New test could help catch serious infections in babies

October 6, 2008

A simple blood test may help detect serious bacterial infections (SBIs) like urinary tract infections and blood stream infections in young infants who come to the emergency department (ED) with fevers that have no clear cause.

Researchers at Children's Hospital Boston, collaborating with investigators at George Washington University, show that a new diagnostic marker called procalcitonin can help identify infants at high risk for SBIs while potentially reducing unnecessary and aggressive testing, medication and hospitalization in low risk infants. The study, published in the October Pediatrics, is the first to examine procalcitonin as a tool for evaluating infant fever in an emergency situation.

The researchers used a novel procalcitonin test, recently approved by the FDA, in 234 feverish babies under 3 months of age, of whom 18 percent had definite or possible SBIs confirmed by independent clinical criteria. The results showed that procalcitonin not only detected all cases of SBIs in feverous infants but proved sensitive enough to establish a threshold value that would identify infants at low risk for serious infections. Indeed, its overall performance as a single clinical marker of infection approached that of current strategies that involve a variety of laboratory tests and clinical evaluations.

In the United States, infant fever accounts for a vast majority of pediatric visits to the ED, of which up to 20 percent of cases have no identifiable cause of infection. While most turn out to be minor and self-limiting illnesses, a proportion of infants have SBIs such as bacteremia, meningitis, pneumonia or urinary tract infections. The risk is most significant in infants under 3 months of age.

"About 12 percent of those whom we consider 'well appearing' end up having serious infections when we do an evaluation," said Richard Bachur, MD, acting chief of emergency medicine at Children's.

Because clinicians cannot reliably determine which children with fever have more serious infections, many babies end up undergoing extensive evaluations. Routine evaluation of infants less than 3 months of age includes blood tests, urine tests, and often a lumbar puncture for spinal fluid, followed by treatment in the hospital with antibiotics.

Prompted by the inefficiency of current fever management in young infants, Bachur and colleagues have sought a rapid diagnostic test that will determine which children have serious infections at the first visit to the ED. "We hope to identify those infants that are at very low risk of serious infection and tailor their evaluation so as to minimize invasive testing and exposure to unnecessary antibiotics," said Bachur.

The high sensitivity of the new procalcitonin test has allowed Bachur and colleagues to establish realistic cut-off values to help guide clinicians in identifying children who are at low risk for SBIs.

The researchers are now looking to do a multi-center study to evaluate the use of procalcitonin on a larger scale. If it proves to be valuable, Bachur hopes it will become a standard tool for the evaluation of young infants with fever.

Source: Children's Hospital Boston

Explore further: Biologic use during pregnancy may not increase opportunistic infection risks in infants

Related Stories

Biologic use during pregnancy may not increase opportunistic infection risks in infants

November 5, 2017
Using a biologic therapy to manage rheumatoid arthritis may not significantly increase an infant's risk for developing opportunistic infections like pneumonia, meningitis, and tuberculosis, according to new research findings ...

Strong maternal antibodies for HIV ineffective for protecting infants from HIV

October 31, 2017
HIV+ mothers who possess a strong neutralizing antibody response may be more likely to pass the virus on to her infant through breast feeding. In addition, infants born to mothers with a strong antibody response are significantly ...

Group B Streptococcus infection causes estimated 150,000 stillbirth, infant death

November 6, 2017
An estimated one in five pregnant women around the world carry Group B Streptococcus (GBS) bacteria which is a major, yet preventable, cause of maternal and infant ill health globally.

New drug enables infants with genetic disorder to live longer, gain motor function

November 1, 2017
Infants with the most severe form of spinal muscular atrophy (SMA) were more likely to show gains in motor function and were 47 percent more likely to survive without permanent assisted ventilation support when treated with ...

Doctors warn of a common respiratory illness in children

October 30, 2017
Like most moms, Shanisty Ireland had dealt with many bugs being passed between her three children. Last winter, she thought her newborn, Adam, had the same cold that had caused her older children to cough and sniffle. But ...

Australia currently on track to eliminate hepatitis C by 2030, but challenges remain for hepatitis B

November 1, 2017
New data released at this year's World Hepatitis Summit in Sao Paulo, Brazil (1-3 November) shows that Australia is currently on track to eliminate hepatitis C thanks to its huge efforts to enable population-wide access to ...

Recommended for you

New approach to tracking how deadly 'superbugs' travel could slow their spread

November 22, 2017
Killer bacteria - ones that have out-evolved our best antibiotics—may not go away anytime soon. But a new approach to tracking their spread could eventually give us a fighting chance to keep their death toll down.

Research points to diagnostic test for top cause of liver transplant in kids

November 22, 2017
Biliary atresia is the most common cause of liver transplants for children in the United States. Now researchers report in Science Translational Medicine finding a strong biomarker candidate that could be used for earlier ...

Metabolites altered in chronic kidney disease

November 22, 2017
Chronic kidney disease (CKD) affects 1 in 7 people in the United States, according to the U.S. National Institute of Diabetes & Digestive & Kidney Diseases (NIDDK). These individuals have a very high risk of cardiovascular ...

Rainfall can indicate that mosquito-borne epidemics will occur weeks later

November 22, 2017
A new study demonstrates that outbreaks of mosquito-borne viruses Zika and Chikungunya generally occur about three weeks after heavy rainfall.Researchers also found that Chikungunya will predominate over Zika when both circulate ...

Alcohol consumption and metabolic factors act together to increase the risk of severe liver disease

November 22, 2017
A new study provides insights into the interaction between alcohol consumption and metabolic factors in predicting severe liver disease in the general population. The findings, which are published in Hepatology, indicate ...

Gastric acid suppressant lansoprazole may target tuberculosis

November 21, 2017
A cheap and widely used drug, used to treat conditions such as heartburn, gastritis and ulcers, could work against the bacteria that cause tuberculosis (TB), according to new research from UCL and the London School of Hygiene ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.