WIP 07 - Evaluating the Clinical Utility of C-Reactive Protein and Procalcitonin for Bacteremia in Non-Neonatal Pediatric Patients: A 10-year Retrospective Review at an Urban Pediatric Academic Center

Publication Number: WIP 07.7391

Natasha Truesdale, The University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States; Christopher E. Aston, University of Oklahoma College of Medicine, Oklahoma City, OK, United States; Neha Gupta, University of Oklahoma College of Medicine, Oklahoma City, OK, United States

Background: C-reactive protein (CRP) and procalcitonin (PCT) levels are frequently ordered concomitantly in pediatric patients to rule out bacteremia, but the literature is limited with regards to when these labs have the most utility and if both should be ordered; leading to patient discomfort from lab draws, possible delayed diagnoses, and excess healthcare costs. Additionally, these biomarkers have not been well studied in school-aged and adolescent patients as most of the pediatric literature focuses on the utility of CRP and PCT in neonates, infants, and immunocompromised individuals.

Objective: To determine the sensitivity, specificity, diagnostic cut-off, and prognostic values of C-reactive Protein and procalcitonin for the diagnosis of bacteremia in pediatric patients beyond the neonatal period.

Design/Methods: This is a retrospective observational study of pediatric patients aged > to 29 days to < 18 years presenting to our pediatric emergency department from July 1st, 2014 - June 30th, 2024 and had CRP, PCT, and blood cultures performed within 24 hours of the visit.

The study has been approved by our site’s Institutional Review Board. Our team is currently completing an electronic medical chart review of patients meeting inclusion criteria, with data collection completion anticipated by April 1, 2025. Data points collected include: patient demographics, age, symptoms, laboratory data such as white blood count, absolute neutrophil count, PCT, CRP, erythrocyte sedimentation rate, lactate, blood cultures, primary diagnosis, comorbidities, co-infections, presence of a central line, length of hospital stay, complications, and patient disposition.

Group descriptive and comparative statistics will be utilized for data analysis. Group comparisons will use t tests or Mann-Whitney U tests for continuous measures, and Chi-square or Fisher’s exact tests for categorical measures. Receiver operator characteristic curves will be used to evaluate measures, such as CRP and PCT, as classification metrics for diagnosis of bacteremia. Statistical analysis will use R Statistical Software.