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• W1986572045 abstract "To The Editors: Serum procalcitonin (PCT), interleukin-6 (IL-6) and C-reactive protein (CRP) have been investigated for distinguishing bacterial vs. viral infections in infants and children. 1–3 PCT is more sensitive in the diagnosis of bacterial infection than are CRP or IL-6. 1, 2 In contrast to these findings, results were not conclusive in the diagnosis of bacterial vs. viral pneumonia. 3 Elevated serum CRP values in cases of bronchitis or bronchiolitis without confirmation of bacterial infection and no need for treatment with antibiotics have been observed. Thus we were interested in comparing serum PCT, IL-6 and CRP values and routine leukocyte counts in infants with bronchiolitis. 4–6 During the respiratory syncytial virus (RSV) season November 2000 to April 2001, 48 consecutively admitted infants <1 year of age were hospitalized for bronchiolitis at the Pediatric Department of the University Hospital Graz, Graz, Austria. Blood was taken by venipuncture for measurement of the inflammatory indices within 24 h of hospitalization after parental informed consent. RSV antigen detection was performed by a rapid RSV enzyme-linked immunosorbent assay (Directigen RSV Test; BD Biosciences, San Jose, CA) from nasopharyngeal aspirates of all included infants (no other diagnostic tests performed). CRP was determined by the immunoturbidometric method with the Tina-quant CRP kit (Roche Diagnostics GmbH, Mannheim, Germany); detection limit was 5 mg/l. PCT was determined using the LUMItest procalcitonin kit (Brahms Diagnostica GmbH, Berlin, Germany); detection limit was 0.1 μg/l. IL-6 was determined with the Endogen interleukin-6 enzyme-linked immunosorbent assay (Endogen, Inc., Cambridge, MA); detection limit was 1 ng/l. The mean age of the infants was 3.65 months with a range from 0.5 to 12 months. Fourteen infants required supplemental oxygen and two infants needed respiratory support (nasal continuous positive airway pressure). PCT, IL-6, CRP and white blood cell values and percentage of lymphocytes (Table 1) did not differ between values in 31 infants with RSV-positive bronchiolitis and those in 17 infants with RSV-negative bronchiolitis. In contrast values of immature-total neutrophils ratio were significantly increased in RSV-positive bronchiolitis. Twelve of 31 infants (38.7%) with RSV-positive bronchiolitis compared with none of 17 infants for RSV-negative bronchiolitis had evidence of immature neutrophils (P = 0.005, t test). Serum PCT values in RSV-positive bronchiolitis ranged from <0.1 to 0.42 μg/l, IL-6 from <1 to 29 ng/l. Only two infants (RSV negative) had PCT values above 0.5 μg/l (0.55 and 1.15 μg/l, respectively). In 15 infants (31%) CRP values were above 8 mg/l compared with 2 infants (4%) with PCT values above 0.5 μg/l, suggesting additional bacterial infection (P < 0.001). Severity of bronchiolitis did not influence any of the values significantly, as did not age ≤3 months or above. None of the infants had a diagnosis of additional bacterial infection confirmed by positive blood culture (a local bacterial ear, nose and throat infection with spontaneous resolution cannot be excluded) or treatment with antibiotics.TABLE 1: Inflammatory indices in 31 infants with RSV-positive and 17 infants with RSV-negative bronchiolitis. Differences were not significant despite IT ratio (P = 0.005).Bernhard Resch, M.D. Walter Gusenleitner, M.D. Wilhelem Müller, M.D." @default.
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• W1986572045 date "2003-05-01" @default.
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• W1986572045 title "Procalcitonin, interleukin-6, C-reactive protein and leukocyte counts in infants with bronchiolitis" @default.
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• W1986572045 doi "https://doi.org/10.1097/01.inf.0000066196.23839.b0" @default.
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