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Comment & Response |

Use of Procalcitonin Assays to Predict Serious Bacterial Infection in Young Febrile Infants

Philip N. Britton, MBBS, FRACP1
[+] Author Affiliations
1Discipline of Paediatrics and Child Health, Sydney Medical School, University of Sydney
JAMA Pediatr. 2016;170(6):622-623. doi:10.1001/jamapediatrics.2016.0379.
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To the Editor Thank you for publishing the study of Milcent et al1 reporting the test characteristics of procalcitonin for the assessment of febrile infants. The authors should be congratulated on this large, observational study and their detailed analysis; in particular, I am pleased at their decision to analyze invasive bacterial infection (IBI) as distinct from serious bacterial infection. They are correct to separate out urinary tract infection, which can be diagnosed with a high degree of certainty using urinalysis/microscopy without needing additional markers.2 They have confirmed the low prevalence (pretest probability) of IBI—0.6% to 1.0% for bacteremia and 0.4% to 0.6% for meningitis (0.5%-0.8% and 0.2%-0.4%, respectively, if the infant is 31-91 days old)1—in febrile infants in areas with comprehensive immunization.3

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Correspondence

January 1, 2016
Karen Milcent, MD, MSc; Sabine Faesch, MD; Christèle Gras-Le Guen, MD, PhD; François Dubos, MD, PhD; Claire Poulalhon, MD; Isabelle Badier, MD; Elisabeth Marc, MD; Christine Laguille, MD; Loïc de Pontual, MD, PhD; Alexis Mosca, MD; Gisèle Nissack, MD; Sandra Biscardi, MD; Hélène Le Hors, MD, PhD; Ferielle Louillet, MD; Andreea Madalina Dumitrescu, MD; Philippe Babe, MD; Christelle Vauloup-Fellous, PharmD, PhD; Jean Bouyer, PhD; Vincent Gajdos, MD, PhD
1Department of Pediatrics, Antoine Béclère University Hospital, Assistance Publique-Hôpitaux de Paris, Clamart, France2INSERM, CESP Centre for Research in Epidemiology and Population Health, Paris-Sud, Paris-Saclay University, Villejuif, France
3Pediatric Emergency Department, Paris Descartes University, Necker Enfants Malades Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
4Department of Pediatrics, Hôpital Mère Enfant, Nantes University Hospital, Nantes, France
5Pediatric Emergency Unit and Infectious Diseases, Lille University, Lille, France
2INSERM, CESP Centre for Research in Epidemiology and Population Health, Paris-Sud, Paris-Saclay University, Villejuif, France
6Department of Pediatrics, Poissy Hospital, Poissy, France
7Department of Pediatrics, Kremlin Bicêtre University Hospital, Assistance Publique-Hôpitaux de Paris, Le Kremlin-Bicêtre, France
8Department of Pediatrics, Dupuytren University Hospital, Limoges, France
9Department of Pediatrics, Jean Verdier Hospital, Assistance Publique-Hôpitaux de Paris, Paris 13 University, Bondy, France
10Department of Pediatrics, Sud Francilien Hospital, Corbeil-Essonnes, France
11Department of Pediatrics, Centre Hospitalier de Marne La Vallée, Jossigny, France
12Department of Pediatrics, Créteil Hospital, Créteil, France
13Department of Paediatric Surgery, Hôpital d'Enfants de La Timone, Marseille, France
14Department of Pediatrics, Rouen University Hospital, Rouen, France
15Department of Pediatrics, Louis Mourier University Hospital, Assistance Publique-Hôpitaux de Paris, Colombes, France
16Pediatric Emergency Unit, Hôpitaux Pédiatriques de Nice, CHU Lenval, Nice, France
17Assistance Publique-Hôpitaux de Paris, Hôpital Paul Brousse, Virologie, National Reference Laboratory for Maternofetal Rubella Infections, Villejuif, France
JAMA Pediatr. 2016;170(1):62-69. doi:10.1001/jamapediatrics.2015.3210.
June 1, 2016
James W. Antoon, MD, PhD; Michael J. Steiner, MD, MPH
1Department of Pediatrics and Adolescent Medicine, Children's Hospital, University of Illinois Hospital and Health Sciences System, Chicago
2Division of General Pediatrics and Adolescent Medicine, Department of Pediatrics, North Carolina Children’s Hospital, University of North Carolina School of Medicine, Chapel Hill
JAMA Pediatr. 2016;170(6):623. doi:10.1001/jamapediatrics.2016.0382.
June 1, 2016
Karen Milcent, MD, PhD; Vincent Gajdos, MD, PhD
1Department of Pediatrics, Antoine Béclère University Hospital, Assistance Publique-Hôpitaux de Paris, Clamart, France2Université Paris-Sud, INSERM, CESP Centre for Research in Epidemiology and Population Health, Villejuif, France
JAMA Pediatr. 2016;170(6):623-624. doi:10.1001/jamapediatrics.2016.0385.
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