Serum soluble ST2 as diagnostic marker of systemic inflammatory reactive syndrome of bacterial etiology in children

Francesca Ippolita Calò Carducci, Lelia Rotondi Aufiero, Laura Folgori, Anna Chiara Vittucci, Donato Amodio, Maia De Luca, Giuseppina Li Pira, Alberto Bergamini, Giuseppe Pontrelli, Andrea Finocchi, Patrizia D'argenio

Research output: Contribution to journalArticlepeer-review


BACKGROUND:: Accurate and timely diagnosis of community-acquired bacterial versus viral infections in children with systemic inflammatory response syndrome (SIRS) remains challenging both for clinician and laboratory. In the quest of new biochemical markers to distinguish bacterial from viral infection, we have explored the possible role of the soluble secreted form of ST2 (sST2). METHODS:: This explorative prospective cohort study included children with SIRS who were suspected of having community-acquired infections. Plasma samples for sST2 measurement were obtained from 64 hospitalized children, 41 of whom had SIRS of bacterial etiology and 23 SIRS of viral etiology, and from 20 healthy, age- and sex-matched control children. sST2 measurement was carried out by enzyme-linked immunosorbent assay in parallel with standard measurements of procalcitonin (PCT) and C reactive protein (CRP). RESULTS:: Our findings demonstrate that children with SIRS associated with bacterial infection present significantly increased levels of sST2, when compared with patients with SIRS of viral etiology and healthy children. More important, receiver operating characteristic curve analysis indicated that sST2 has a significant diagnostic performance with respect to early identification of SIRS of bacterial etiology, which was similar to that of PCT and greater than that of CRP. Finally, the combination of sST2 plus PCT and/or CRP, and PCT plus CRP increased their sensitivity and negative predictive value compared with sST2, PCT and CRP alone. CONCLUSIONS:: In conclusion, sST2 level may prove useful in predicting bacterial etiology in children with SIRS.

Original languageEnglish
Pages (from-to)199-203
Number of pages5
JournalPediatric Infectious Disease Journal
Issue number2
Publication statusPublished - 2014


  • diagnosis
  • marker
  • pediatric
  • systemic inflammatory response syndrome

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Infectious Diseases
  • Microbiology (medical)


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