Procalcitonin Identifies Bacterial Coinfections in Vietnamese Children with Severe Respiratory Syncytial Virus Pneumonia.

Quyet Do,Tuan Minh Dao,Tran Ngoc Thi Nguyen,Tam Thi Ngo,Hau Thi Nguyen,Quynh Anh Tran

doi:10.1155/2020/7915158

Quyet Do, Tuan Minh Dao + Show 4 more

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https://doi.org/10.1155/2020/7915158

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Abstract

This study assessed the diagnostic value of interleukin- (IL-) 6, high-sensitivity C-reactive protein (hs-CRP), and procalcitonin (PCT) in differentiating severe pneumonia caused by respiratory syncytial virus (RSV) alone and RSV with bacterial coinfections among Vietnamese children under 5 years old. A cross-sectional study on 70 children with severe RSV pneumonia was conducted. IL-6, hs-CRP, and PCT tests were performed. Receiver operating characteristic (ROC) analysis was employed to measure the diagnostic values of PCT, IL-6, and hs-CRP. Of 70 children, 11 children were confirmed to have bacterial coinfections. The most common bacterial coinfection was Haemophilus influenzae. This study underlined that inflammatory biomarkers such as PCT had a moderate-to-high capability of disseminating severe pneumonia children with RSV alone or RSV and bacterial coinfections. This may support clinicians in administrating appropriate antibiotics to children suffering from severe RSV pneumonia.

Highlights

Respiratory syncytial virus (RSV) is well recorded as a leading cause of lower respiratory tract infection (LRTI) in infants under 1 year old
This study is aimed at assessing the diagnostic value of highsensitivity C-reactive protein (hs-CRP), PCT, and IL-6 in differentiating severe pneumonia caused by RSV alone and RSV with bacterial coinfections among Vietnamese children under 5 years old
Of 70 children diagnosed with severe RSV pneumonia during the study period, 11 children were confirmed to have bacterial coinfections (15.7%)

Summary

Introduction

Respiratory syncytial virus (RSV) is well recorded as a leading cause of lower respiratory tract infection (LRTI) in infants under 1 year old. RSV is annually attributable to 34 million LRTI episodes, accounting for 80% of LRTI cases globally [1, 2]. This virus causes approximately 200,000 deaths among children aged less than five years, which mostly happened in resource-constrained countries [1]. Bacterial coinfections could elevate the severity of pneumonia in children compared to viral infections alone [3,4,5]. PCT has been used in several guidelines to manage antibiotic use in children with respiratory diseases [11, 12] because a high level of serum PCT concentration frequently occurs in those with bacterial or parasitic infections [13]

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