Procalcitonin to Predict Bacterial Coinfection in Infants With Acute Bronchiolitis: A Preliminary Analysis

  title={Procalcitonin to Predict Bacterial Coinfection in Infants With Acute Bronchiolitis: A Preliminary Analysis},
  author={James L. Laham and Patrick J. Breheny and Brian M Gardner and Henrietta S. Bada},
  journal={Pediatric Emergency Care},
Objective The aim of this study was to conduct a preliminary analysis of serum procalcitonin (PCT) to predict bacterial coinfection in infants with acute bronchiolitis. Methods Retrospective cohort chart review of 40 infants admitted with acute bronchiolitis to the pediatric intensive care unit. Logistic regression models were used to determine the association of PCT and white blood count with presence of bacterial coinfection defined by either positive culture or chest radiograph result… 

Association of Procalcitonin Value and Bacterial Coinfections in Pediatric Patients With Viral Lower Respiratory Tract Infections Admitted to the Pediatric Intensive Care Unit.

The data add evidence to the relatively high negative predictive value of PCT concentrations in identifying patients with bacterial coinfection, specifically in the case of viral LRTI.

Use of procalcitonin and C-reactive protein in the diagnosis of bacterial infection in infants with severe bronchiolitis

PCT was presented as a novel test in comparison with the traditional CRP screening test to discern which bronchiolitis patients have IBI, specially for pneumonia and sepsis diagnoses and proved to be more sensitive and specific than CRP, with statistically significant differences.

The Use of Procalcitonin for Prediction of Pulmonary Bacterial Coinfection in Children With Respiratory Failure Associated With Viral Bronchiolitis

Procalcitonin (PCT) did not predict concomitant bacterial pneumonia in children with viral bronchiolitis and no correlation was found between PCT and bronchiolaitis with bacterial coinfection.

Procalcitonin Identifies Bacterial Coinfections in Vietnamese Children with Severe Respiratory Syncytial Virus Pneumonia

It was underlined that inflammatory biomarkers such as PCT had a moderate-to-high capability of disseminating severe pneumonia children with RSV alone or RSV and bacterial coinfections, and may support clinicians in administrating appropriate antibiotics to children suffering from severe RSV pneumonia.

Use of Procalcitonin for Identification of Cobacterial Pneumonia in Pediatric Patients.

PCT was found to be strongly associated with cobacterial pneumonia with an underlying viral etiology, and temperature, WBC, and C-reactive protein failed to be significant predictors in differentiating between viral and cob bacterial pneumonia.

Diagnostic accuracy of procalcitonin for bacterial pneumonia in children – a systematic review and meta-analysis

It is recommended that procalcitonin be used in conjunction with other findings for management and disposition of children with pneumonia, given the moderate diagnostic accuracy of procalCitonin for bacterial pneumonia.

A Procalcitonin and C-Reactive Protein-Guided Clinical Pathway for Reducing Antibiotic Use in Children Hospitalized with Bronchiolitis

An evidence-based CP supported by educational lectures was associated with significant changes in the physicians’ prescribing habits and a statistically significant decrease in beta2-agonists’ use and a quasi-significant decrease in corticosteroid use were observed.

CD64 on monocytes and granulocytes in severe acute bronchiolitis: Pilot study on its usefulness as a bacterial infection biomarker

This is the first study to describe CD64 surface expression on monocytes and granulocytes in SAB, finding CD64 values to be higher in children with PBI.

Procalcitonin: Is This the Promised Biomarker for Critically Ill Patients?

In pediatric patients with acute lower respiratory tract infections, the use of PCT-based algorithms also led to a safe decrease in antibiotic treatment duration, and more research is needed in critically ill children to determine the utility of P CT-driven antibiotic therapy in this population.

Acute Viral Bronchiolitis: A Narrative Review

The management of AVB remains a challenge, as the role of various interventions is not clear, and the routine administration of antibiotics, bronchodilators, corticosteroids, steam inhalation, chest physiotherapy, heliox, and antiviral drugs are not recommended.



Procalcitonin in Young Febrile Infants for the Detection of Serious Bacterial Infections

Procalcitonin has favorable test characteristics for detecting serious bacterial infections in young febrile infants and performed especially well in detecting the most serious occult infections.

Bedside procalcitonin and C-reactive protein tests in children with fever without localizing signs of infection seen in a referral center.

PCT and CRP performed better than IL-6, WBC, and/or band count in predicting the occurrence of SBI and should be considered in the initial work-up of children with fever without source.

A Score Identifying Serious Bacterial Infections in Children With Fever Without Source

A simple clinical tool to identify serious bacterial infection in children with fever without a source and the sensitivity of the score for the identification of SBI was 94% and the specificity 81%.

Procalcitonin and C-Reactive Protein as Diagnostic Markers of Severe Bacterial Infections in Febrile Infants and Children in the Emergency Department

Both PCT and CRP are valuable markers in predicting SBI in children with fever without source and they perform better than WBC and ANC, which appears more accurate at the beginning of infections.

Procalcitonin as a predictor of renal scarring in infants and young children

It is suggested that serum PCT concentration at admission is a useful predictive tool of renal scarring in infants and young children with acute pyelonephritis.

Serum procalcitonin, C‐reactive protein and interleukin‐6 for distinguishing bacterial and viral pneumonia in children

The results indicate that the measurement of serum PCT, CRP and IL‐6 has little value in the differentiation of bacterial and viral pneumonia in children, however, in some patients with very high serum P CT,CRP or IL‐ 6 values, bacterial pneumonia is probable.

Comparison of procalcitonin with C-reactive protein, interleukin 6 and interferon-alpha for differentiation of bacterial vs. viral infections.

A PCT value of 1 microg/l or greater had better specificity, sensitivity and predictive value than CRP, interleukin 6 and interferon-alpha in children for distinguishing between viral and bacterial infections.

Serum procalcitonin in children with suspected sepsis: A comparison with C-reactive protein and neutrophil count*

Serum procalcitonin levels show a rapid increase in children with sepsis, even in infants <12 month old, and they have a better prognostic value than C-reactive protein or neutrophil count.