Can procalcitonin be a diagnostic marker for catheter-related blood stream infection in children?

Ozsurekci, Yasemin; Arıkan, Kamile Oktay; Bayhan, Cihangül; Karadağ-Öncel, Eda; Aycan, Ahmet Emre; Gürbüz, Venhar; Hasçelik, Gülşen; Ceyhan, Mehmet

doi:10.1016/j.jped.2015.11.004

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Original articles • J. Pediatr. (Rio J.) 92 (4) • Jul-Aug 2016 • https://doi.org/10.1016/j.jped.2015.11.004 copy

Can procalcitonin be a diagnostic marker for catheter-related blood stream infection in children?^☆ ☆ Please cite this article as: Ozsurekci Y, Oktay Arıkan K, Bayhan C, Karadağ-Öncel E, Emre Aycan A, Gürbüz V, et al. Can procalcitonin be a diagnostic marker for catheter-related blood stream infection in children? J Pediatr (Rio J). 2016;92:414–20.

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Objective

The potential role of procalcitonin (PCT) in the diagnosis of catheter-related bloodstream infection (CRBSIs) is still unclear and requires further research. The diagnostic value of serum PCT for the diagnosis of CRBSI in children is evaluated here.

Method

This study was conducted between October 2013 and November 2014, and included patients with suspected CRBSI from 1 month to 18 years of age who were febrile, with no focus of infection, and had a central venous catheter. Levels of PCT and other serum markers were measured, and their utility as CRBSI markers was assessed. Additionally, the clinical performance of a new, automated, rapid, and quantitative assay for the detection of PCT was tested.

Results

Among the 49 patients, 24 were diagnosed with CRBSI. The PCT-Kryptor and PCT-RTA values were significantly higher in proven CRBSI compared to those in unproven CRBSI (p = 0.03 and p = 0.03, respectively). There were no differences in white blood cell count and C-reactive protein (CRP) levels between proven CRBSI and unproven CRBSI. Among the 24 patients with CRBSI, CRP was significantly higher among those with Gram-negative bacterial infection than in those with Gram-positive bacterial infections. PCT-Kryptor was also significantly higher among patients with Gram-negative bacterial infection than in those with Gram-positive bacterial infections (p = 0.01 and p = 0.02, respectively).

Conclusions

The authors suggest that PCT could be a helpful rapid diagnostic marker in children with suspected CRBSIs.

Keywords
Biomarkers; Bloodstream infection; Children; C-reactive protein; Procalcitonin

	Proven CRBSI (n = 24)	Not proven CRBSI (n = 25)	p
Age [month; mean ± SD (Min.–Max.)]	67.2 ± 71.7 (3.0–252.0)	78.2 ± 63.1 (2.0–245.0)	0.24^a a Student's t test.
Gender			0.14^b b Chi-squared test.
Female [n (%)]	11 (45.8)	6 (24)
Male [n (%)]	13 (54.2)	19 (76)
Primary admission diagnosis			0.39^b b Chi-squared test.
Hematological [n (%)]	12 (50)	15 (60)
Nephrological [n (%)]	4 (16.7)	1 (4.0)
Immunological [n (%)]	2 (8.3)	2 (8.0)
Gastroenterological [n (%)]	3 (12.5)	1 (4.0)
Other [n (%)]	3 (12.5)	6 (24.0)
WBC count [10³/µL; median (IQR)]	5.20 (0.9–13.0)	1.7 (0.8–5.4)	0.17^c c Mann–Whitney test.
Platelet [10³/µL; median (IQR)]	118.0 (43.0–237.2)	111.0 (22.0 –214.5)	0.83^c c Mann–Whitney test.
CRP [mg/dL; median (IQR)]	5.63 (1.17–12.45)	2.10 (0.73–8.5)	0.33^c c Mann–Whitney test.
PCT-Kryptor [ng/mL; median (IQR)]	1.77 (0.30–4.96)	0.28 (0.17–0.68)	0.03^c c Mann–Whitney test. , ^d d Statistically significant difference.
PCT-RTA [ng/mL; median (IQR)]	1.76 (0.71–3.13)	0.57 (0.26–1.00)	0.03^c c Mann–Whitney test. , ^d d Statistically significant difference.
Mortality [n (%)]	2 (8.3)	0 (0)	N/A

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[1] * Corresponding author. E-mail:yas.oguz99@yahoo.com (Y. Ozsurekci).