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Procalcitonin as a biomarker of bacterial infection in pediatric patients after congenital heart surgery


1 Department of Pediatrics, Division of Cardiology, New York University Langone Medical Center, New York, New York, USA
2 Department of Cardiothoracic Surgery, New York University Langone Medical Center, New York, New York, USA

Correspondence Address:
Sujata B Chakravarti
Department of Pediatrics, Division of Cardiology, Room 404, 4th Floor, Rivergate Building, 403 East 34th Street, New York - 10016, New York
USA
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0974-2069.180665

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Year : 2016  |  Volume : 9  |  Issue : 2  |  Page : 115-119

 

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Background: Bacterial infection (BI) after congenital heart surgery (CHS) is associated with increased morbidity and is difficult to differentiate from systemic inflammatory response syndrome caused by cardiopulmonary bypass (CPB). Procalcitonin (PCT) has emerged as a reliable biomarker of BI in various populations. Aim: To determine the optimal PCT threshold to identify BI among children suspected of having infection following CPB. Setting and Design: Single-center retrospective observational study. Setting and Design: Single-center retrospective observational study. Statistical Analysis: The Wilcoxon rank-sum test was used for nonparametric variables. The diagnostic performance of PCT was evaluated using a receiver operating characteristic (ROC) curve. Results: Ninety-eight patients were included. The median age was 2 months (25th and 75th interquartile of 0.1-7.5 months). Eleven patients were included in the BI group. The median PCT for the BI group (3.42 ng/mL, 25th and 75th interquartile of 2.34-5.67) was significantly higher than the median PCT for the noninfected group (0.8 ng/mL, 25th and 75th interquartile 0.38-3.39), P = 0.028. The PCT level that yielded the best compromise between the sensitivity (81.8%) and specificity (66.7%) was 2 ng/mL with an area under the ROC curve of 0.742. Conclusion: A PCT less than 2 ng/mL makes BI unlikely in children suspected of infection after CHS.






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1 Department of Pediatrics, Division of Cardiology, New York University Langone Medical Center, New York, New York, USA
2 Department of Cardiothoracic Surgery, New York University Langone Medical Center, New York, New York, USA

Correspondence Address:
Sujata B Chakravarti
Department of Pediatrics, Division of Cardiology, Room 404, 4th Floor, Rivergate Building, 403 East 34th Street, New York - 10016, New York
USA
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0974-2069.180665

Rights and Permissions

Background: Bacterial infection (BI) after congenital heart surgery (CHS) is associated with increased morbidity and is difficult to differentiate from systemic inflammatory response syndrome caused by cardiopulmonary bypass (CPB). Procalcitonin (PCT) has emerged as a reliable biomarker of BI in various populations. Aim: To determine the optimal PCT threshold to identify BI among children suspected of having infection following CPB. Setting and Design: Single-center retrospective observational study. Setting and Design: Single-center retrospective observational study. Statistical Analysis: The Wilcoxon rank-sum test was used for nonparametric variables. The diagnostic performance of PCT was evaluated using a receiver operating characteristic (ROC) curve. Results: Ninety-eight patients were included. The median age was 2 months (25th and 75th interquartile of 0.1-7.5 months). Eleven patients were included in the BI group. The median PCT for the BI group (3.42 ng/mL, 25th and 75th interquartile of 2.34-5.67) was significantly higher than the median PCT for the noninfected group (0.8 ng/mL, 25th and 75th interquartile 0.38-3.39), P = 0.028. The PCT level that yielded the best compromise between the sensitivity (81.8%) and specificity (66.7%) was 2 ng/mL with an area under the ROC curve of 0.742. Conclusion: A PCT less than 2 ng/mL makes BI unlikely in children suspected of infection after CHS.






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