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Use of procalcitonin as a biomarker for sepsis in moderate to major paediatric burns

Research output: Contribution to journalArticle

Original languageEnglish
Pages (from-to)192-200
Number of pages9
Issue number3
Early online date27 Mar 2018
DateAccepted/In press - 25 Jan 2018
DateE-pub ahead of print - 27 Mar 2018
DatePublished (current) - 1 Jul 2019


Introduction: Accurate and early detection of sepsis poses a significant challenge in burn populations. Our objective was to assess whether procalcitonin is a marker of blood culture positive sepsis in moderate to severe paediatric burns. Methods: We analysed procalcitonin levels in 27 children admitted with burns of 15–65% total body surface area. Procalcitonin was measured at admission (baseline), 24 and 48 h post-admission and during periods of suspected sepsis (diagnosed against pre-defined criteria). Patients were categorised into controls with no episodes of suspected sepsis (n = 10) and those with episodes of suspected sepsis (n = 17). The latter were split into two groups based on blood culture results: culture positive (bacteraemia) and culture negative patients. Results: Baseline procalcitonin levels increased with burn size (odds ratio (95% confidence interval): 1.15 (1.02–1.29)). Suspected sepsis patients had larger burns than controls (median 31 vs. 20%; p = 0.003). Only 5/23 suspected sepsis episodes were blood culture positive. Procalcitonin levels were similar in culture positive and culture negative patients (p = 0.43). Sensitivity for predicting positive blood culture was 100% (95% confidence interval: 47.8–100.0%) but specificity was only 22.2% (95% confidence interval: 6.4–47.6%). Area under the curve was poor at 0.62 (95% confidence interval: 0.33–0.90). There was no significant change in procalcitonin levels from baseline to septic episode in either group (positive: p = 0.35; negative: p = 0.95). Conclusion: We conclude that evidence for the use of procalcitonin to diagnose bacteraemia in this population is poor, with burn size playing a significant role implying a correlation with systemic inflammation rather than sepsis.

    Research areas

  • Procalcitonin, sepsis, burn injury, children, C-reactive protein

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    Rights statement: This is the author accepted manuscript (AAM). The final published version (version of record) is available online via SAGE at Please refer to any applicable terms of use of the publisher.

    Accepted author manuscript, 526 KB, PDF document


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