Clinical significance of early detection of serum procalcitonin in children with hand-foot-and-mouth disease complicated by bacterial infection / 中国基层医药

ABSTRACT

Objective:To investigate the clinical significance of early detection of serum procalcitonin in children with hand-foot-and-mouth disease complicated by bacterial infection and provide reference for clinical diagnosis of the disease in children.Methods:A total of 126 children patients with hand-foot-and-mouth disease who received treatment in the First People's Hospital of Taizhou between December 2017 and December 2018 were included in this study. They were assigned into viral plus bacterial infection group and simple viral infection group ( n = 63/group) according to whether they suffered from bacterial infection. An additional 20 healthy children who concurrently received physical examination in the First People's Hospital of Taizhou were included in the control group. Serum levels of interleukin-6, interleukin-10, white blood cell count, C-reactive protein, and procalcitonin were compared among the three groups and bacterial infection was analyzed. Results:Serum levels of interleukin-6, interleukin-10 and C-reactive protein in the simple viral infection group were (3.75 ± 0.76) ng/L, (55.31 ± 11.27) ng/L, (10.91 ± 1.16) mg/L, respectively, which were significantly higher than those in the control group [(1.39 ± 0.41) ng/L, (11.72 ± 9.58) ng/L,(2.16 ± 0.65) ng/L, t = 8.040, 16.982, 7.825, all P < 0.05]. Serum levels of interleukin-6 and interleukin-10 in the bacterial plus viral infection group were (4.10 ± 1.09) ng/L and (66.64 ± 7.42) ng/L, respectively, which were significantly higher than those in the control and simple viral infection groups ( t = 13.088, 9.053, 10.031, 15.021, all P < 0.05). Serum C-reactive protein level in the bacterial plus viral infection group was significantly higher than that in the simple viral infection group [(26.28 ± 4.35) mg/L vs. (10.91 ± 1.16) mg/L, t = 21.938, P < 0.05]. Serum procalcitonin level and white blood cell counts in the bacterial plus viral infection group were (0.63 ± 0.04) μg/L, (15.12 ± 3.97) × 10 9/L, respectively, which were significantly higher than those in the control group [(0.13 ± 0.02) μg/L, (7.93 ± 1.91) × 10 9/L, both P < 0.05] and simple virus infection group [(0.07 ± 0.01) μg/L, (8.78 ± 1.12) × 10 9/L, both P < 0.05]. The infection rates of enterovirus 71 and universal enterovirus in the simple viral infection group were significantly lower than those in the bacterial plus viral infection group ( χ2 = 20.329, 31.924, both P < 0.05). Conclusion:Serum procalcitonin level is highly specific and accurate for the diagnosis of hand-foot-and-mouth disease. Serum procalcitonin level and white blood cell can be used together as a sensitive index to identify whether bacterial infection occurs in children with hand-foot-and-mouth disease.