Procalcitonin and Presepsin as Markers of Infectious Respiratory Diseases in Children: A Scoping Review of the Literature

Abstract

Introduction: Procalcitonin and presepsin have been suggested to be able to discriminate bacterial and viral infections, also in children. This scoping review aims to better explore the available evidence around the potential role of these biomarkers in the subgroup of children with respiratory infectious diseases. Methods: We performed a systematic scoping review of studies published until March 2023 in the following bibliographic databases: PubMed, EMBASE, Cochrane and SCOPUS. Results: In children with bacterial infection, procalcitonin values ranged from 0.5 ng/mL to 8.31 ng/dL, while in those hospitalized in an intensive care unit ranged from 0.6 ng/dL to 452.8 ng/dL with PCR from 2 ng/dL to 51.7 ng/dL. In children with viral infections, procalcitonin value values ranged from 0.2 ng/dL to 0.84 ng/dL, while in those hospitalized in an intensive care unit ranged from 0.61 ng/dL to 46.6 ng/dL. No studies on presepsin in children with respiratory infections were retrieved. Conclusions: Although the available literature is highly heterogeneous, evidence does not suggest a role of procalcitonin in accurately differentiating bacterial and viral infections in children with respiratory infections. In future, new approaches based on multiple markers may better help determine which febrile children require antibiotics.

Determinants of antibiotic prescription in children with adenovirus respiratory tract infections

“…In fact, previous studies showed that HAdV can present with high CrP values [16][17][18][19][20] and, although the evidence is less straightforward, also high PCT values [21]. In a recent systematic review, we also showed that both CrP and PCT may wrongly classify HAdV infections as bacterial ones [22]. Recent in vitro study has confirmed that the exposure to HAdV induces an immediate and relevant innate host response inducing the release of acute-phase proteins, inducing in alveolar macrophages and peripheral blood mononuclear cells the expression of mRNA of IL-6 and TNF-α [23,24].…”