Accuracy of serum procalcitonin, C-reactive protein, and soluble CD14 subtype levels in diagnosis of sepsis in children

Abstract

Background/Aim. Despite the widespread use of procalci-tonin, C-reactive protein (CRP), and soluble CD14 subtype (sCD14-ST), their diagnostic accuracy in children with sepsis is not yet clear. The aim of the study was to establish and compare the diagnostic accuracy of procalcitonin, CRP, and sCD14-ST in children admitted to the hospital under suspi-cion of having sepsis. Methods. The study was designed as a retrospective cross-sectional study on children admitted to the Pediatrics Clinic in Kragujevac, Serbia, under suspicion of sepsis, during a 6-month period. Diagnostic accuracy was tested by the construction of receiver operating characteristic (ROC) curves and their comparison in terms of area under the curve (AUC). Results. Procalcitonin had the largest AUC [0.75; 95% confidence interval (CI) 0.63-0.88], followed by CRP (0.68; 95% CI 0.54-0.81) and sCD14-ST (0.65; 95% CI 0.52 - 0.79). Differences between the areas under the ROC curves were not significant (CRP vs. procalcitonin z = 1.054, p = 0.291; CRP vs. sCD14-ST z = 0.238, p = 0.812; procalci-tonin vs. sCD14-ST z = 1.089, p = 0.286). Conclusion. Our study showed relatively low sensitivity and moderate specifici-ty of procalcitonin, C-reactive protein and sCD14-ST in diag-nosing sepsis among children, as well as similar diagnostic ac-curacy of the three biomarkers.