SHM Converge Scientific Abstract ePoster Gallery-Procalcitonin:albumin Ratio as Predictor of Bacterial Infection in Febrile Infants

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This retrospective cohort study examined whether the procalcitonin-to-albumin ratio (PCT:Alb) improves prediction of bacterial infection (BI) in febrile infants 8–60 days old compared with procalcitonin (PCT) alone. The study included 403 infants seen from 2018–2020; 106 (26%) had confirmed BI, defined as true positive blood, urine, or cerebrospinal fluid cultures with clinician-judged infection and antibiotic treatment. The main outcomes were odds of BI and diagnostic performance using area under the curve (AUC), sensitivity, and specificity.<br /><br />Both elevated PCT:Alb ratio and elevated PCT alone were significantly associated with BI. However, the two markers performed very similarly. The PCT:Alb ratio had an odds ratio of 1.03 (95% CI 1.02–1.04; p=0.01) and an AUC of 0.86, with sensitivity 80% and specificity 79% at the optimal Youden index. PCT alone had a higher odds ratio of 2.64 (95% CI 1.82–3.82; p=0.01) and an AUC of 0.85, with sensitivity 78% and specificity 80%.<br /><br />Overall, the authors concluded that the PCT:Alb ratio is not better than PCT alone for predicting bacterial infection in febrile infants 8–60 days old. Limitations included a relatively small BI sample, possible effects of outliers, limited ability to analyze bacteremia and meningitis separately, and selection bias because not all infants had albumin measured. The authors recommend larger multicenter studies, especially focused on invasive bacterial infections.

Asset Subtitle

Jared Kusma

Meta Tag

Author List Andrew Ritchey, Jared Kusma, Lucia Mirea, Maheshwor Kafle, Sandra L. Gage

Category Research

Concept Febrile Infant

Concept Bacterial Infection

Concept Procalcitonin

Concept Procalcitonin-to-Albumin Ratio

Concept Conclusion

Distinguished Non-Finalist

Presenter Organization Phoenix Children's

Presenting Author Jared Kusma

Track Pediatric

Keywords

procalcitonin-to-albumin ratio

PCT:Alb

procalcitonin

bacterial infection

febrile infants

retrospective cohort study

diagnostic performance

area under the curve

sensitivity and specificity

invasive bacterial infection

Febrile Infant

Bacterial Infection

Procalcitonin

Procalcitonin-to-Albumin Ratio

Conclusion