Role of procalcitonin in the diagnosis of acute pyelonephritis in children

ZHANG Lin; YU Qiang; GUO Kuan-Peng; YI Su-Wu; LI Sai; MO Li-Ya

doi:10.7499/j.issn.1008-8830.2013.02.002

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Chinese Journal of Contemporary Pediatrics ›› 2013, Vol. 15 ›› Issue (2) : 85-87. DOI: 10.7499/j.issn.1008-8830.2013.02.002

CLINICAL RESEARCH

Role of procalcitonin in the diagnosis of acute pyelonephritis in children

ZHANG Lin, YU Qiang, GUO Kuan-Peng, YI Su-Wu, LI Sai, MO Li-Ya

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Abstract

OBJECTIVE: To study the role of procalcitonin (PCT) in the diagnosis of acute pyelonephritis (APN) in children. METHODS: Retrospective analysis was performed on the clinical records of children aged under 3 years who were diagnosed with primary urinary tract infection (UTI) from September 2011 to February 2012. These children were divided into those with upper UTI (UUTI) (APN) and those with lower UTI (LUTI) (non-APN) based on 99mTc-dimercaptosuccinic acid (DMSA) renal scan results as a gold standard. The UUTI and LUTI groups were compared in terms of serum levels of PCT and C-reactive protein (CRP). Receiver operating characteristic (ROC) curves were drawn to evaluate the diagnostic values of serum PCT and CRP. RESULTS: Sixty-five children with UTI, including 39 cases of APN and 26 cases of LUTI, were included in this study. The APN cases had significantly higher serum levels of PCT (3.08 ng/mL vs 0.37 ng/Ml; P<0.01) and CRP (6.25 mg/L vs 3.01 mg/L; P<0.01) than the LUTI cases. The sensitivity and specificity of serum PCT level for APN were 84.6% and 88.5%, respectively, with an area under the ROC curve (AUC) of 0.873 (95%CI=0.781-0.965) and an optimal threshold point of 1.03 ng/mL. The sensitivity and specificity of serum CRP level for APN were 71.8% and 69.2%, respectively, with an AUC of 0.735 (95%CI=0.612-0.858) and an optimal threshold point of 3.91 mg/L. CONCLUSIONS: As a result of its high sensitivity and specificity for the disease, serum PCT can be used as a marker in the early diagnosis of APN in children.

Key words

Procalcitonin / Acute pyelonephritis / Receiver operating curve / Urinary tract infection / Child

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ZHANG Lin, YU Qiang, GUO Kuan-Peng, YI Su-Wu, LI Sai, MO Li-Ya. Role of procalcitonin in the diagnosis of acute pyelonephritis in children[J]. Chinese Journal of Contemporary Pediatrics. 2013, 15(2): 85-87 https://doi.org/10.7499/j.issn.1008-8830.2013.02.002

References

［1］Montini G, Tullus K, Hewitt I. Febrile urinary tract infections in children［J］. N Engl J Med, 2011, 365(3): 239-250.

［2］刘延霞, 杨青, 林瑞霞. 小儿尿路感染与膀胱输尿管反流［J］. 中国当代儿科杂志, 2008, 10(1):83-84.

［3］Chen SM, Chang HM, Hung TW, Chao YH, Tsai JD, Lue KH, et al. Diagnostic performance of procalcitonin for hospitalised children with acute pyelonephritis presenting to the paediatric emergency department［J］. Emerg Med J, 2012.［Epub ahead of print］.

［4］屈文烈, 白旭明. 尿路感染患者的血清降钙素原水平研究［J］. 临床和实验医学杂志, 2008, 7(12):11-12.

［5］Nikfar R, Khotaee G, Ataee N, Shams S. Usefulness of procalcitonin rapid test for the diagnosis of acute pyelonephritis in children in the emergency department［J］. Pediatr Int, 2010, 52(2): 196-198.

［6］Slekovec C, Leroy J, Vernaz-Hegi N, Faller JP, Sekri D, Hoen B, et al. Impact of a region wide antimicrobial stewardship guideline on urinary tract infection prescription patterns［J］. Int J Clin Pharm, 2012, 34(2): 325-329.

［7］Routh JC, Grant FD, Kokorowski PJ, Nelson CP, Fahey FH, Treves ST, et al. Economic and radiation costs of initial imaging approaches after a child′s first febrile urinary tract infection［J］. Clin Pediatr (Phila), 2012, 51(1): 23-30.

［8］Nazarko L. Urinary tract infection: diagnosis, treatment and prevention［J］. Br J Nurs, 2009, 18(19): 1170-1174.

［9］Gilsdorf JR. C reactive protein and procalcitonin are helpful in diagnosis of serious bacterial infections in children［J］. J Pediatr, 2012, 160(1): 173-174.

［10］Kotoula A, Gardikis S, Tsalkidis A, Mantadakis E, Zissimopoulos A, Kambouri K, et al. Procalcitonin for the early prediction of renal parenchymal involvement in children with UTI: preliminary results［J］. Int Urol Nephrol, 2009, 41(2): 393-399.