Article in Japanese

Clinical usefulness of procalcitonin measurement in pediatric infectious disease

Shinichi TAMURA, Takuyo KANAYAMA, Naoko FURUKAWA, Masayuki HORI, Kentaro YOKOI, Takeshi NAITO, Hiroyuki ISHIDA, Takao YOSHIHARA

Purpose: Procalcitonin (PCT) is a useful biomarker in the diagnosis of severe bacterial infection. The serum concentrations of PCT in 85 children with severe infection were obtained, for evaluating the clinical accuracy of PCT for the diagnosis of bacterial sepsis in children.
Patients and methods: Eighty-five patients were divided into three groups, 47 with bacterial sepsis, 19 with non-bacterial sepsis and 19 with infection not accompanied by systemic inflammatory response syndrome (SIRS). In 77 patients blood culture samples were collected simultaneously with the PCT blood draw. The cut-off value of 0.5 ng/ml of PCT was used.
Results: The PCT was elevated in 37 patients. The positive rates of PCT were 57%, 16% and 37% in bacterial sepsis, non-bacterial sepsis and non-SIRS infection, respectively. Significantly higher serum concentrations of PCT were observed in patients with bacterial sepsis than in patients with non-bacterial sepsis or non-SIRS infection. Also, in the 56 children whose samples were collected within two days from the onset, PCT was significantly elevated in bacterial sepsis compared with the other two groups. In patients with bacterial sepsis, a sensitivity of PCT positive (56%) was superior to that of blood culture (31%), although a specificity of PCT positive (71%) was inferior to that of blood culture (93%).
Conclusion: PCT can be a useful diagnostic marker in differentiating bacterial sepsis from non-bacterial sepsis or non-SIRS infection. The faster diagnosis and higher sensitivity of PCT compared to blood culture can be helpful for early therapeutic intervention in children with bacterial sepsis.

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Department of Pediatrics, Matsushita Memorial Hospital

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Received	November 18, 2010
Accepted	August 5, 2011

24 (1)：3─9,2012