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Utility Of The Serum C - Reactive Protein And Procalcitonin For Detection Of Occult Bacterial Infection In 3-36 Month Old Children

Year 2008, Volume: 61 Issue: 2, 82 - 89, 01.02.2008

Ayhan Abacı , Mehmet Ali Öktem Edip Ünal Mehmet Atilla Türkmen

https://doi.org/10.1501/Tipfak_0000000657

Abstract

Keywords

-

References

  • Pulliam PN, Attia MW, Cronan KM. C- reactive protein in febrile children 1 to 36 months of age with clinically undetectable serious bacterial infec- tion. Pediatrics 2001;108:1275-1279.
  • Kuppermann N. Occult bacteremia in young febrile children. Pediatr Clin North Am 1999;46:1073-1109.
  • Isaacman DJ, Burke BL. Utility of the serum C-reactive protein for detec- tion of occult bacterial infection in children. Arch Pediatr Adolesc Med 2002;156:905-909.
  • Finkelstein JA, Christiansen CL, Platt R. Fever in pediatric primary care: occurrence, management, and out- comes. Pediatrics 2000;105:260-266.
  • Braithwaite S. Procalcitonin: new in- sights on regulation and origin. Crit Care Med 2000;28:586-588.
  • Hatherill M, Tibby SM, Sykes K,et al. Diagnostic markers of infection: comparison of procalcitonin with C reactive protein and leucocyte count. Arch Dis Child 1999;81:417-421.
  • Lacour AG, Gervaix A, Zamora SA, 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. Eur J Pediatr 2001;160:95-100.
  • Nijsten MW, Olinga P, The TH, et al. Procalcitonin behaves as a fast responding acute phase protein in vivo and in vitro. Crit Care Med 2000;28:458-461.
  • Schwarz S, Bertram M, Schwab S, et al. Serum procalcitonin levels in bac- terial and abacterial meningitis. Crit Care Med 2000;28:1828-1832.
  • Smolkin V, Koren A, Raz R, et al. Pro- calcitonin as a marker of acute pye- lonephritis in infants and children. Pediatr Nephrol 2002;17:409-412.
  • Thayyil S, Shenoy M, Hamaluba M, et al. Is procalcitonin useful in ear- ly diagnosis of serious bacterial in- fections in children? Acta Paediatr 2005;94:155-158.
  • Vincent JL. Procalcitonin: THE marker of sepsis? Crit Care Med 2000;28:1226-1228.
  • Whicher J, Bienvenu J, Monneret G. Procalcitonin as an acute phase mar- ker. Ann Clin Biochem 2001;38:483- 493. 14. Rush S.S. Procalcitonin--Mar
  • ker or mediator? Crit Care Med 1998;26:977-978.
  • Jaye DL, Waites KB. Clinical applica- tions of C-reactive protein in pediat- rics. Pediatr Infect Dis J 1997;16:735- 746.
  • Fernandez LA, Luaces CC, Garcia JJ, et al. Procalcitonin in pediatric emer- gency departments for the early diag- nosis of invasive bacterial infections in febrile infants: results of a multi- center study and utility of a rapid qu- alitative test for this marker. Pediatr Infect Dis J 2003;22:895-903.
  • Gendrel D, Raymond J, Coste J, et al. Comparison of procalcitonin with C-reactive protein, interleukin 6 and interferon-alpha for differentiation of bacterial vs. viral infections. Pedi- atr Infect Dis J 1999;18:875-881.
  • McCarthy PL, Sharpe MR, Spiesel SZ, et al. Observation scales to identify serious illness in febrile children. Pe- diatrics 1982;70:802-809.
