Abstract
Introduction: Given the limitation of non-specific nature of signs, symptoms and physical examination in diagnosing sepsis; especially in young children, a diagnostic marker that will aid in an early diagnosis is needed. Procalcitonin satisfies most of the criteria for smart biomarker of sepsis. The present study is done to compare procalcitonin (PCT) with C-reactive protein (CRP) as a diagnostic marker of sepsis in children. Materials & Methods: A prospective observational study was done in the Department of Paediatrics, ASRAM Medical College and Hospital, Eluru from July 2015 to June 2016. Children admitted to PICU during the above tenure are included in the study. Specific inclusion and exclusion criteria are formulated with a sample size of 100. Procalcitonin level is analyzed by enzyme linked immunoluminometric assay using Elecsys Brahms PCT kit.CRP analysis is done using immunoturbidometry which is a quantitative method. Results: Out of 100 children 72 have sepsis. The mean procalcitonin level in children with sepsis is 19.09 ± 24.53 ng/ml compared to 0.34 ± 0.49 ng/ml in children without sepsis. In comparing sepsis with asepsis, PCT (Cutoff value of 0.58ng/ml) have a better sensitivity (90.3%) and specificity (92.9%) than CRP (Cut off value of 0.7mg/dl) sensitivity of 87.5% and specificity of 57.1%. Conclusion: PCT offers better sensitivity and specificity than CRP, to differentiate sepsis from asepsis. In febrile children PCT is a better diagnostic marker of sepsis than CRP.
Highlights
Given the limitation of non-specific nature of signs, symptoms and physical examination in diagnosing sepsis; especially in young children, a diagnostic marker that will aid in an early diagnosis is needed
Age distribution: In the present study around half of the study population is between 1-20 months of age and 72% of the subjects are under 5 years of age indicating that the most common age group with fever requiring PICU admission is < 5 years
Using the student’s test for statistics, 95% confidence limits, it is found that there is no significant difference in the mean age distribution among two groups. (p = 0.564)
Summary
Fever is the most common reason for visits to paediatrician. Given the limitation of non-specific nature of signs, symptoms and physical examination in diagnosing sepsis; especially in young children, a diagnostic marker that will aid in an early diagnosis is needed. When its elevated levels were reported in patients with bacterial infection, PCT became an important protein in the detection and differential diagnosis of inflammatory states [3]. Aims and objectives of the study: To compare Procalcitonin (PCT) versus C-reactive protein (CRP) as a diagnostic marker of sepsis in children and to assess the utility of PCT as an early marker in diagnosis of sepsis. This is a prospective observational study done in the department of Pediatrics, ASRAM medical college and hospital, a tertiary care centre, Eluru, Andhra Pradesh.
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