Clinical Significance of Procalcitonin Measurement in Children with Sepsis

Objective To evaluate the value of serum procalcitonin(PCT) measurement on diagnosis of sepsis in children.Methods From Mar.to Dec.2005,62 patients in our pediatric intensive care unit(PICU) with mean age of(4.6±1.2)years old(range 1 month to 11 years) were divided into sepsis group(S,n=30) and non-sepsis group(N,n=32) according to the 2005 definition for sepsis.Furthermore,the sepsis group was divided into severe(SS,n=11) and mild(SM,n=19) groups.Patients′ severity was checked according to a domestic scoring system.Within 24 hours of hospitalization,serum PCT,C reactive protein(CRP),white blood cell(WBC),blood gas and pathogenic microorganisms were measured.Results Levels of PCT,CRP and WBC in S group were significantly higher than those in N group(Pa0.01).No differences were found in gender and age between the two groups.When PCT≥2.2 μg/L was applied as optimal cut-off values in diagnosing sepsis,its sensitivity,specificity,positive predictive value,negative predictive value were 96.7%,87.5%,87.9% and 96.5%,respectively,and area under receiver operating characteristic(ROC) curve was 0.992;when CRP≥25 mg/L was applied,the values were 83%,75%,75.8%, 82.8% and 0.796,respectively;and when WBC≥13.09×109/L was applied,the values were 53%,75%,69.6%,64.1% and 0.651,respectively.The PCT level was inversely correlated to patients′ severity score(r=-0.64 P0.01).The PCT level in SS group was higher than that in SM group(P0.01).There were no differences in the levels of CRP and WBC between the two groups.Conclusion PCT may be a more sensitive serologic marker than WBC and CRP in differential diagnosis of sepsis.As there was an inverse correlation between PCT and severity score,PCT may be helpful to evaluate the severity of illness,therapeutic effect and prognosis in pediatric patients with sepsis.