Authors: Lala, Sanjay¹; Madhi, Shabir²; Pettifor, John¹

Source: Annals of Tropical Paediatrics: International Child Health, Volume 22, Number 3, September 2002 , pp. 271-279(9)

Publisher: Maney Publishing

Abstract:

This study assessed the value of routine CRP measurements to discriminate between bacterial and viral lower respiratory tract infection (LRTI) in HIV-1-infected and-uninfected children. A total of 570 children, prospectively enrolled, were categorised into four aetiological groups, as follows: (i) bacteraemic pneumonia (n=50), (ii) respiratory virus-associated LRTI (n=146), (iii) bacteraemic and respiratory virus-associated (mixed) LRTI (n=10), and (iv) LRTI of undetermined aetiology (n=364). The discriminative ability of threshold CRP values was evaluated, and values predicting bacteraemic pneumonia were used to construct receiver-operating characteristic (ROC) plots. Median CRP values were significantly higher in bacteraemic pneumonia (195 mg/L, p<0.0001), and threshold CRP values ranging from 10 to 100 mg/L differentiated bacteraemic from virus-associated LRTI (p<0.0001). The discriminative ability of CRP values assessed by ROC plots in pneumonia is 80%, and CRP 10 mg/L identified 90% of all bacteraemic pneumonia. In HIV-1 infection, median CRP values were significantly higher in bacteraemic pneumonia (200 mg/L) but correlated with levels in uninfected children, irrespective of LRTI aetiology. Although CRP responses are significantly different in bacteraemic and virus-associated LRTI, the considerable overlap between these aetiological groups hinders selection of threshold CRP values that are clinically useful in differentiating bacteraemic from virus-associated LRTI pneumonia.

Keywords:

Document Type: Research Article

DOI: http://dx.doi.org/10.1179/027249302125001570

Affiliations: 1: Department of Paediatrics and Child Health, University of the Witwatersrand, Johannesburg, South Africa 2: Department of Paediatrics and Child Health and Paediatric Infectious Diseases Research Unit, University of the Witwatersrand, Johannesburg, South Africa

Publication date: 2002-09-01

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• In 2012 Annals of Tropical Paediatrics changed its name to Paediatrics and International Child Health to reflect changes and developments in the subject area. View the issues of Paediatrics and International Child Health available online.
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