Title : Diagnostic reliability of procalcitonin in paediatric sepsis: Insights from Southeast Asia
Abstract:
Background: Early identification of paediatric sepsis remains a clinical challenge, particularly in resource-limited settings. Procalcitonin (PCT) has emerged as a promising biomarker for bacterial infection and sepsis, but its diagnostic accuracy in the paediatric population requires further evaluation. This study aimed to assess the diagnostic performance of PCT in paediatric sepsis and its correlation with C-reactive protein (CRP) and total white cell count (TWC).
Methods: A retrospective descriptive study was conducted at Hospital Sultanah Nur Zahirah (HSNZ), Terengganu, Malaysia. Children age 1 month to 18 years who fulfilled systemic inflammatory response syndrome (SIRS) criteria with confirmed or suspected sepsis were included. Sensitivity, specificity, and area under the curve (AUC), were calculated using Analyse-it software. Correlations between PCT, CRP, and TWC were analysed using Spearman's rank correlation.
Results: Among 242 paediatric patient, PCT showed a sensitivity of 76.0% and specificity of 73.5%, with an AUC of 0.747 (95% CI: 0.692–0.802). PCT was moderately correlated with CRP (r = 0.546, p < 0.001) but not with TWC (r = 0.052).
Conclusion: PCT demonstrates moderate diagnostic accuracy in paediatric sepsis and may serve as a useful adjunct to clinical assessment. Prospective studies are needed to refine its role in paediatric sepsis protocols and to explore optimal cutoff values.
Keywords: Procalcitonin, paediatric sepsis, sepsis, biomarker.
