{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,22]],"date-time":"2025-11-22T11:41:41Z","timestamp":1763811701268,"version":"3.45.0"},"reference-count":25,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2025,6,26]],"date-time":"2025-06-26T00:00:00Z","timestamp":1750896000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Paediatrica"],"published-print":{"date-parts":[[2025,11]]},"abstract":"ABSTRACT<\/jats:title>\n \n Aim<\/jats:title>\n \n To investigate the diagnostic accuracy of procalcitonin (\n PCT<\/jats:styled-content>\n ), C\u2010reactive protein (\n CRP<\/jats:styled-content>\n ) and absolute neutrophil count (\n ANC<\/jats:styled-content>\n ) to rule out invasive bacterial infections (\n IBI<\/jats:styled-content>\n ) in well\u2010appearing febrile infants aged \u2264\u200960\u2009days.\n <\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n Multicentre study of infants \u2264\u200960\u2009days with fever without source. We calculated the sensitivity, specificity, positive predictive value (\n PPV<\/jats:styled-content>\n ) and negative predictive value (\n NPV<\/jats:styled-content>\n ) of\n ANC<\/jats:styled-content>\n ,\n CRP<\/jats:styled-content>\n and\n PCT.<\/jats:styled-content>\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n We included 2053 well\u2010appearing infants. The sensitivity of\n PCT<\/jats:styled-content>\n >\u20090.5\u2009ng\/mL was 83% (95%\n CI<\/jats:styled-content>\n , 45%\u201399%), the specificity was 90% (95%\n CI<\/jats:styled-content>\n , 88%\u201392%), the\n PPV<\/jats:styled-content>\n was 7.4% (95%\n CI<\/jats:styled-content>\n 2.7\u201315.1) and the\n NPV<\/jats:styled-content>\n was 99.8% (95%\n CI<\/jats:styled-content>\n 99.2\u2013100). The sensitivity of\n CRP<\/jats:styled-content>\n >\u200920\u2009mg\/L was 63% (95%\n CI<\/jats:styled-content>\n , 43%\u201350%) and of\n ANC<\/jats:styled-content>\n >\u20094090\/\u03bcL was 72% (95%\n CI<\/jats:styled-content>\n , 50%\u201389%). There was 1\n IBI<\/jats:styled-content>\n with\n PCT<\/jats:styled-content>\n \u2264\u20090.5\u2009ng\/mL and 9\n IBIs<\/jats:styled-content>\n with\n CRP<\/jats:styled-content>\n \u2264\u200920\u2009mg\/L.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n Procalcitonin showed the highest accuracy for ruling out\n IBI<\/jats:styled-content>\n in well\u2010appearing febrile infants aged \u2264\u200960\u2009days. With a\n PCT<\/jats:styled-content>\n cutoff of 0.5\u2009ng\/mL,\n CRP<\/jats:styled-content>\n and\n ANC<\/jats:styled-content>\n had no extra value in ruling out\n IBIs<\/jats:styled-content>\n , while\n ANC<\/jats:styled-content>\n had an added value with a\n CRP<\/jats:styled-content>\n cutoff of 20\u2009mg\/L. The\n PPV<\/jats:styled-content>\n of\n PCT<\/jats:styled-content>\n >\u20090.5\u2009ng\/\n mL<\/jats:styled-content>\n was low, which can lead to unnecessary investigations, antibiotic treatments and hospitalisations.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/apa.70201","type":"journal-article","created":{"date-parts":[[2025,6,26]],"date-time":"2025-06-26T07:59:12Z","timestamp":1750924752000},"page":"2969-2975","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Accuracy of Inflammatory Biomarkers for Ruling out Invasive Bacterial Infections in Young Febrile Infants"],"prefix":"10.1111","volume":"114","author":[{"given":"Ebba Nordstr\u00f6m","family":"Carlsson","sequence":"first","affiliation":[{"name":"University of Lund Lund Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julie","family":"Ansorge","sequence":"additional","affiliation":[{"name":"University of Lund Lund Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0466-4499","authenticated-orcid":false,"given":"Ioannis","family":"Orfanos","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences Lund University Lund Sweden"},{"name":"Department of Pediatrics Sk\u00e5ne University Hospital Lund Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,6,26]]},"reference":[{"key":"e_1_2_11_2_1","first-page":"1","article-title":"National Hospital Ambulatory Medical Care Survey: 2004 Emergency Department Summary","volume":"372","author":"McCaig L. 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