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C-reactive protein, procalcitonin poor indicators of bacterial infection in children
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Recent data show insufficiencies in the use of C-reactive protein and procalcitonin for diagnosing bacterial infections in young children with severe acute malnutrition.
Researchers analyzed blood, urine, and stool samples from 311 children aged 6 to 59 months who were hospitalized for complicated severe acute malnutrition. Chest X-rays were performed on study participants upon entrance to the study. C-reactive protein and procalcitonin were measured by rapid tests and quantitative methods using frozen serum. The study was conducted from November 2007 to July 2008 in Maradi, Niger.
The study findings show median C-reactive protein and procalcitonin levels were higher in children with bacteremia or pneumonia than in those with no proven bacterial infection. However, researchers found C-reactive protein and procalcitonin were poor indicators of bacterial infections. C-reactive protein was an accurate identifier of those at risk for death.
“The inflammatory proteins C-reactive protein and procalcitonin do not appear to be adequate markers of invasive bacterial infections in a sub-Saharan African population of hospitalized children with severe acute malnutrition plus medical complications, and therefore cannot help reduce antibiotic use. Whether the markers’ low performances in this context are due to malnutrition, high prevalence of infections, and/or other factors specific to this population, remains unclear. However, these markers could be helpful in identifying children most at risk for dying, which could potentially be useful for triage purposes,” study researcher Anne-Laure Page, PhD, of the Epidemiology and Population Health Epicentre, Paris, and colleagues concluded.
Disclosure: The study was funded by Médecins Sans Frontières, France. The researchers report no relevant financial disclosures.
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