• Efraim Bilavsky, Havatzelet Yarden-Bilavsky, Shai Ashkenazi, and Jacob Amir.
• Department of Paediatrics C, Schneider Children's Medical Center of Israel, Petah Tiqva, Israel. yoji@netvision.net.il
• Acta Paediatr. 2009 Nov 1; 98 (11): 1776-80.

ObjectiveTo determine the potential predictive power of C-reactive protein (CRP) as a marker of serious bacterial infection (SBI) in hospitalized febrile infants aged < or =3 months.Patients And MethodsData on blood CRP levels were collected prospectively on admission for all infants aged < or =3 months who were hospitalized for fever from 2005 to 2008. The patients were divided into two groups by the presence or absence of findings of SBI.ResultsA total of 892 infants met the inclusion criteria, of whom 102 had a SBI. Mean CRP level was significantly higher in the infants who had a bacterial infection than in those who did not (5.3 +/- 6.3 mg/dL vs. 1.3 +/- 2.2 mg/dL, p < 0.001). The area under the ROC curve (AUC) was 0.74 (95% CI: 0.67-0.80) for CRP compared to 0.70 (95% CI: 0.64-0.76) for white blood cell (WBC) count. When analyses were limited to predicting bacteremia or meningitis only, the AUCs for CRP and WBC were 0.81 (95% CI: 0.66-0.96) and 0.63 (95% CI: 0.42-0.83), respectively.ConclusionC-reactive protein is a valuable laboratory test in the assessment of febrile infants aged < or =3 months old and may serve as a better diagnostic marker of SBI than total WBC count.

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