Diagnostic test accuracy of point-of-care procalcitonin to diagnose serious bacterial infections in children

Waterfield, Thomas; Maney, Julie Ann; McKenna, James P; Lyttle, Mark D; Roland, Damian; Corr, Michael; Patenall, Bethany; Shields, Michael D; Woolfall, Kerry; Fairley, Derek; On behalf of Paediatric Emergency Research in the UK and Ireland (PERUKI)

Abstract

Background: The National Institute for Health and Care Excellence (NICE) have called for research into the role of biomarkers, and specifically procalcitonin (PCT), for the early diagnosis of serious bacterial infections (SBI) in children. The aim of this study was to compare the diagnostic test accuracy of C-reactive protein (CRP) and PCT for the diagnosis of SBI in children. Methods: Data was collected prospectively from four UK emergency departments (ED) between November 2017 and June 2019. Consecutive children under 18years of age with fever and features of possible sepsis and/or meningitis were eligible for inclusion. The index tests were PCT and CRP and the reference standard was the confirmation of SBI. Results: 213 children were included in the final analysis. 116 participants (54.5%) were male, and the median age was 2 years, 9months. Parenteral antibiotics were given to 100 (46.9%), three (1.4%) were admitted to a paediatric intensive care unit and there were no deaths. There were ten (4.7%) confirmed SBI. The area under the curve for PCT and CRP for the detection of SBI was identical at 0.70. Conclusions: There was no difference in the performance of PCT and CRP for the recognition of SBI in this cohort. Trial registration: Registered at https://www.clinicaltrials.gov(trial registration: NCT03378258) on the 19th of December 2017.

• Journal Article Type: Article
• Acceptance Date: Oct 13, 2020
• Online Publication Date: Oct 21, 2020
• Publication Date: Dec 1, 2020
• Deposit Date: Apr 1, 2021
• Publicly Available Date: Apr 1, 2021
• Journal: BMC Pediatrics
• Electronic ISSN: 1471-2431
• Publisher: BioMed Central
• Peer Reviewed: Peer Reviewed
• Volume: 20
• Issue: 1
• Article Number: 487
• DOI: https://doi.org/10.1186/s12887-020-02385-2
• Keywords: Pediatrics, Perinatology, and Child Health
• Public URL: https://uwe-repository.worktribe.com/output/7244236
• Additional Information: Received: 26 June 2020; Accepted: 13 October 2020; First Online: 21 October 2020; : The Northern Ireland Research Ethics Committee (REC Reference − 17/NI/0169) and the Belfast Health & Social Care Trust Research Governance (Reference 16201MS-SW) approved the protocol. All participants were invited to provide written consent to take part, consent was obtained from a parent or guardian on behalf of any participants under the age of 16.; : Not applicable; : JMcK Holds share options in HiberGene Diagnostics Ltd. TW has received an honorarium for speaking at educational events for Thermofisher.