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Although serum procalcitonin (PCT) is a well-established biomarker, its measurement requires invasive blood sampling. This study investigated the correlation between salivary and serum PCT and evaluated the diagnostic accuracy of salivary PCT for identifying SBIs in infants under 1\u00a0year of age.\u00a0This prospective observational study included 160 infants under one 1 year of age  presenting to a pediatric emergency department with suspected SBI. Paired serum and saliva  samples were collected. Salivary PCT and serum PCT levels were measured. Serum C-reactive  protein (CRP), a routinely used inflammatory marker in pediatric emergency practice, was  included as a comparator biomarker. Patients were classified into SBI and viral infection groups  based on final diagnoses. The diagnostic accuracy of the biomarkers was assessed and  compared using receiver operating characteristic (ROC) curve analysis.Of the 160 infants (median age 8 months; 63% male), 11.3% (\n                    <jats:italic>n<\/jats:italic>\n                    = 18) were diagnosed  with SBI and 88.7% (\n                    <jats:italic>n<\/jats:italic>\n                    = 142) with viral infections. Median salivary PCT levels were markedly  higher in the SBI group than in the viral infection group (69.3 pg\/mL vs. &lt;0.01 pg\/mL;\n                    <jats:italic>p<\/jats:italic>\n                    &lt;  0.001). The area under the curve (AUC) for diagnosing SBI was 0.92 for salivary PCT, 0.96 for  serum PCT, and 0.88 for serum CRP. At a cutoff value of 31.3 pg\/mL, salivary PCT  demonstrated a sensitivity of 89% and a specificity of 92.3%, with a negative predictive value  (NPV) of 98.7%. A weak but statistically significant correlation was found between serum and  salivary PCT levels (r = 0.250;\n                    <jats:italic>p<\/jats:italic>\n                    = 0.001).\u00a0\n                    <jats:italic>Conclusion:<\/jats:italic>\n                    Salivary PCT shows strong correlation with serum PCT and demonstrates high  diagnostic accuracy as a non-invasive biomarker for identifying SBIs in infants. Its performance  approaches that of serum PCT and exceeds that of serum CRP, highlighting its potential clinical  value in reducing the need for invasive blood sampling.\n                    <jats:table-wrap>\n                      <jats:table>\n                        <jats:tbody>\n                          <jats:tr>\n                            <jats:td colspan=\"2\">\n                              <jats:bold>What is Known:<\/jats:bold>\n                              \u2022\n                              <jats:italic>Serum procalcitonin (PCT) is a well-established marker for detecting serious bacterial infections (SBI) in infants, surpassing CRP, though it requires invasive sampling.<\/jats:italic>\n                            <\/jats:td>\n                          <\/jats:tr>\n                          <jats:tr>\n                            <jats:td colspan=\"2\">\n                              <jats:bold>What is New:<\/jats:bold>\n                              \u2022\n                              <jats:italic>Salivary PCT demonstrates comparable diagnostic performance to serum PCT and exceeds CRP, highlighting its potential as a non-invasive alternative for SBI assessment in infants.<\/jats:italic>\n                            <\/jats:td>\n                          <\/jats:tr>\n                        <\/jats:tbody>\n                      <\/jats:table>\n                    <\/jats:table-wrap>\n                  <\/jats:p>","DOI":"10.1007\/s00431-026-06763-3","type":"journal-article","created":{"date-parts":[[2026,1,20]],"date-time":"2026-01-20T11:29:03Z","timestamp":1768908543000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["A comparative evaluation of salivary and serum procalcitonin to identify infants with serious bacterial infections"],"prefix":"10.1007","volume":"185","author":[{"given":"Sercan","family":"\u00c7\u0131narl\u0131","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali","family":"Yurtseven","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caner","family":"Turan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elif","family":"Azars\u0131z","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timur","family":"K\u00f6se","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eylem Ula\u015f","family":"Saz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,1,20]]},"reference":[{"key":"6763_CR1","doi-asserted-by":"publisher","first-page":"106","DOI":"10.1016\/S2352-4642(21)00311-4","volume":"6","author":"J Perin","year":"2022","unstructured":"Perin J, Mulick A, Yeung D et al (2022) Global, regional, and national causes of under-5 mortality in 2000-19: an updated systematic analysis with implications for the sustainable development goals. 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