The procalcitonin assay is an accurate and effective tool in detecting bacterial meningitis in infants, according to a new study.
Diagnosis of severe bacterial infections such as urinary tract infections (UTI) and invasive bacterial infections such as bacteremia (bacteria in the blood) and bacterial meningitis in infants younger than 3 months is often difficult. A recent study published in JAMA Pediatrics evaluated the specificity and sensitivity of the procalcitonin (PCT) assay in detecting severe and invasive bacterial infections in 7 to 90 day old infants with fever. Procalcitonin is the precursor of the hormone calcitonin that is involved in calcium metabolism. The level of procalcitonin in the blood increases in the presence of bacterial infection and inflammation.
The study compared the PCT assay to standard diagnostic tests such white blood cell (WBC) counts and the C-reactive protein (CRP) assay, a protein also found at high levels in the blood during an infection. The diagnostics tests were used to detect severe and invasive bacterial infections in more than 2000 infants with fever at age 7 to 90 days old. The presence of pathogenic bacteria in the urine, blood or cerebrospinal fluid was deemed as a definite diagnosis of severe or invasive bacterial infection. Of all infants examined, 139 infants were diagnosed with severe bacterial infection (115 infants with UTI) while 13 infants had bacteremia and 8 infants had bacterial meningitis. The PCT assay performed equally well in predicting severe bacterial infection in infants as the CRP, WBC, and urinalysis tests. However, the PCT assay was more accurate and specific in detecting bacteremia and bacterial meningitis in infants compared to the other tests.
Based on the diagnostic performance of the PCT assay, the study encouraged its inclusion, along with standard tests, in the diagnosis and management of invasive bacterial infections in infants.
Milcent K, Faesch S, Gras-Le Gue C, Dubos F, Poulalhon C, Badier I,…Bouyer J, Gajdos V. Use of procalcitonin assays to predict serious bacterial infection in young febrial infants. JAMA Pediatr. Published online 23 November 2015. DOI: 10.1001/jamapediatrics.2015.3210
Written by Ana Victoria Pilar, PhD