Validity of the quick-read C-reactive protein test in the prediction of bacterial pneumonia in the pediatric emergency department

Nufar Marcus, Meirav Mor, Lisa Amir, Marc Mimouni, Yehezkel Waisman

Research output: Contribution to journalArticlepeer-review

Abstract

BACKGROUND: C-reactive protein (CRP) values are clinically useful in differentiating viral from bacterial illnesses in children, but the regular test is impractical in the emergency department (ED) setting. OBJECTIVE: To investigate the validity and feasibility of the 2-min bedside Quick Read (QR)-CRP test in the prediction of bacterial pneumonia in children in the ED. METHODS: Fifty randomly selected children aged 4 days to 17 years, who presented to a pediatric ED with symptoms and signs of pneumonia over a 6-month period, were prospectively studied. The diagnosis of bacterial/viral pneumonia was based on clinical and radiological findings. CRP was measured in leftover blood (0.2 ml) using the QR-CRP kit. Clinical and laboratory data were statistically analyzed against CRP values for ability to predict bacterial pneumonia. RESULTS: Thirty-six patients (72%) were diagnosed with bacterial pneumonia and 14 (28%) with viral pneumonia; mean CRP levels were 121.3±122 and 27.2±26 mg/l, respectively (P=0.007). Significantly higher CRP levels were associated with bacterial than with viral pneumonia in the patients who presented before 96 h of symptom onset (P=0.013-0.028), but not in those who presented later. On receiver operating characteristics analysis, CRP was a better indicator of a chest radiograph picture of bacterial pneumonia (area under the curve=0.79) than absolute neutrophil count (0.78) or white blood cell count (0.73). Combining all three parameters yielded an area of 0.865. CONCLUSION: The QR-CRP test seems to be an useful predictor of bacterial pneumonia in children, especially those with a shorter illness duration, and is feasible for use in the ED.

Original languageEnglish
Pages (from-to)158-161
Number of pages4
JournalEuropean Journal of Emergency Medicine
Volume15
Issue number3
DOIs
StatePublished - Jun 2008

Keywords

  • Bacterial
  • C-reactive protein
  • Children
  • Diagnosis
  • Emergency department
  • Pneumonia
  • Point-of-care testing
  • Viral

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