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  • Title: C-reactive protein concentrations can help to determine which febrile infants under three months should receive blood cultures during influenza seasons.
    Author: Li W, Luo S, Zhu Y, Wen Y, Shu M, Wan C.
    Journal: Acta Paediatr; 2017 Dec; 106(12):2017-2024. PubMed ID: 28799220.
    Abstract:
    AIM: We explored whether C-reactive protein (CRP) concentrations could indicate which infants with fever without source (FWS) should receive undergo blood culture tests during influenza seasons. METHODS: This retrospective study focused on patients under three months of age with FWS who had received blood culture tests at the West China Second University Hospital Paediatric Emergency Department during the influenza seasons from June 2013 to January 2015. The statistical analysis comprised specificity, sensitivity, multilevel likelihood ratios (LRs), receiver operating characteristic analysis and a multivariate logistic regression model. RESULTS: We enrolled 592 febrile patients and 7.1% had bacteraemia, with levels falling with increasing age. According to the receiver operating characteristic analysis, the optimum threshold of CRP was 30.5 mg/L, and when the CRP level was higher than 30.5 mg/L, the positive LR of bacteraemia was 2.32. In patients aged 29-90 days, when the CRP level was higher than 5 mg/L, the negative LR of bacteraemia was 0.38. In the neonatal group, a CRP level of ≥30.5 mg/L had a positive LR of bacteraemia of 3.55. CONCLUSION: We found that CRP concentrations could indicate which febrile children under three months of age should undergo blood culture tests during influenza seasons.
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