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Procalcitonin, IL-6, IL-8, IL-1 receptor antagonist and C-reactive protein as identificators of serious bacterial infections in children with fever without localising signs

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Published in European Journal of Pediatrics. 2001, vol. 160, no. 2, p. 95-100
Abstract Fever without localising signs in very young children remains a diagnostic problem. Until present, a clinical scoring system combined with leucocyte count, urine analysis and determination of CRP are recognised as being helpful to identify patients at risk of serious bacterial illness. In this study we asked the question whether the determination of procalcitonin (PCT), interleukin (IL)-6, IL-8 and interleukin-1 receptor antagonist (IL- Ra) was superior to these commonly used markers for the prediction of a serious bacterial infection (SBI). Children, 7 days to 36 months of age, with a rectal temperature above 38 degrees C and without localising signs of infection were prospectively enrolled. For each infant, we performed a physical examination, a clinical score according to McCarthy, a complete white cell count, an urine analysis and a determination of CRP. We further determined PCT, IL-6, IL-8, and IL-1Ra concentrations and compared their predictive value with those of the usual management of fever without localising signs. Each infant at risk of SBI had blood culture, urine and cerebrospinal fluid cultures when indicated, and received antibiotics until culture results were available. A total of 124 children were included of whom 28 (23%) had SBI. Concentrations of PCT, CRP and IL-6 were significantly higher in the group of children with SBI but IL-8 and IL-1Ra were comparable between both groups. PCT showed a sensitivity of 93% and a specificity of 78% for detection of SBI and CRP had a sensitivity of 89% and a specificity of 75%.
Keywords Bacteremia/diagnosis/metabolismBacterial Infections/diagnosis/metabolismBiological MarkersC-Reactive Protein/metabolismCalcitonin/metabolismHumansInfantInfant, NewbornInterleukin-1/agonistsInterleukin-6/metabolismInterleukin-8/metabolismInterleukins/metabolismLogistic ModelsPredictive Value of TestsProspective StudiesProtein Precursors/metabolismSensitivity and SpecificitySeverity of Illness Index
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PMID: 11271398
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Article (Published version) (95 Kb) - document accessible for UNIGE members only Limited access to UNIGE
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Research group Etiologie des pneumonies et marqueurs inflammatoires chez l'enfant fébrile (183)
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GALETTO-LACOUR, Annick et al. Procalcitonin, IL-6, IL-8, IL-1 receptor antagonist and C-reactive protein as identificators of serious bacterial infections in children with fever without localising signs. In: European Journal of Pediatrics, 2001, vol. 160, n° 2, p. 95-100. https://archive-ouverte.unige.ch/unige:72729

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Deposited on : 2015-05-21

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