OBJECTIVE: To determine the clinical usefulness of the bedside Quick-Read (QR) C-reactive protein (CRP) test for predicting bacterial gastroenteritis in the pediatric emergency department. STUDY DESIGN: We tested for CRP in 44 children who presented to the emergency department with gastroenteritis and underwent blood tests and stool culture. C-reactive protein was measured in leftover blood or serum (0.2 mL) using the immunoturbidimetric QR-CRP test kit. Background and outcome data were collected from the files. Pearson correlation, analysis of variance, and logistic regression were used to determine the diagnostic ability of CRP. RESULTS: Stool culture was positive for bacteria in 8 patients. High CRP levels correlated with a greater likelihood of a positive culture; the area under the receiver operating characteristics curve was 0.9427. The CRP values of 95 mg/L or higher had a sensitivity of 87% and a specificity of 91.7% for predicting culture-confirmed bacterial gastroenteritis. CONCLUSIONS: The QR-CRP test seems to be a useful predictor of bacterial gastroenteritis in children. It is amenable for use in the emergency department, making it a promising tool for infection control and for aiding physicians in decisions regarding antibiotic treatment. The CRP levels of 95 mg/L or higher during the first 48 hours are suggestive of bacterial disease.
OBJECTIVE: To determine the clinical usefulness of the bedside Quick-Read (QR) C-reactive protein (CRP) test for predicting bacterial gastroenteritis in the pediatric emergency department. STUDY DESIGN: We tested for CRP in 44 children who presented to the emergency department with gastroenteritis and underwent blood tests and stool culture. C-reactive protein was measured in leftover blood or serum (0.2 mL) using the immunoturbidimetric QR-CRP test kit. Background and outcome data were collected from the files. Pearson correlation, analysis of variance, and logistic regression were used to determine the diagnostic ability of CRP. RESULTS: Stool culture was positive for bacteria in 8 patients. High CRP levels correlated with a greater likelihood of a positive culture; the area under the receiver operating characteristics curve was 0.9427. The CRP values of 95 mg/L or higher had a sensitivity of 87% and a specificity of 91.7% for predicting culture-confirmed bacterial gastroenteritis. CONCLUSIONS: The QR-CRP test seems to be a useful predictor of bacterial gastroenteritis in children. It is amenable for use in the emergency department, making it a promising tool for infection control and for aiding physicians in decisions regarding antibiotic treatment. The CRP levels of 95 mg/L or higher during the first 48 hours are suggestive of bacterial disease.
Authors: Mahbuba Meem; Joyanta K Modak; Roman Mortuza; Mahboob Morshed; Mohammad Shahidul Islam; Samir K Saha Journal: J Glob Health Date: 2011-12 Impact factor: 4.413