Preprint Review Version 1 Preserved in Portico This version is not peer-reviewed

Biomarkers and Predictor Models for Serious Bacterial Infections in Febrile Children

Version 1 : Received: 11 December 2023 / Approved: 12 December 2023 / Online: 12 December 2023 (12:56:57 CET)

A peer-reviewed article of this Preprint also exists.

Bernardi, L.; Bossù, G.; Dal Canto, G.; Giannì, G.; Esposito, S. Biomarkers for Serious Bacterial Infections in Febrile Children. Biomolecules 2024, 14, 97. Bernardi, L.; Bossù, G.; Dal Canto, G.; Giannì, G.; Esposito, S. Biomarkers for Serious Bacterial Infections in Febrile Children. Biomolecules 2024, 14, 97.

Abstract

Febrile infections are a common cause of presentation to the emergency department (ED) in chil-dren. While viral infections are usually self-limiting, sometimes bacterial illnesses may lead to sepsis and severe complications. Inflammatory biomarkers such as C reactive protein (CRP) and procalcitonin are usually the first blood exams performed in the ED to differentiate bacterial and viral infections; the better understanding of immunochemical pathways has nowadays led to the discovery of new and more specific biomarkers that could play a role in the emergency setting. The aim of this narrative review is to provide the most recent evidence on biomarkers and predictor models combining them for serious bacterial infections (SBI) diagnosis in febrile children. Litera-ture analysis showed that inflammatory response is a complex mechanism in which many bio-chemical and immunological factors contribute to host response in SBI. CRP and procalcitonin still represent the most used biomarkers in the pediatric ED for the diagnosis of SBI. Their sensibility and sensitivity increase when combined and for this reason it is reasonable to take them both into consideration in the evaluation of a febrile children. The potential of machine learning tools, who represent a real novelty in medical practice, in conjunction with routine clinical and biological in-formation, may improve accuracy of diagnosis and target therapeutic options in SBI. However, studies on this matter are not yet validated in younger populations, making their relevance in pe-diatric precision medicine still uncertain. More data from further researches are needed to improve clinical practice and decision making using these new technologies.

Keywords

biomarker; C reactive protein; interleukin; presepsin; procalcitonin; serious bacterial infection.

Subject

Medicine and Pharmacology, Pediatrics, Perinatology and Child Health

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