Estimating the probability of bacterial infection using a novel biomarker among pediatric patients in the emergency department

Abstract

Context: IL-27 is a novel biomarker to identify bacterial infection in children.

Objective: IL-27 was evaluated among pediatric emergency department (ED) patients and compared with procalcitonin (PCT).

Methods and results: Children undergoing blood, urine, or cerebrospinal fluid cultures had IL-27 and PCT assays performed. Bacterial infection was defined as a positive culture or a clinical diagnosis based on chart review. IL-27 and PCT were increased among patients with bacterial infection and demonstrated comparable AUC’s (0.62 versus 0.61). A decision tree incorporating IL-27, PCT, and white blood cell count improved the AUC (0.80).

Conclusion: IL-27 is a viable candidate biomarker to identify bacterial infection among ED patients and is comparable with PCT.

• Interleukin-27
• IL-27
• procalcitonin
• sepsis

Acknowledgements

The authors wish to acknowledge Terri Byczkowski, PhD, Cincinnati Children’s Hospital Medical Center, Division of Emergency Medicine, for her assistance with study design, sample size calculation, and manuscript review.

Declaration of interest

The Cincinnati Children’s Hospital Research Foundation and Hector R. Wong have submitted a patent application for the use of IL-27 as a sepsis diagnostic biomarker. This research was supported by NIH Grants R01GM099773 and R01GM108025, and an Innovation Grant from the Cincinnati Children’s Hospital Research Foundation.