Diagnostic and Differential Effects of CRP and PCT on Respiratory Virus and Mycoplasma Pneumoniae Infections in Children with Respiratory Tract Infections: A Meta-Analysis
,
Abstract
Background: This study aimed to investigate the differential diagnostic value of CRP and PCT in distinguishing viral and Mycoplasma pneumonia infections in children with respiratory tract infections.
Methods: A total of 13 relevant articles (12 of relatively high quality) were included after quality evaluation, through a literature search. Meta-analysis and SROC curve evaluation were performed.
Results: The pooled sensitivity and specificity of CRP diagnosis were 0.91 (95% CI: 0.893-0.937) and 0.4815 (95% CI: 0.440-0.523), respectively, and the area under the SROC curve was 0.699. The pooled sensitivity and specificity of PCT were 68.92% (95% CI: 64.9%-72.7%) and 50.00% (95% CI: 45.6%-54.4%), respectively, and the area under the curve was 0.595.
Conclusion: CRP demonstrated higher sensitivity, while PCT showed relatively better specificity. Using both together could improve diagnostic performance.
1. Reed KD (2015). Respiratory Tract Infec-tions: A Clinical Approach. Mol Med Mi-crobiol, 1499–1506.
2. Smith DK, Kuckel DP, Recidoro AM (2021). Community-Acquired Pneumonia in Children: Rapid Evidence Review. Am Fam Physician 104(6):618-625.
3. Hammitt LL, Murdoch DR, Scott JA, et al (2012). Specimen collection for the di-agnosis of pediatric pneumonia. Clin In-fect Di: 54(Suppl 2):S132–S139.
4. Neuman MI, Monuteaux MC, Scully KJ, et al (2011). Prediction of pneumonia in a pediatric emergency department. Pediatr 128(2):246-53.
5. Dworsky ZD, Lee B, Ramchandar N, et al (2022). Impact of Cell-Free Next-Generation Sequencing on Management of Pediatric Complicated Pneumonia. Hosp Pediatric :12(4):377-384.
6. Liang G, Zheng L (2020). A transfer learn-ing method with deep residual network for pediatric pneumonia diagnosis. Comput Methods Programs Biomed: 187:104964.
7. Florin TA, Tancredi DJ, Ambroggio L, et al (2020). Pediatric Emergency Research Networks (PERN) Pneumonia Investiga-tors. Predicting severe pneumonia in the emergency department: a global study of the Pediatric Emergency Research Networks (PERN)-study protocol. BMJ Open 10(12):e041093.
8. Huawen L, Rinuan W, Qiyan Y, et al (2022). Clinical and laboratory characteristics of 200 children with respiratory tract in-fection. Chin J Nosocomiol 32(21):3357-3360.
9. Li Y, Min L, Zhang X (2021). Usefulness of procalcitonin (PCT), C-reactive protein (CRP), and white blood cell (WBC) lev-els in the differential diagnosis of acute bacterial, viral, and mycoplasmal respir-atory tract infections in children. BMC Pulm Med 26;21(1):386.
10. Zhiqiang Z (2022). Characteristics of WBC, CRP, PCT levels in peripheral blood of children with different types of pneu-monia pathogens and their relationship with the severity of pneumonia in chil-dren. Jiangxi Med J 57(12):2196-2197.
11. Shoujuan L, Xibo F, Zhihua W, et al (2021). Characteristics and correlation of WBC, CRP and PCT levels in peripheral blood and serum of different types of pneu-monia pathogens in children. J Clin Exp Med 20(06):667-670.
12. Xiaoqiao L, Rui T (2017). Clinical Value of WBC CRP and PCT in Children with Respiratory Tract Infection Caused by Different Pathogens. Hebei Med 23(4):561-564.
13. Alcoba G, Keitel K, Maspoli V, et al (2017). A three-step diagnosis of pediatric pneumonia at the emergency depart-ment using clinical predictors, C-reactive protein, and pneumococcal PCR. Eur J Pediatr 176(6):815-824.
14. Maohao Z (2016). Clinical significance of serum procalcitonin detection in the early diagnosis of bacterial pneumonia in children. Chin J Infect Control 15(10):800-801.
15. Xiaomei H (2015). Practical value analysis of procalcitonin, C-reactive protein, and white blood cell count in the diagnosis of pediatric pneumonia. Chin J Lab Diag 12(1):53-55.
