Value of serum procalcitonin combined with soluble triggering receptor expressed on myeloid cells-1 in the differential diagnosis of bacterial and viral diarrhea in children
YANG Xue-Li, BAI Jing, SONG Zi-Xia, ZHANG Juan, LIANG Min
Department of Pediatrics, Nanchong Central Hospital, Second Clinical Medical College of North Sichuan Medical College, Nanchong, Sichuan 637000, China
Abstract Objective To study the value of serum procalcitonin (PCT) combined with soluble triggering receptor expressed on myeloid cells-1 (STREM-1) in the differential diagnosis of bacterial diarrhea and viral diarrhea in children. Methods A retrospective analysis was performed on the medical data of 73 children with bacterial infectious diarrhea (bacteria group) and 68 children with viral infectious diarrhea (virus group) who were treated from February 2018 to May 2019. The receiver operating characteristic (ROC) curve was used to analyze the diagnostic efficacy of serum PCT and STREM-1 for bacterial infectious diarrhea and viral infectious diarrhea. Results Compared with the virus group, the bacteria group had significantly higher detection rates of fecal red blood cells (79% vs 43%, P < 0.05) and pus (51% vs 19%, P < 0.05), as well as significantly higher serum levels of PCT and STREM-1 (P < 0.05). The ROC curve analysis showed that in the differential diagnosis of bacterial infectious diarrhea and viral infectious diarrhea, serum PCT had a cut-off value of 0.97 ng/mL and an area under the ROC curve (AUC) of 0.792, and STREM-1 had a cut-off value of 15.66 ng/mL and an AUC of 0.889. Serum PCT combined with STREM-1 had an AUC of 0.955, which was significantly higher than that of each index alone (P < 0.05). Conclusions Children with bacterial diarrhea have increased serum levels of PCT and STREM-1 than those with viral diarrhea. Both serum PCT and STREM-1 can be used as the indices for the differential diagnosis of bacterial diarrhea and viral diarrhea in children, and the combined measurement of PCT and STREM-1 can improve the efficiency of differential diagnosis.
YANG Xue-Li,BAI Jing,SONG Zi-Xia et al. Value of serum procalcitonin combined with soluble triggering receptor expressed on myeloid cells-1 in the differential diagnosis of bacterial and viral diarrhea in children[J]. CJCP, 2020, 22(8): 887-891.
YANG Xue-Li,BAI Jing,SONG Zi-Xia et al. Value of serum procalcitonin combined with soluble triggering receptor expressed on myeloid cells-1 in the differential diagnosis of bacterial and viral diarrhea in children[J]. CJCP, 2020, 22(8): 887-891.
Shane AL, Mody RK, Crump JA, et al. 2017 Infectious Diseases Society of America clinical practice guidelines for the diagnosis and management of infectious diarrhea[J]. Clin Infect Dis, 2017, 65(12):e45-e80.
[4]
The HC, Florez de Sessions P, Jie S, et al. Assessing gut microbiota perturbations during the early phase of infectious diarrhea in Vietnamese children[J]. Gut Microbes, 2018, 9(1):38-54.
[5]
Li A, Tran S, Wang H, et al. Multiplex polymerase chain reaction test to diagnose infectious diarrhea in the emergency department[J]. Am J Emerg Med, 2019, 37(7):1368-1370.
[6]
Das R, Ahmed T, Saha H, et al. Clinical risk factors, bacterial aetiology, and outcome of urinary tract infection in children hospitalized with diarrhoea in Bangladesh[J]. Epidemiol Infect, 2017, 145(5):1018-1024.
[7]
Riddle MS, DuPont HL, Connor BA. ACG clinical guideline:diagnosis, treatment, and prevention of acute diarrheal infections in adults[J]. Am J Gastroenterol, 2016, 111(5):602-622.
Tarr GAM, Chui L, Lee BE, et al. Performance of stool-testing recommendations for acute gastroenteritis when used to identify children with 9 potential bacterial enteropathogens[J]. Clin Infect Dis, 2019, 69(7):1173-1182.
[10]
Larcombe S, Hutton ML, Lyras D. Involvement of bacteria other than clostridium difficile in antibiotic-associated diarrhoea[J]. Trends Microbiol, 2016, 24(6):463-476.
[11]
Yang S, Li M, Cheng J, et al. Diagnostic determination of Norovirus infection as one of the major causes of infectious diarrhea in HIV patients using a multiplex polymerase chain reaction assay[J]. Int J STD AIDS, 2019, 30(6):550-556.
[12]
Qi XL, Wang HX, Bu SR, et al. Incidence rates and clinical symptoms of Salmonella, Vibrio parahaemolyticus, and Shigella infections in China, 1998-2013[J]. J Infect Dev Ctries, 2016, 10(2):127-133.
[13]
Tickell KD, Brander RL, Atlas HE, et al. Identification and management of Shigella infection in children with diarrhoea:a systematic review and meta-analysis[J]. Lancet Glob Health, 2017, 5(12):e1235-e1248.
Misic AM, Miedel EL, Brice AK, et al. Culture-independent profiling of the fecal microbiome to identify microbial species associated with a diarrheal outbreak in immunocompromised mice[J]. Comp Med, 2018, 68(4):261-268.
[16]
Gaensbauer JT, Lamb M, Calvimontes DM, et al. Identification of enteropathogens by multiplex PCR among rural and urban guatemalan children with acute diarrhea[J]. Am J Trop Med Hyg, 2019, 101(3):534-540.
[17]
Pavlinac PB, Denno DM, John-Stewart GC, et al. Failure of syndrome-based diarrhea management guidelines to detect Shigella infections in Kenyan children[J]. J Pediatric Infect Dis Soc, 2016, 5(4):366-374.
[18]
Barral-Arca R, Pardo-Seco J, Martinón-Torres F, et al. A 2-transcript host cell signature distinguishes viral from bacterial diarrhea and it is influenced by the severity of symptoms[J]. Sci Rep, 2018, 8:8043.
[19]
Zaman S, Ahad A, Sarker MS. Isolation and identification of buccal and intestinal bacteria in goats in Chittagong, Bangladesh[J]. Int J Adv Res Biol Sci, 2018, 5(4):64-71.
[20]
Maldonado NC, Chiaraviglio J, Bru E, et al. Effect of milk fermented with lactic acid bacteria on diarrheal incidence, growth performance and microbiological and blood profiles of newborn dairy calves[J]. Probiotics Antimicrob Proteins, 2018, 10(4):668-676.