  • Alper BS, Curry SH. Urinary tract in- fection in children. Am Fam Physici- an 2005;72:2483-2488.
  • Baraff LJ. Management of fever wit- hout source in infants and children. Ann Emerg Med 2000;36:602-614.
  • Kuppermann N, Fleisher GR, Jaffe DM. Predictors of occult pneumococ- cal bacteremia in young febrile child- ren. Ann Emerg Med 1998;31:679- 687.
  • Hsiao AL, Baker MD. Fever in the new millennium: a review of recent studies of markers of serious bacteri- al infection in febrile children. Curr Opin Pediatr 2005;17:56-61.
  • Baraff LJ, Bass JW, Fleisher GR,et al. Practice guideline for the manage- ment of infants and children 0 to 36 months of age with fever without source. Agency for Health Care Po- licy and Research. Ann Emerg Med 1993;22:1198-1210.
  • Pratt A, Attia MW. Duration of fever and markers of serious bacterial in- fection in young febrile children. Pe- diatr Int 2007;49:31-35.
  • van Rossum AM, Wulkan RW, Oudes- luys-Murphy AM. Procalcitonin as an early marker of infection in neona- tes and children. Lancet Infect Dis 2004;4:620-630.
  • Peltola H, Jaakkola M. C-reactive pro- tein in early detection of bacteremic versus viral infections in immuno- competent and compromised child- ren. J Pediatr 1988;113:641- 646.
  • Simon L, Gauvin F, Amre DK, et al. Serum procalcitonin and C-reactive protein levels as markers of bacte- rial infection: a systematic review and meta-analysis. Clin Infect Dis 2004;39:206-217.
  • Assicot M, Gendrel D, Carsin H, et al. High serum procalcitonin concen- trations in patients with sepsis and infection. Lancet 1993;341:515-518.
  • Muller B, Becker KL. Procalcitonin: how a hormone became a marker and mediator of sepsis. Swiss Med Wkly 2001;131:595-602.
  • Whang KT, Steinwald PM, White JC, et al. Serum calcitonin precur- sors in sepsis and systemic inflam- mation. J Clin Endocrinol Metab 1998;83:3296-3301.
  • Galetto-Lacour A, Zamora SA, Ger- vaix A. Bedside procalcitonin and C-reactive protein tests in children with fever without localizing signs of infection seen in a referral center. Pediatrics 2003;112:1054-1060.
  • Turner RB, Lande AE, Chase P, et al. Pneumonia in pediatric outpatients: cause and clinical manifestations. J Pediatr 1987;111:194-200.
  • Bettenay FA, de Campo JF, McCros- sin DB. Differentiating bacterial from viral pneumonias in children. Pediatr Radiol 1988;18:453-454.
  • Toikka P, Irjala K, Juven T, et al. Serum procalcitonin, C-reactive protein and interleukin-6 for distinguishing bac- terial and viral pneumonia in child- ren. Pediatr Infect Dis J 2000;19:598- 602.
  • Appenzeller C, Ammann RA, Dup- penthaler A, et al. Serum C-reac- tive protein in children with ade- novirus infection. Swiss Med Wkly 2002;132:345-350.
  • Kawasaki Y, Hosoya M, Katayose M, et al. Correlation between serum interleukin 6 and C-reactive protein concentrations in patients with ade- noviral respiratory infection. Pediatr Infect Dis J 2002;21:370-374.
  • Ruuskanen O, Putto A, Sarkkinen H, et al. C-reactive protein in res- piratory virus infections. J Pediatr 1985;107:97-100.
  • Chua AP, Lee KH. Procalcitonin in severe acute respiratory syndrome (SARS). J Infect 2004;48:303-306.