16. Jinhong G (2015). The Application of PCT and CRP in the Diagnosis of Infectious Pneumonia in Children. Hebei Med J (24):3765-3767.
17. Yingrong L, Jinbiao J, Lingling L, Danfeng P (2014). CRP and PCT test value for early diagnosis of children's lower res-piratory infection. Chin Med Herald 11(8):88-90.
18. Ruili Z (2015). Clinical value of C-reactive protein combined with procalcitonin in detecting acute respiratory tract infec-tions in children. Chin Remed Clin 10(5):717-719.
19. Huali Z, Chao W, Rui Z, et (2016). Diagnos-tic value of high sensitive C reactive protein, calcitonin, and immune func-tion in children with pneumonia. Chin Med Equipment 13(12):109-111,112.
20. Yanmin G, Zhe W, Xiaomin W (2019). Clinical study on changes in procalci-tonin, hypersensitive C-reactive protein, and cellular immune indicators in chil-dren with pneumonia. Chin J Lab Diag 23(9):1579-1580.
21. Hassan MZ, Chowdhury MAB, Hassan I, et al (2019). Respiratory viral infection in early life and development of asthma in childhood: A protocol for systematic review and meta-analysis. Medicine (Balti-more). 98(18): e15419.
22. Yu Y, Yang T, Ding Z, et al (2022). Circ_0026579 alleviates LPS-induced WI-38 cells inflammation injury in infantile pneumonia. Innate Immun: 2022, 28(1):37-48.
23. Chaabna K, Doraiswamy S, Mamtani R, et aL (2021). Facemask use in community settings to prevent respiratory infection transmission: A rapid review and meta-analysis. Int J Infect Dis: 104:198-206.
24. Walter JM, Wunderink RG (2018). Testing for Respiratory Viruses in Adults with Severe Lower Respiratory Infection. Chest: 154(5):1213-1222.
25. Chen L, Chen Y, Huang J, et al (2022). LncRNA LINC00707 serves as a sponge of miR-382-5p to alleviate lipopolysac-charide (LPS)-induced WI-38 cell injury through upregulating NKAP in infantile pneumonia. Autoimmunity: 55(5):328-338.
26. Pscheidt VM, Gregianini TS, Martins LG, ET AL (2021). Epidemiology of human adenovirus associated with respiratory infection in southern Brazil. Rev Med Vi-rol. 31(4):e2189.
27. Forton JT (2019). Detecting respiratory in-fection in children with cystic fibrosis: Cough swab, sputum induction or Bron-cho alveolar lavage. Paediatr Respir Rev 31:28-31.
2. Smith DK, Kuckel DP, Recidoro AM (2021). Community-Acquired Pneumonia in Children: Rapid Evidence Review. Am Fam Physician 104(6):618-625.
3. Hammitt LL, Murdoch DR, Scott JA, et al (2012). Specimen collection for the di-agnosis of pediatric pneumonia. Clin In-fect Di: 54(Suppl 2):S132–S139.
4. Neuman MI, Monuteaux MC, Scully KJ, et al (2011). Prediction of pneumonia in a pediatric emergency department. Pediatr 128(2):246-53.
5. Dworsky ZD, Lee B, Ramchandar N, et al (2022). Impact of Cell-Free Next-Generation Sequencing on Management of Pediatric Complicated Pneumonia. Hosp Pediatric :12(4):377-384.
6. Liang G, Zheng L (2020). A transfer learn-ing method with deep residual network for pediatric pneumonia diagnosis. Comput Methods Programs Biomed: 187:104964.
7. Florin TA, Tancredi DJ, Ambroggio L, et al (2020). Pediatric Emergency Research Networks (PERN) Pneumonia Investiga-tors. Predicting severe pneumonia in the emergency department: a global study of the Pediatric Emergency Research Networks (PERN)-study protocol. BMJ Open 10(12):e041093.
8. Huawen L, Rinuan W, Qiyan Y, et al (2022). Clinical and laboratory characteristics of 200 children with respiratory tract in-fection. Chin J Nosocomiol 32(21):3357-3360.
9. Li Y, Min L, Zhang X (2021). Usefulness of procalcitonin (PCT), C-reactive protein (CRP), and white blood cell (WBC) lev-els in the differential diagnosis of acute bacterial, viral, and mycoplasmal respir-atory tract infections in children. BMC Pulm Med 26;21(1):386.
10. Zhiqiang Z (2022). Characteristics of WBC, CRP, PCT levels in peripheral blood of children with different types of pneu-monia pathogens and their relationship with the severity of pneumonia in chil-dren. Jiangxi Med J 57(12):2196-2197.
