Proadrenomedullin and copeptin in pediatric pneumonia: a prospective diagnostic accuracy study.

Abstract

BACKGROUND:

Community-acquired-pneumonia is the leading cause of child mortality worldwide. Very few studies have explored the predictive value of Proadrenomedullin and Copeptin in pediatric severe pneumonia and bacteremia.

METHODS:

Proadrenomedullin and Copeptin were assessed as predictors for complicated community-acquired pneumonia (bacteremia, empyema) in 88 children aged 0 to 16 years presenting to the pediatric emergency department, using B.R.A.H.M.S. Kryptor Compact pro-ADM and Copeptin with the TRACE technology (time-resolved amplified cryptase emission). STARD standard reporting was used.

RESULTS:

A complicated community-acquired pneumonia was found in 11 out of 88 children (12.5 %). Proadrenomedullin median values increased more than twofold, in complicated vs. uncomplicated (0.18 vs. 0.08 nmol/L, p = 0.039), and fivefold in bacteremic vs. non-bacteremic pneumonia (0.40 vs. 0.08 nmol/L, p = 0.02). Proadrenomedullin > 0.16 nmol/L showed 100 % sensitivity (95 % CI 39.8 - 100.0) and 70 % (95 % CI 58.7 - 79.7) specificity for bacteremia. Copeptin showed no added-value.

CONCLUSIONS:

Proadrenomedullin seems a reliable and available predictor for complicated CAP, and could therefore help the physician with the decision to hospitalize, and choose the antibiotics administration route. Larger studies are needed.

• Authors: Gabriel Alcoba, Sergio Manzano, Laurence Lacroix, Annick Galetto-Lacour, Alain Gervaix
• Journal: BMC infectious diseases (BMC Infect Dis) Vol. 15 Pg. 347 (Aug 19 2015) ISSN: 1471-2334 [Electronic] England
• PMID: 26286191 (Publication Type: Journal Article)

Chemical References

• Biomarkers
• Glycopeptides
• Protein Precursors
• copeptins
• proadrenomedullin
• Adrenomedullin

Topics

• Adolescent
• Adrenomedullin (blood)
• Bacteremia (blood, complications, diagnosis)
• Biomarkers (blood)
• Child
• Child, Preschool
• Cohort Studies
• Community-Acquired Infections (blood, complications, diagnosis)
• Emergency Service, Hospital
• Empyema, Pleural (blood, complications, diagnosis)
• Female
• Glycopeptides (blood)
• Humans
• Infant
• Infant, Newborn
• Logistic Models
• Male
• Pneumonia, Bacterial (blood, complications, diagnosis)
• Prognosis
• Prospective Studies
• Protein Precursors (blood)
• Sensitivity and Specificity