40
Abstracts
P R O B E
• V o l . L I I I • N o . 3 • A p r – J u n 2 0 1 4
Infections
Appropriateness of Testing for Serious Bacterial
Infection in Children Hospitalized With
Bronchiolitis
Librizzi J, et al
Hosp Pediatr.
2014;4(1):33–38.
The goal of this study was to evaluate provider practice
patterns for evaluation of serious bacterial infection (SBI)
in patients hospitalized with bronchiolitis and to assess the
association of SBI testing with length of stay and
antibiotic use.
This was a retrospective chart review of hospitalized
patients < 24 months of age with a discharge diagnosis of
bronchiolitis from 2 separate study sites.
A total of 1233 charts met inclusion criteria. The incidence
of urinary tract infections in patients who underwent
urine testing was 2.3%. Of the 367 patients undergoing
blood culture testing, all 13 positive-result blood cultures
were contaminated specimens. In total, 64.5% of patients
tested for SBI had a blood culture obtained, 45.0% had a
urinalysis or urine culture, and 16.3% had a cerebral spinal
fluid culture obtained. Of those patients who underwent
SBI testing, 53.8% received antibiotics versus 19.1% who
did not (
P
< .0001). Length of stay for patients undergoing
SBI testing was 3.4 days versus 2.3 days for those without
SBI testing (
P
< .0001).
SBI is uncommon in children hospitalized for bronchiolitis
and urinary tract infection is the most common diagnosis.
In the evaluation of SBI in bronchiolitis, providers more
frequently obtain blood cultures than urinalysis and/
or urine cultures. Evaluation for SBI is associated with
increased antibiotic use and increased LOS.
Usefulness of Serum Procalcitonin Level for
Prediction of Vesicoureteral Reflux in Pediatric
Urinary Tract Infection
Mortazavi F, Ghojazadeh M
Iran J Kidney Dis
. 2014;8(1):37–41.
The aim of this study was to evaluate the predictive value
of procalcitonin in the diagnosis of vesicoureteral reflux
(VUR) in children with febrile urinary tract infection.
One hundred and eight children aged 2 months to 12 years
with febrile urinary tract infection were evaluated. Serum
procalcitonin was measured before initiation of antibiotics.
Standard voiding cystourethrography (VCUG) was
performed in all children as the gold standard for detection
of VUR.
Forty-eight patients (44%) had VUR at least in 1 kidney,
including grade 1 to 2 in 12 patients (11.1%), grade 3
in 16 (14.8%), and grade 4 to 5 in 20 patients (18.5%).
Procalcitonin level ranged from 0.05 ng/mL to 13.6 ng/mL.
Procalcitonin level was significantly higher with increasing
the grading of reflux. Comparing procalcitonin levels with
VCUG results, a sensitivity of 97% and a specificity of
75% was obtained at a procalcitonin level of 0.59 ng/mL
for diagnosis of VUR. There was a significant correlation
between procalcitonin level and leukocytosis, erythrocyte
sedimentation rate, and C-reactive protein.
A high procalcitonin level may be used for prediction
of all grades of VUR in children with febrile urinary
tract infection. A low procalcitonin level may be used for
avoidance of unnecessary VCUG in some low-risk patients.