11. Shoujuan L, Xibo F, Zhihua W, et al (2021). Characteristics and correlation of WBC, CRP and PCT levels in peripheral blood and serum of different types of pneu-monia pathogens in children. J Clin Exp Med 20(06):667-670.
12. Xiaoqiao L, Rui T (2017). Clinical Value of WBC CRP and PCT in Children with Respiratory Tract Infection Caused by Different Pathogens. Hebei Med 23(4):561-564.
13. Alcoba G, Keitel K, Maspoli V, et al (2017). A three-step diagnosis of pediatric pneumonia at the emergency depart-ment using clinical predictors, C-reactive protein, and pneumococcal PCR. Eur J Pediatr 176(6):815-824.
14. Maohao Z (2016). Clinical significance of serum procalcitonin detection in the early diagnosis of bacterial pneumonia in children. Chin J Infect Control 15(10):800-801.
15. Xiaomei H (2015). Practical value analysis of procalcitonin, C-reactive protein, and white blood cell count in the diagnosis of pediatric pneumonia. Chin J Lab Diag 12(1):53-55.
16. Jinhong G (2015). The Application of PCT and CRP in the Diagnosis of Infectious Pneumonia in Children. Hebei Med J (24):3765-3767.
17. Yingrong L, Jinbiao J, Lingling L, Danfeng P (2014). CRP and PCT test value for early diagnosis of children's lower res-piratory infection. Chin Med Herald 11(8):88-90.
18. Ruili Z (2015). Clinical value of C-reactive protein combined with procalcitonin in detecting acute respiratory tract infec-tions in children. Chin Remed Clin 10(5):717-719.
19. Huali Z, Chao W, Rui Z, et (2016). Diagnos-tic value of high sensitive C reactive protein, calcitonin, and immune func-tion in children with pneumonia. Chin Med Equipment 13(12):109-111,112.
20. Yanmin G, Zhe W, Xiaomin W (2019). Clinical study on changes in procalci-tonin, hypersensitive C-reactive protein, and cellular immune indicators in chil-dren with pneumonia. Chin J Lab Diag 23(9):1579-1580.
21. Hassan MZ, Chowdhury MAB, Hassan I, et al (2019). Respiratory viral infection in early life and development of asthma in childhood: A protocol for systematic review and meta-analysis. Medicine (Balti-more). 98(18): e15419.
22. Yu Y, Yang T, Ding Z, et al (2022). Circ_0026579 alleviates LPS-induced WI-38 cells inflammation injury in infantile pneumonia. Innate Immun: 2022, 28(1):37-48.
23. Chaabna K, Doraiswamy S, Mamtani R, et aL (2021). Facemask use in community settings to prevent respiratory infection transmission: A rapid review and meta-analysis. Int J Infect Dis: 104:198-206.
24. Walter JM, Wunderink RG (2018). Testing for Respiratory Viruses in Adults with Severe Lower Respiratory Infection. Chest: 154(5):1213-1222.
25. Chen L, Chen Y, Huang J, et al (2022). LncRNA LINC00707 serves as a sponge of miR-382-5p to alleviate lipopolysac-charide (LPS)-induced WI-38 cell injury through upregulating NKAP in infantile pneumonia. Autoimmunity: 55(5):328-338.
26. Pscheidt VM, Gregianini TS, Martins LG, ET AL (2021). Epidemiology of human adenovirus associated with respiratory infection in southern Brazil. Rev Med Vi-rol. 31(4):e2189.
27. Forton JT (2019). Detecting respiratory in-fection in children with cystic fibrosis: Cough swab, sputum induction or Bron-cho alveolar lavage. Paediatr Respir Rev 31:28-31.
| Files | ||
| Issue | Vol 54 No 8 (2025) | |
| Section | Review Article(s) | |
| DOI | https://doi.org/10.18502/ijph.v54i8.19575 | |
| Keywords | ||
| Respiratory tract infection Respiratory virus Mycoplasma infection | ||
| Rights and permissions | |
|
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
How to Cite
1.
Hu C, Xu Y, Sheng F, Chen B, Cao L. Diagnostic and Differential Effects of CRP and PCT on Respiratory Virus and Mycoplasma Pneumoniae Infections in Children with Respiratory Tract Infections: A Meta-Analysis. Iran J Public Health. 2025;54(8):1667-1677.
