A Case-Control Study to Assess Procalcitonin Serum Levels in Children Under the Age of Five with UTI

Aim: The aim of the present study to evaluate the Procalcitonin Serum Levels in Children Younger than Five Years Old with Urinary Tract Infection. Methods: This case-control was done the Department of Paediatrics, Government Medical College, Bettiah, West Champaran, Bihar, India for 1 year. The 100 (100 case and 100 control) children less than 5 years of age were included in this study. The children in the case group suffered from UTI based on a positive urinary culture test. They also were undergone VCUG and accordingly were divided into two groups: having VUR and not having VUR. Their serum levels of PCT were measured before starting antibiotic therapy using the chemiluminiscence immunoassay (CLIA). They had negative results for both urine culture (UTI) and urinary analysis tests that the serum levels of PCT were measured for them. In both groups children under 5 years without genetically diseases and chronic kidney diseases included in the study. Results: Of the samples, 130 children (65%) were female. The median age of the samples was 23.7 months with an interquartile range between 11.5 and 36.5 months. Accordingly, both the evaluation methods diagnosed 90 children to be healthy, while 92% of children with VUR positive simultaneously were PCT positive. The odds of one positive and two positive for one way 1.714 (P=0.015) times and 1.212(P=0.785) times were higher than the group without reflux. However the odds of 4 positive for one way 0.239 (P=0.3) times was lower than control group. The positive and negative predictive values of the serum level of PCT were 40% and 90%, respectively. In this respect, 50% of the samples diagnosed by serum level of PCT were false positive and 12% were false negative. It meant that sensitivity and specificity of PCT measurement were 90% and 50%, respectively. The kappa score for the level of serum PCT was 0.5 (P < 0.0001). The positive predictive value of serum PCT for the female and male samples was 42% and 54% respectively. Conclusion: No statistically significant relationship between vesicoureteral reflux and the serum level of PCT.