Ng’weina Francis Magitta^1,2* and Meshack Denson Shimwela³

¹Ifakara Health Institute (IHI), Biomedical and Laboratory Sciences Thematic Group, Dar es Salaam, Tanzania
²Department of Biochemistry, Mbeya College of Health and Allied Sciences, University of Dar es Salaam, Mbeya, Tanzania
³Department of Internal Medicine, Amana Regional Referral Hospital, Dar es Salaam, Tanzania

*Corresponding Author: Ng’weina Francis Magitta, Ifakara Health Institute (IHI), Biomedical and Laboratory Sciences Thematic Group, Dar es Salaam, Tanzania.

Received: February 13, 2018; Published: March 20, 2018

DOI: 10.31080/ASMI.2018.01.0037

Citation: Ng’weina Francis Magitta and Meshack Denson Shimwela. “Potential Biomarkers for Predicting Bloodstream Bacterial Infection in Tanzanian Children”. Acta Scientific Microbiology 1.4 (2018).

Abstract

Background: Bloodstream bacterial infection is a major cause of morbidity and mortality among children in Africa. The existing biomarkers have limited sensitivity and specificity. Irrational use of antibiotics in non-malarial fevers increases healthcare cost, mor - bidity and accelerate antibiotic resistance.

Objective: To identify potential biomarkers for bloodstream bacterial infection in children for developing a point-of-care diagnostic test in limited-resource setting.

Methods: We obtained blood from children aged less than 5 years with clinically-suspected septicaemia. Blood cultures were per - formed by BACTEC^TM technique followed by bacterial identification using conventional methods and PCR. Using ELISA we analysed previously reported serum biomarkers for bloodstream bacterial infection; procalcitonin (PCT) and C-reactive protein (CRP), lipo- polysaccharide (LPS) and lipoteichoic acid (LTA).

Results: We recruited 79 children, 54% were male, mean age of 34 months. Almost all patients had fever, with a mean duration of sickness of 3.8 days; 92% completed age-appropriate vaccines; 67% received prior antibiotic therapy and 20% had altered con- sciousness. Using box plot, LTA displayed the most sensitivity compared to LPS, PCT and CRP. Further, we used receiver-operating characteristic (ROC) curves to evaluate the performance of the markers based on the subset analysis of 25 samples using quantitative PCR results as a reference. The curves displayed similar sensitivity for PCT and LPS with area under the curve (AUC) of 0.69. Consis - tently, CRP did not perform well in both analyses.

Conclusion: Both PCT and LPS showed acceptable diagnostic thresholds for septicaemia. However, large-powered studies are re- quired for validation prior to their use in clinical practice.

Keywords: Biomarkers; Bloodstream Bacterial Infection; Procalcitonin; C-Reactive Protein; Lipopolysaccharide; Lipoteichoic Acid

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Copyright: © 2018 Ng’weina Francis Magitta and Meshack Denson Shimwela. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.