Work

Neutrophil-to-Lymphocyte Ratio and Other Complete Blood Count Parameters in the Diagnosis of Serious Bacterial Infections in Febrile Infants Under Three Months

Year: 2024

Type: article

Abstract: BACKGROUND: The incidence of serious bacterial infections (SBI) in febrile infants under three months is high. Complete blood count parameters, an easily accessible and low-cost test, may have diagnostic potential for SBI. OBJECTIVES: This study evaluated the efficacy of absolute neutrophil count (ANC), neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR), platelet-to-lymphocyte ratio (PLR), platelet-to-mean platelet volume ratio (PLT/MPV), red cell distribution width (RDW), and C-reactive protein (CRP) in distinguishing febrile infants under three months with SBI. METHODS: A random sample of an eight-year registry-based retrospective cohort study included infants aged under three months who were hospitalized with fever. Patients were divided into those with and without SBI. Complete blood count parameters and CRP levels at admission, 24-48 hours, and discharge were compared between the groups. RESULTS: In total, 224 infants were included. At admission, infants with SBI (n=112) had higher median values (p=0.001) of CRP, ANC, and PLR and lower LMR (p=0.001) than those with negative cultures. CRP at admission was the best diagnostic marker for SBI (AUC: 0.857, 95% CI: 0.808-0.907), followed by ANC (AUC: 0.825, 95% CI: 0.772-0.879), NLR (AUC: 0.797, 95% CI: 0.738-0.855), and LMR (AUC: 0.642, 95% CI: 0.570-0.714). The combination of CRP with ANC, NLR, and LMR was found to be superior to any of the single markers (AUC: 0.918, 95% CI: 0.88 to 0.95). The combination of ANC and NLR proved to be a better discriminator compared to each parameter individually (AUC: 0.842, 95% CI: 0.79 to 0.90). At 24-48 hours, CRP continued to perform better, followed by ANC and NLR. At discharge, infants with SBI had higher PLT/MPV compared to those with negative cultures (p=0.009), but no significant differences in other parameters were observed. CONCLUSIONS: The strongest predictor of SBI in febrile infants aged under three months was CRP, while ANC, NLR, and LMR also showed diagnostic potential. The combination of these parameters demonstrates the highest diagnostic value overall.

Source: Cureus

DOI: 10.7759/cureus.75945

Authors: Aikaterini Mikelatou, Maria Eirini Gourtzelidou, Krino Maria Liveri, Athanasios Michos, Tania Siahanidou

Institution: National and Kapodistrian University of Athens

Language: English

Topic: Neonatal and Maternal Infections

Subfield: Public Health, Environmental and Occupational Health

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: diamond

OpenAlex ID: W4405538458