Rapid CRP Test in Early Detection of Serious Bacterial Infection in Egyptian Children

Background: CRP is a commonly used marker of inflam-mation to select serious bacterial infections (SBI). Difficult accessibility in segregated districts clinics lowers of its value for rapid prediction and start of antibiotics. A bed site rapid test is supposed to solve this problem provided having at least the same accuracy in documenting bacterial infection. Patients and Methods: 96 patients of pediatric age group presenting with acute infections were subjected to CRP laboratory and radioimmunoassay Actim CRP rapid test. The definitive diagnosis was confirmed without both tests inter-ference. Results: Of the 96 cases, 49 had simple infections and 47 SBI. Of them, 26 patients had streptococcal pharyngo-tonsillitis, 10 patients had bacterial pneumonia and 11 patients had sepsis. The sensitivity, specificity, negative predictive value, positive predictive value of CRP to serious bacterial infection were 91.5%, 59.2%, 68.3% and 87.9% respectively. While that of Actim rapid test were 89.4%, 63.3%, 70.0% and 86.1% respectively. The receiver-operating characteristic (ROC) area under the curve for CRP laboratory was 75.3% and that for Actim 76.3%. Conclusion: CRP laboratory and Actim are quite similar in predicting SBI. However, Actim is slightly more accurate and definitively more practical as regard time and space. Serial evaluation of rapid test increases of its sensitivity and negative predictive value to SBI. We can accept a low speci- ficity and positive predictive value as the test is affected by non serious bacterial infection.