The diagnostic and prognostic accuracy of five markers of serious bacterial infection in Malawian children with signs of severe infection

Early recognition and prompt and appropriate antibiotic treatment can significantly reduce mortality from serious bacterial infections (SBI). The aim of this study was to evaluate the utility of five markers of infection: C-reactive protein (CRP), procalcitonin (PCT), soluble triggering receptor exp...

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Bibliographic Details
Published in:PloS one 2009-08, Vol.4 (8), p.e6621-e6621
Main Authors: Carrol, Enitan D, Mankhambo, Limangeni A, Jeffers, Graham, Parker, Deborah, Guiver, Malcolm, Newland, Paul, Banda, Daniel L, Molyneux, Elizabeth M, Heyderman, Robert S, Molyneux, Malcolm E, Hart, C Anthony
Format: Article
Language:English
Subjects:
Accuracy
Adolescent
Antibiotics
Bacteria
Bacterial infections
Bacterial Infections - diagnosis
Bacterial Infections - mortality
Bacterial Infections - pathology
Biomarkers - analysis
C-reactive protein
CD163 antigen
Child
Child, Preschool
Children
Children & youth
Childrens health
Chromosomal proteins
Critical Care and Emergency Medicine/Sepsis and Multiple Organ Failure
Diagnosis
Diagnostic systems
Fatalities
Female
Fever
HMGB1 protein
Hospitals
Human immunodeficiency virus
Humans
Immunoassay
Infant
Infections
Infectious Diseases/Bacterial Infections
Malaria
Malawi - epidemiology
Male
Markers
Medical diagnosis
Medical prognosis
Medical research
Medicine
Meningitis
Mortality
Myeloid cells
Pediatrics and Child Health
Pneumonia
Procalcitonin
Prognosis
Prospective Studies
Proteins
Reproducibility of Results
Sepsis
Severity of Illness Index
Studies
Tuberculosis
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Summary:Early recognition and prompt and appropriate antibiotic treatment can significantly reduce mortality from serious bacterial infections (SBI). The aim of this study was to evaluate the utility of five markers of infection: C-reactive protein (CRP), procalcitonin (PCT), soluble triggering receptor expressed on myeloid cells-1 (sTREM-1), CD163 and high mobility group box-1 (HMGB1), as markers of SBI in severely ill Malawian children. Children presenting with a signs of meningitis (n = 282) or pneumonia (n = 95), were prospectively recruited. Plasma samples were taken on admission for CRP, PCT, sTREM-1 CD163 and HMGB1 and the performance characteristics of each test to diagnose SBI and to predict mortality were determined. Of 377 children, 279 (74%) had SBI and 83 (22%) died. Plasma CRP, PCT, CD163 and HMGB1 and were higher in HIV-infected children than in HIV-uninfected children (p
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0006621