Üç-36 Ay Arası Çocuklarda Gizli Bakteriyel Enfeksiyonları Saptamada C-reaktif Proteinin Ve Prokalsitoninin KullanıIabilirliği

Year 2008, Volume: 61 Issue: 2, 82 - 89, 01.02.2008

Ayhan Abacı , Mehmet Ali Öktem Edip Ünal Mehmet Atilla Türkmen

https://doi.org/10.1501/Tipfak_0000000657

Abstract

Amaç: Üç–36 ay arası gizli bakteriyel enfeksiyon riski taşıyan hastaların saptanmasında C-reaktif proteinin (CRP) ve Prokalsitoninin (PCT) kullanılabilirliğini saptamak. Gereç ve Yöntem: Yaşları 3-36 ay arası olan, 38.3oC üzerinde ateş yüksekliği şikayeti ile acil servise başvuran ve ateş odağı saptanamayan hastalar çalışmaya alındı. Başvuru anında, cinsiyetleri, yaşları, ateş yüksekliğinin derecesi, Yale Gözlem Ölçeği (YGÖ) skoru, hastaneye yatma ve antibiyotik başlanma durumları kaydedildi. Başvuru anında, rutin idrar analizi, beyaz küre sayıları, CRP ve PCT’nin düzeylerinin ölçümü için testler yapıldı. Viral serolojik inceleme yapıldı ve akut faz dönemindeki spesifik IgM pozitifliği ve/veya konvalasan fazda spesifik IgG düzeylerinde 4 katlık artış pozitif olarak kabul edildi. Tüm hastalardan kan kültürü, idrar kültürü yapıldı ve akciğer grafileri çekildi. Hastalar gizli bakteriyal enfeksiyon ve viral enfeksiyon grubu olmak üzere ikiye ayrıldı. İki grup verileri her bir belirleyici açısından karşılaştırıldı. Bulgular: Gizli bakteriyel enfeksiyonlu 10 hastada, altı idrar yolu enfeksiyonu, iki bronkopnömoni, bir menenjit, bir bakteriyemili hasta saptanırken, viral enfeksiyon saptanan 16 hastada, beş Adenovirus, beş Respiratory syncytial virus, dört Enterovirus, bir Parainfluenza Tip1 ve bir Epstein-Barr virus enfeksiyonlu hasta saptandı. Gizli bakteriyel enfeksiyon grubu, viral enfeksiyon grubu ile CRP değerleri açısından karşılaştırıldığında istatistiksel olarak anlamlı fark saptanmazken (sırasıyla, ortanca 44.84 mg/L ve 23.3 mg/L, p=0.097), PCT değerleri istatistiksel olarak anlamlı saptandı (sırasıyla, ortanca 2.38 ng/mL, 0.28 ng/mL, p=0.014). Sonuç: Bu çalışma, çocuk acil bölümlerinde PCT’nin gizli bakteriyel enfeksiyonları saptamada CRP’ye göre daha üstün bir belirleyici olduğunu ve tarama amaçlı kullanılabileceğini, ancak bazı viral enfeksiyonlarda yüksek saptanabileceğini göstermiştir.

