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C‐reactive protein as a marker of serious bacterial infections in hospitalized febrile infants
Author(s) -
Bilavsky Efraim,
YardenBilavsky Havatzelet,
Ashkenazi Shai,
Amir Jacob
Publication year - 2009
Publication title -
acta pædiatrica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.772
H-Index - 115
eISSN - 1651-2227
pISSN - 0803-5253
DOI - 10.1111/j.1651-2227.2009.01469.x
Subject(s) - medicine , white blood cell , c reactive protein , bacteremia , gastroenterology , meningitis , predictive marker , pediatrics , antibiotics , inflammation , cancer , microbiology and biotechnology , biology
Objective: To determine the potential predictive power of C‐reactive protein (CRP) as a marker of serious bacterial infection (SBI) in hospitalized febrile infants aged ≤3 months. Patients and Methods: Data on blood CRP levels were collected prospectively on admission for all infants aged ≤3 months who were hospitalized for fever from 2005 to 2008. The patients were divided into two groups by the presence or absence of findings of SBI. Results: A total of 892 infants met the inclusion criteria, of whom 102 had a SBI. Mean CRP level was significantly higher in the infants who had a bacterial infection than in those who did not (5.3 ± 6.3 mg/dL vs. 1.3 ± 2.2 mg/dL, p < 0.001). The area under the ROC curve (AUC) was 0.74 (95% CI: 0.67–0.80) for CRP compared to 0.70 (95% CI: 0.64–0.76) for white blood cell (WBC) count. When analyses were limited to predicting bacteremia or meningitis only, the AUCs for CRP and WBC were 0.81 (95% CI: 0.66–0.96) and 0.63 (95% CI: 0.42–0.83), respectively. Conclusion: C‐reactive protein is a valuable laboratory test in the assessment of febrile infants aged ≤3 months old and may serve as a better diagnostic marker of SBI than total WBC count.