TY - JOUR
T1 - Procalcitonin to Reduce the Number of Unnecessary Cystographies in Children with a Urinary Tract Infection
T2 - A European Validation Study
AU - Leroy, Sandrine
AU - Romanello, Carla
AU - Galetto-Lacour, Annick
AU - Smolkin, Vladislav
AU - Korczowski, Bartosz
AU - Rodrigo, Carlos
AU - Tuerlinckx, David
AU - Gajdos, Vincent
AU - Moulin, Florence
AU - Contardo, Marzia
AU - Gervaix, Alain
AU - Halevy, Raphaël
AU - Duhl, Barbara
AU - Prat, Cristina
AU - Borght, Thierry Vander
AU - Foix-l'Hélias, Laurence
AU - Dubos, François
AU - Gendrel, Dominique
AU - Bréart, Gérard
AU - Chalumeau, Martin
N1 - Funding Information:
Supported by a grant from the Assistance Publique-Hôpitaux de Paris (PHRC AOM 05 110).
PY - 2007/1
Y1 - 2007/1
N2 - Objective: To validate high serum procalcitonin (PCT) as a predictor of vesicoureteral reflux (VUR) in children with a first febrile urinary tract infection (UTI). Study design: This secondary analysis of prospective hospital-based cohort studies included children ages 1 month to 4 years with a first febrile UTI. Results: Of the 398 patients included in 8 centers in 7 European countries, 25% had VUR. The median PCT concentration was significantly higher in children with VUR than in those without: 1.6 versus 0.7 ng/mL (P = 10-4). High PCT (≥0.5 ng/mL) was associated with VUR (OR: 2.3; 95% CI, 1.3 to 3.9; P = 10-3). After adjustment for all cofactors, the association remained significant (OR: 2.5; 95% CI, 1.4 to 4.4; P = 10-3). The strength of the relation increased with the grade of reflux (P = 10-5). The sensitivity of procalcitonin was 75% (95% CI, 66 to 83) for all-grade VUR and 100% (95% CI, 81 to 100) for grade ≥4 VUR, both with 43% specificity (95% CI, 37 to 48). Conclusions: High PCT is a strong, independent and now validated predictor of VUR that can be used to identify low-risk patients and thus avoid one third of the unnecessary cystourethrographies in children with a first febrile UTI.
AB - Objective: To validate high serum procalcitonin (PCT) as a predictor of vesicoureteral reflux (VUR) in children with a first febrile urinary tract infection (UTI). Study design: This secondary analysis of prospective hospital-based cohort studies included children ages 1 month to 4 years with a first febrile UTI. Results: Of the 398 patients included in 8 centers in 7 European countries, 25% had VUR. The median PCT concentration was significantly higher in children with VUR than in those without: 1.6 versus 0.7 ng/mL (P = 10-4). High PCT (≥0.5 ng/mL) was associated with VUR (OR: 2.3; 95% CI, 1.3 to 3.9; P = 10-3). After adjustment for all cofactors, the association remained significant (OR: 2.5; 95% CI, 1.4 to 4.4; P = 10-3). The strength of the relation increased with the grade of reflux (P = 10-5). The sensitivity of procalcitonin was 75% (95% CI, 66 to 83) for all-grade VUR and 100% (95% CI, 81 to 100) for grade ≥4 VUR, both with 43% specificity (95% CI, 37 to 48). Conclusions: High PCT is a strong, independent and now validated predictor of VUR that can be used to identify low-risk patients and thus avoid one third of the unnecessary cystourethrographies in children with a first febrile UTI.
UR - http://www.scopus.com/inward/record.url?scp=33845662798&partnerID=8YFLogxK
U2 - 10.1016/j.jpeds.2006.08.066
DO - 10.1016/j.jpeds.2006.08.066
M3 - Article
C2 - 17188622
AN - SCOPUS:33845662798
SN - 0022-3476
VL - 150
SP - 89
EP - 95
JO - Journal of Pediatrics
JF - Journal of Pediatrics
IS - 1
ER -