ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2017
Association of C-Reactive Protein With Bacterial and Respiratory Syncytial Virus-Associated Pneumonia Among Children Aged <5 Years in the PERCH Study.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 65 papers, 1 of them a synthesis that pooled it.
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Who cites it
65 citing papers in PubMed, 1 synthesis or guideline pooled it, 106 citations in OpenAlex.
- Can child pneumonia in low-resource settings be treated without antibiotics? A systematic review & meta-analysis.Journal of global health · 2022Pooled it
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- Trial
- Host-response biomarker panels for distinguishing selected acute respiratory viral-bacterial co-infections from mono-infections.iScience · 2026Review
- ERS/ESCMID state-of-the-science statement on the role of rapid diagnostic tests for the diagnosis and management of community-acquired lower respiratory tract infections.The European respiratory journal · 2026Review
- Lung ultrasound combined with C-reactive protein for identifying a bacterial component in children hospitalized with acute lower respiratory tract infections: a prospective observational study.European journal of pediatrics · 2026Observational
- Host-response biomarker MxA for etiological discrimination of pediatric lower respiratory tract infections: implications for diagnostic study design.Translational pediatrics · 2026Review
- Limited discriminatory value of C-reactive protein for viral coinfection and respiratory severity in children evaluated in the emergency department for acute respiratory tract illness.Frontiers in pediatrics · 2026Article
- Prevalence, Risk Factors, and Disease Progression of Severe Pneumonia in a Tertiary Hospital in Ethiopia.Ethiopian journal of health sciences · 2025Article
- Construction and Validation of a Convenient Death Prediction Model for Pediatric Pneumonia Patients in Intensive Care Units.Indian journal of pediatrics · 2025Article
- Performance of procalcitonin point-of-care tests in predicting bacterial causes of acute febrile illness in Northwest Ethiopia.BMC infectious diseases · 2025Article
- Point-of-care lung ultrasound to differentiate bacterial and viral lower respiratory tract infections in pediatric age: a multicenter prospective observational study.Scientific reports · 2025Observational
- Clinical Factors Associated with Inappropriate Antibiotic Use in Children with Acute Bronchiolitis.Children (Basel, Switzerland) · 2025Article
- C-reactive protein and serum amyloid A protein as complementary biomarkers in differentiating viral and bacterial community-acquired pneumonia in children.BMC pediatrics · 2025Article
- Clinical and CT characteristics of human metapneumovirus-associated severe pneumonia in children in Beijing.Italian journal of pediatrics · 2025Article
- Review
- The use of the Prospector calculator reduces antibiotic therapy in exacerbations of chronic obstructive pulmonary disease.Scientific reports · 2025Article
- Etiology and Clinical Prediction of Community-Acquired Lower Respiratory Tract Infection in Children.Journal of Korean medical science · 2025Article
- Comparison between point-of-care testing from capillary samples and conventional laboratory testing from venous samples for white blood cells and C-reactive protein in a pediatric outpatient setting.Journal of general and family medicine · 2025Article
- Identification of circulating Tfh/Th subsets as a biomarker of developed hospital-acquired pneumonia.Frontiers in immunology · 2025Article
5 more citing papers are in PubMed but not listed here.
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Authors and funding
38 authors at 16 institutions in 13 countries.
Funding
Abstract
BACKGROUND.: Lack of a gold standard for identifying bacterial and viral etiologies of pneumonia has limited evaluation of C-reactive protein (CRP) for identifying bacterial pneumonia. We evaluated the sensitivity and specificity of CRP for identifying bacterial vs respiratory syncytial virus (RSV) pneumonia in the Pneumonia Etiology Research for Child Health (PERCH) multicenter case-control study. METHODS.: We measured serum CRP levels in cases with World Health Organization-defined severe or very severe pneumonia and a subset of community controls. We evaluated the sensitivity and specificity of elevated CRP for "confirmed" bacterial pneumonia (positive blood culture or positive lung aspirate or pleural fluid culture or polymerase chain reaction [PCR]) compared to "RSV pneumonia" (nasopharyngeal/oropharyngeal or induced sputum PCR-positive without confirmed/suspected bacterial pneumonia). Receiver operating characteristic (ROC) curves were constructed to assess the performance of elevated CRP in distinguishing these cases. RESULTS.: Among 601 human immunodeficiency virus (HIV)-negative tested controls, 3% had CRP ≥40 mg/L. Among 119 HIV-negative cases with confirmed bacterial pneumonia, 77% had CRP ≥40 mg/L compared with 17% of 556 RSV pneumonia cases. The ROC analysis produced an area under the curve of 0.87, indicating very good discrimination; a cut-point of 37.1 mg/L best discriminated confirmed bacterial pneumonia (sensitivity 77%) from RSV pneumonia (specificity 82%). CRP ≥100 mg/L substantially improved specificity over CRP ≥40 mg/L, though at a loss to sensitivity. CONCLUSIONS.: Elevated CRP was positively associated with confirmed bacterial pneumonia and negatively associated with RSV pneumonia in PERCH. CRP may be useful for distinguishing bacterial from RSV-associated pneumonia, although its role in discriminating against other respiratory viral-associated pneumonia needs further study.
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