Work

Predictive role of CRP, MPV and NLR for osteoarticular involvement in brucellosis: a two-center retrospective study

Year: 2026

Type: article

Abstract: Background Brucellosis is a systemic infectious disease frequently associated with various localized complications. This study evaluated the predictive value of baseline C-reactive protein (CRP), neutrophil-to-lymphocyte ratio (NLR), mean platelet volume (MPV), and red cell distribution width (RDW) standardized markers for predicting focal organ involvement in brucellosis patients. Materials and methods This retrospective, two-center study evaluated 230 patients diagnosed with brucellosis between January 2022 and May 2024. Patients were stratified according to the presence of organ involvement, and baseline clinical and laboratory parameters were compared between the cohorts. Results Organ involvement was documented in 54.8% of cases (n = 126). Complicated patients exhibited significantly higher CRP (p < 0.001), NLR (p = 0.016), and neutrophil counts (p = 0.003), alongside lower MPV/ULN (p = 0.026) and RDW/ULN (p = 0.023) ratios. Multivariable logistic regression integrated with internal bootstrap validation (1,000 resamples) confirmed elevated CRP (adjusted OR = 1.034, bootstrap p = 0.018), higher NLR (adjusted OR = 1.393, bootstrap p = 0.028), lower MPV/ULN (adjusted OR = 0.021, bootstrap p = 0.015), and lower RDW/ULN (B = -13.959, bootstrap p = 0.001) as robust independent predictors of focal disease. Standalone ROC analysis revealed that CRP yielded the highest individual diagnostic accuracy (AUC = 0.702, cut-off: 9.5 mg/L, sensitivity: 65%, specificity: 61%). Conclusion Baseline CRP, NLR, MPV/ULN, and RDW/ULN indices provide a cost-effective and readily accessible multivariable tool for predicting organ involvement in brucellosis. Internal validation highlights their cooperative independent predictive value for early risk stratification, which could significantly optimize the identification of focal complications in endemic and resource-constrained settings.

Source: BMC Infectious Diseases

DOI: 10.1186/s12879-026-14014-x

Authors: Seda Zor, Esma Eryilmaz-Eren, Emine Arman-Firat, Üner Kayabaş, İlhami Çeli̇k

Institutions: Sincan Training and Research Hospital, Kayseri Eğitim ve Araştırma Hastanesi, Sağlık Bilimleri Üniversitesi

Language: English

Topic: Brucella: diagnosis, epidemiology, treatment

Subfield: Small Animals

Field: Veterinary

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $3,090