Keywords

Gizli Bakteriyal Enfeksiyon C-reaktif protein Prokalsitonin

References

  • Pulliam PN, Attia MW, Cronan KM. C- reactive protein in febrile children 1 to 36 months of age with clinically undetectable serious bacterial infec- tion. Pediatrics 2001;108:1275-1279.
  • Kuppermann N. Occult bacteremia in young febrile children. Pediatr Clin North Am 1999;46:1073-1109.
  • Isaacman DJ, Burke BL. Utility of the serum C-reactive protein for detec- tion of occult bacterial infection in children. Arch Pediatr Adolesc Med 2002;156:905-909.
  • Finkelstein JA, Christiansen CL, Platt R. Fever in pediatric primary care: occurrence, management, and out- comes. Pediatrics 2000;105:260-266.
  • Braithwaite S. Procalcitonin: new in- sights on regulation and origin. Crit Care Med 2000;28:586-588.
  • Hatherill M, Tibby SM, Sykes K,et al. Diagnostic markers of infection: comparison of procalcitonin with C reactive protein and leucocyte count. Arch Dis Child 1999;81:417-421.
  • Lacour AG, Gervaix A, Zamora SA, 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. Eur J Pediatr 2001;160:95-100.
  • Nijsten MW, Olinga P, The TH, et al. Procalcitonin behaves as a fast responding acute phase protein in vivo and in vitro. Crit Care Med 2000;28:458-461.
  • Schwarz S, Bertram M, Schwab S, et al. Serum procalcitonin levels in bac- terial and abacterial meningitis. Crit Care Med 2000;28:1828-1832.
  • Smolkin V, Koren A, Raz R, et al. Pro- calcitonin as a marker of acute pye- lonephritis in infants and children. Pediatr Nephrol 2002;17:409-412.
  • Thayyil S, Shenoy M, Hamaluba M, et al. Is procalcitonin useful in ear- ly diagnosis of serious bacterial in- fections in children? Acta Paediatr 2005;94:155-158.
  • Vincent JL. Procalcitonin: THE marker of sepsis? Crit Care Med 2000;28:1226-1228.
  • Whicher J, Bienvenu J, Monneret G. Procalcitonin as an acute phase mar- ker. Ann Clin Biochem 2001;38:483- 493. 14. Rush S.S. Procalcitonin--Mar
  • ker or mediator? Crit Care Med 1998;26:977-978.
  • Jaye DL, Waites KB. Clinical applica- tions of C-reactive protein in pediat- rics. Pediatr Infect Dis J 1997;16:735- 746.
  • Fernandez LA, Luaces CC, Garcia JJ, et al. Procalcitonin in pediatric emer- gency departments for the early diag- nosis of invasive bacterial infections in febrile infants: results of a multi- center study and utility of a rapid qu- alitative test for this marker. Pediatr Infect Dis J 2003;22:895-903.
  • Gendrel D, Raymond J, Coste J, et al. Comparison of procalcitonin with C-reactive protein, interleukin 6 and interferon-alpha for differentiation of bacterial vs. viral infections. Pedi- atr Infect Dis J 1999;18:875-881.
  • McCarthy PL, Sharpe MR, Spiesel SZ, et al. Observation scales to identify serious illness in febrile children. Pe- diatrics 1982;70:802-809.
  • Alper BS, Curry SH. Urinary tract in- fection in children. Am Fam Physici- an 2005;72:2483-2488.
  • Baraff LJ. Management of fever wit- hout source in infants and children. Ann Emerg Med 2000;36:602-614.
  • Kuppermann N, Fleisher GR, Jaffe DM. Predictors of occult pneumococ- cal bacteremia in young febrile child- ren. Ann Emerg Med 1998;31:679- 687.
  • Hsiao AL, Baker MD. Fever in the new millennium: a review of recent studies of markers of serious bacteri- al infection in febrile children. Curr Opin Pediatr 2005;17:56-61.
  • Baraff LJ, Bass JW, Fleisher GR,et al. Practice guideline for the manage- ment of infants and children 0 to 36 months of age with fever without source. Agency for Health Care Po- licy and Research. Ann Emerg Med 1993;22:1198-1210.
  • Pratt A, Attia MW. Duration of fever and markers of serious bacterial in- fection in young febrile children. Pe- diatr Int 2007;49:31-35.
  • van Rossum AM, Wulkan RW, Oudes- luys-Murphy AM. Procalcitonin as an early marker of infection in neona- tes and children. Lancet Infect Dis 2004;4:620-630.
  • Peltola H, Jaakkola M. C-reactive pro- tein in early detection of bacteremic versus viral infections in immuno- competent and compromised child- ren. J Pediatr 1988;113:641- 646.
  • Simon L, Gauvin F, Amre DK, et al. Serum procalcitonin and C-reactive protein levels as markers of bacte- rial infection: a systematic review and meta-analysis. Clin Infect Dis 2004;39:206-217.
  • Assicot M, Gendrel D, Carsin H, et al. High serum procalcitonin concen- trations in patients with sepsis and infection. Lancet 1993;341:515-518.
  • Muller B, Becker KL. Procalcitonin: how a hormone became a marker and mediator of sepsis. Swiss Med Wkly 2001;131:595-602.
  • Whang KT, Steinwald PM, White JC, et al. Serum calcitonin precur- sors in sepsis and systemic inflam- mation. J Clin Endocrinol Metab 1998;83:3296-3301.
  • Galetto-Lacour A, Zamora SA, Ger- vaix A. Bedside procalcitonin and C-reactive protein tests in children with fever without localizing signs of infection seen in a referral center. Pediatrics 2003;112:1054-1060.
  • Turner RB, Lande AE, Chase P, et al. Pneumonia in pediatric outpatients: cause and clinical manifestations. J Pediatr 1987;111:194-200.
  • Bettenay FA, de Campo JF, McCros- sin DB. Differentiating bacterial from viral pneumonias in children. Pediatr Radiol 1988;18:453-454.
  • Toikka P, Irjala K, Juven T, et al. Serum procalcitonin, C-reactive protein and interleukin-6 for distinguishing bac- terial and viral pneumonia in child- ren. Pediatr Infect Dis J 2000;19:598- 602.
  • Appenzeller C, Ammann RA, Dup- penthaler A, et al. Serum C-reac- tive protein in children with ade- novirus infection. Swiss Med Wkly 2002;132:345-350.
  • Kawasaki Y, Hosoya M, Katayose M, et al. Correlation between serum interleukin 6 and C-reactive protein concentrations in patients with ade- noviral respiratory infection. Pediatr Infect Dis J 2002;21:370-374.
  • Ruuskanen O, Putto A, Sarkkinen H, et al. C-reactive protein in res- piratory virus infections. J Pediatr 1985;107:97-100.
  • Chua AP, Lee KH. Procalcitonin in severe acute respiratory syndrome (SARS). J Infect 2004;48:303-306.
There are 38 citations in total.

