PCT kit (Biomerieux SA, France). Outcomes Sensitivity and specificity of procalcitonin for diagnosis of radiologically confirmed pneumonia. Results Serum Procalcitonin was measured in 370 patients; median (IQR) age of these children being 12 (7, 22) months, 235 (63.5%) were boys. The median (IQR) serum procalcitonin concentration was 0.1(0.05, 0.4) ng/mL.Sensitivity and specificity of raised PCT (> 0.5 ng/mL) for pneumonia as per any CXR abnormalities were 29.7% and87.5%,(P < 0.001) respectively. Raised PCT was also significantly associated with consolidation (34.5%,79.2%,P < 0.02)and pleural effusion(54.6%,79%,P < 001). Adding PCT to the existing clinical criteria of WHO did not improve the sensitivity for diagnosis of pneumonia. PCT was significantly higher in children with severe pneumonia. Conclusion Positive PCT (> 0.5 ng/mL) is significantly associated with radiographic pneumonia but not with pneumonia based on WHO criteria.However, it can act as a surrogate marker for severe pneumonia.https://doi.org/10.1186/s12887-022-03286-2BiomarkersChildrenPneumoniaProcalcitoninAcute respiratory infection |
| spellingShingle | Vinod H. Ratageri Puspha Panigatti Aparna Mukherjee Rashmi R. Das Jagdish Prasad Goyal Javeed Iqbal Bhat Bhadresh Vyas Rakesh Lodha Deepak Singhal Prawin Kumar Kuldeep Singh Samarendra Mahapatro Bashir Ahmad Charoo S. K. Kabra K. R. Jat Role of procalcitonin in diagnosis of community acquired pneumonia in Children BMC Pediatrics Biomarkers Children Pneumonia Procalcitonin Acute respiratory infection |
| title | Role of procalcitonin in diagnosis of community acquired pneumonia in Children |
| title_full | Role of procalcitonin in diagnosis of community acquired pneumonia in Children |
| title_fullStr | Role of procalcitonin in diagnosis of community acquired pneumonia in Children |
| title_full_unstemmed | Role of procalcitonin in diagnosis of community acquired pneumonia in Children |
| title_short | Role of procalcitonin in diagnosis of community acquired pneumonia in Children |
| title_sort | role of procalcitonin in diagnosis of community acquired pneumonia in children |
| topic | Biomarkers Children Pneumonia Procalcitonin Acute respiratory infection |
| url | https://doi.org/10.1186/s12887-022-03286-2 |
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