BACKGROUND: Hospital-acquired pneumonia (HAP) is a common complication after abdominal surgery. The aim of this study was to evaluate the role of procalcitonin (PCT) and C-reactive protein (CRP) as early biomarkers for the diagnosis of postoperative HAP after abdominal surgery. METHODS: This study was conducted on 100 patients undergoing abdominal surgery. White blood cell counts, highest body temperature, and serum levels of CRP and PCT were recorded preoperatively and daily postoperatively until postoperative day (POD) 5. Chest radiography was performed preoperatively and daily postoperatively until POD 5. RESULTS: HAP was diagnosed in 14% of patients. Regarding the biomarkers studied after POD 1, CRP and PCT were significantly higher in patients with HAP than in those without HAP (P < 0.05). On POD 2, PCT had higher sensitivity and specificity (84% and 72%, respectively) than those for CPR (70% and 60%, respectively). The cut-off value of PCT on POD 2 was 1.4 ng/ml. On POD 3, 4, and 5, the sensitivity and specificity of PCT and CRP were not significantly different. CONCLUSIONS: PCT and CRP are accurate biomarkers for early prediction of postoperative HAP after abdominal surgery. The diagnostic ability of PCT was significantly better than that of CRP on POD 2. After POD 2, the diagnostic ability was not significantly different between the biomarkers.
Biomarkers ; Body Temperature ; C-Reactive Protein ; Cardiopulmonary Resuscitation ; Diagnosis ; Humans ; Leukocyte Count ; Pneumonia* ; Radiography ; Sensitivity and Specificity ; Thorax

Objective To determine the prevalence of astrovirus, norovirus, adenovirus in children below five years old with diarrhea by multiplex reverse transcriptase polymerase chain reaction (RT-PCR) along with rotavirus antigen detection by enzyme linked immunosorbant assay. Methods The study was conducted on children below five years old complaining of acute diarrhea. The study included stool examination by molecular method for detection of norovirus, adenovirus and astrovirus by multiplex RT-PCR. Rotavirus antigen was detected in the stool by enzyme linked immunosorbant assay. Results The study included 100 children below 5 years old with acute diarrhea. Multiplex RT-PCR was positive in 34% of the children. The most frequently detected virus was rotavirus (44%), followed by norovirus (30%), adenovirus (20%) and astrovirus (14%). The clinical symptoms were more significantly associated with viral diarrhea such as fever (P = 0.03), bloody diarrhea (P = 0.025), vomiting (P = 0.000 1) and watery diarrheas (P = 0.05). The frequency of diarrhea with viral pathogen was significantly presented in winter season (39.7%). There were significant frequencies of norovirus and adenovirus in age ranging 1–2 years old (P = 0.04, P = 0.01 respectively). Conclusions The present study spotlights on the prevalence of viral pathogens as an important etiology in diarrhea in children below five years old. Astrovirus, norovirus and adenovirus are common along with rotavirus in this group of patients. Multiplex PCR leads to improve the laboratory diagnosis of these viruses along with antigen detection method. Further longitudinal studies are required to evaluate the epidemiological data associated with these viruses and for proper management of such drastic infection.