Details

Primary Language Turkish
Journal Section Articles
Authors

Ayhan Abacı

Mehmet Ali Öktem This is me

Edip Ünal This is me

Mehmet Atilla Türkmen This is me

Publication Date February 1, 2008
Published in Issue Year 2008 Volume: 61 Issue: 2

Cite

APA Abacı, A., Öktem, M. A., Ünal, E., Türkmen, M. A. (2008). Üç-36 Ay Arası Çocuklarda Gizli Bakteriyel Enfeksiyonları Saptamada C-reaktif Proteinin Ve Prokalsitoninin KullanıIabilirliği. Ankara Üniversitesi Tıp Fakültesi Mecmuası, 61(2), 82-89. https://doi.org/10.1501/Tipfak_0000000657
AMA Abacı A, Öktem MA, Ünal E, Türkmen MA. Üç-36 Ay Arası Çocuklarda Gizli Bakteriyel Enfeksiyonları Saptamada C-reaktif Proteinin Ve Prokalsitoninin KullanıIabilirliği. Ankara Üniversitesi Tıp Fakültesi Mecmuası. February 2008;61(2):82-89. doi:10.1501/Tipfak_0000000657
Chicago Abacı, Ayhan, Mehmet Ali Öktem, Edip Ünal, and Mehmet Atilla Türkmen. “Üç-36 Ay Arası Çocuklarda Gizli Bakteriyel Enfeksiyonları Saptamada C-Reaktif Proteinin Ve Prokalsitoninin KullanıIabilirliği”. Ankara Üniversitesi Tıp Fakültesi Mecmuası 61, no. 2 (February 2008): 82-89. https://doi.org/10.1501/Tipfak_0000000657.
EndNote Abacı A, Öktem MA, Ünal E, Türkmen MA (February 1, 2008) Üç-36 Ay Arası Çocuklarda Gizli Bakteriyel Enfeksiyonları Saptamada C-reaktif Proteinin Ve Prokalsitoninin KullanıIabilirliği. Ankara Üniversitesi Tıp Fakültesi Mecmuası 61 2 82–89.
IEEE A. Abacı, M. A. Öktem, E. Ünal, and M. A. Türkmen, “Üç-36 Ay Arası Çocuklarda Gizli Bakteriyel Enfeksiyonları Saptamada C-reaktif Proteinin Ve Prokalsitoninin KullanıIabilirliği”, Ankara Üniversitesi Tıp Fakültesi Mecmuası, vol. 61, no. 2, pp. 82–89, 2008, doi: 10.1501/Tipfak_0000000657.
ISNAD Abacı, Ayhan et al. “Üç-36 Ay Arası Çocuklarda Gizli Bakteriyel Enfeksiyonları Saptamada C-Reaktif Proteinin Ve Prokalsitoninin KullanıIabilirliği”. Ankara Üniversitesi Tıp Fakültesi Mecmuası 61/2 (February 2008), 82-89. https://doi.org/10.1501/Tipfak_0000000657.
JAMA Abacı A, Öktem MA, Ünal E, Türkmen MA. Üç-36 Ay Arası Çocuklarda Gizli Bakteriyel Enfeksiyonları Saptamada C-reaktif Proteinin Ve Prokalsitoninin KullanıIabilirliği. Ankara Üniversitesi Tıp Fakültesi Mecmuası. 2008;61:82–89.
MLA Abacı, Ayhan et al. “Üç-36 Ay Arası Çocuklarda Gizli Bakteriyel Enfeksiyonları Saptamada C-Reaktif Proteinin Ve Prokalsitoninin KullanıIabilirliği”. Ankara Üniversitesi Tıp Fakültesi Mecmuası, vol. 61, no. 2, 2008, pp. 82-89, doi:10.1501/Tipfak_0000000657.
Vancouver Abacı A, Öktem MA, Ünal E, Türkmen MA. Üç-36 Ay Arası Çocuklarda Gizli Bakteriyel Enfeksiyonları Saptamada C-reaktif Proteinin Ve Prokalsitoninin KullanıIabilirliği. Ankara Üniversitesi Tıp Fakültesi Mecmuası. 2008;61(2):82-9.