Validity of bacterial pneumonia score for predicting bacteremia in children with pneumonia
Abstract
Background Bacteremia in children with pneumonia reflects a severe condition, with longer duration of hospital care and potentially lethal complications. Early detection of bacteremia in patients with pneumonia may reduce serious complications. Few bacteremia screening tools have been widely used in chidren with pneumonia. One of those tools is the bacterial pneumonia score (BPS).
Objective To assess the validity of the bacterial pneumonia score for predicting bacteremia in pediatric patients with pneumonia.
Methods A diagnostic test was conducted on children aged 1 to 60 months hospitalized with pneumonia from December 2009 to August 2010. Subjects were collected consecutively. Pneumonia was diagnosed using the World Healt Organization (WHO) criteria. Subjects underwent complete blood counts and blood culture examinations at admission. Statistical analyses included sensitivity, specificity, positive and negative predictive value (PPV/NPV), positive and negative likelihood ratio (PLR/NLR), and post-test probability.
Results Our study included 229 children. Based on BPS with a cut-off score of ≥ 4, the sensitivity was 83.3%, specificity 49.7%, PPV 8.4%, NPV 98.2%, PLR 1.66, NLR 0.31, and post-test probability 8.4% for detecting bacteremia in pediatric pneumonia patients.
Conclusion BPS can not be used for predicting bacteremia in pediatric patients with pneumonia.
References
2. Siadi P, Ismoedijanto CK, Sri RHH, Robin H. Streptococcus pneumonia di Indonesia. In: Hanifah O, Sri RHH, Partini PT, Rini S, editors. National symposium on immunization. 2nd ed. Jakarta: IDAI; 2010. p. 63-7.
3. American Thoracic Society. Guidelines for the management of adults with community-acquired pneumonia. Am J Respr Crit Care Med. 2001;163:1730-54.
4. Metersky ML, Ma A, Bratzler DW, Houck PM. Predicting bacteremia in patients with community-acquired pneumonia. Am J Respr Crit Care Med. 2004;169:342-7.
5. Moreno M, Krishnan JA, Duren P, Ferero F. Development and validation of a clinical prediction rule to distinguish bacterial from viral pneumonia in children. Pediatric Pulmonology. 2006;41:331-7.
6. Retno S, Landia S, Makmuri S, editors. Pneumoni. Proceedings of the continuing education of child health; 2006 July 29-30; Surabaya, Indonesia. Surabaya: Badan Penerbit Fakultas Kedokteran Unair; 2006.
7. Flaws ML. Bacteremia and sepsis. In: Mahon CR, Lehman DC, Manuselis G, editors. Text book of diagnostic microbiology. 4th ed. Missouri: WB Saunders; 2011. p. 867-80.
8. Weistein MP, Towns ML, Quartey SM. The clinical significance of positive blood cultures in the 1990: a prospective comprehensive evaluation of the microbiology, epidemiology, and outcome of bacteremia and fungiemia in adults. Clin Infect Dis. 1997;7:584-602.
9. Stephens M, Smith WR, Hitchcock K. Can you differentiate bacterial from viral pediatric infections based on the CBC? Family Physicians Inquiries Network. 2007;56:390-2.
10. Isaacman DJ, Shults J, Gross TK, Davis PH, Harper M. Predictors of bacteremia in febrile children 3 to 36 months of age. Pediatrics. 2000;106:977-82.
11. Prabda P, Sutthi J, Anek K, Teerasak C, Henry C, Somsak T, et al. Epidemiology of radiographically-confirmed and bacteremic pneumonia in Rural Thailand. Southeast Asian J Trop Med Public Health. 2008;39:707-16.
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Published 2011-12-31
