PCT, CRP, WBC And PLTC Values For Discrimination of Culture Positive Bacterial Infections in Febrile Children

Sabiha Sahin; Omer Kilic

Volume : VIII, Issue : I, January - 2019

PCT, CRP, WBC And PLTC Values For Discrimination of Culture Positive Bacterial Infections in Febrile Children

Sabiha Sahin, Omer Kilic

Abstract :

Introduction: Although procalcitonin (PCT) concentration increases in bacterial infections, it does not increase in viral infections and inflammatory diseases. Rapid change and stability of the molecule made PCT as a potentially useful marker for the differentiation of bacterial and viral infections. In the present study, we aimed to compare PCT, CRP, WBC and thrombocyte count values as an infection marker. Methods: Patients admitted to the pediatric emergency department with fever (≥38.5 °C), and collected blood, urine, stool and CSF samples for culture test were enrolled. 52% of patients were girl. The mean age was 6.77±4.84 years. PCT, CRP, WBC and PLTC values obtained from blood and serum samples at admission to the pediatric emergency department were compared. Results: The mean PCT concentration was ≥3.375 µg/L in children with positive CSF culture. It was ≥1.95 µg/L in children with positive blood culture which was statistically significant. It was not significant in children with positive urine and stool culture. CRP threshold value was ≥1.285 mg/L in children with a positive CSF culture; it was statistically significant. CRP was not significant in children with a positive blood culture. The WBC value was significantly higher in children with a positive urine culture. PLTC was not statistically significant in whole patients. PCT, WBC, CRP and PLTC values were not significantly differed in children with pathogenic bacterial growth in a stool culture. Discussion: In our study, PCT value of ≥1.95 µg/L has higher specificity and sensitivity compared to CRP to differentiate various bacterial infections. The threshold value of 3.375 µg/L for PCT was significantly higher specificity, sensitivity for septicaemia and meningeal infections compared to CRP. The threshold value of 1.285 mg/L for CRP was seen in children with positive CSF culture, and it was statistically significant. CRP can be useful in differentiating bacterial and viral infections in children, but PCT has a more significant significance in the pediatric emergency setting, especially for the decision to start early treatment of antibiotic in septicemia and meningitis.