Potential and promising marker for serious bacterial infections in children: Delta neutrophil index.
children
delta neutrophil index
serious bacterial infection
Journal
Journal of paediatrics and child health
ISSN: 1440-1754
Titre abrégé: J Paediatr Child Health
Pays: Australia
ID NLM: 9005421
Informations de publication
Date de publication:
09 2022
09 2022
Historique:
revised:
09
05
2022
received:
13
07
2021
accepted:
18
05
2022
pubmed:
24
6
2022
medline:
9
9
2022
entrez:
23
6
2022
Statut:
ppublish
Résumé
This study aimed to evaluate the usefulness and accuracy of the delta neutrophil index (DNI), an index expressing the number of immature granulocytes as a proportion of the total, as an inflammatory marker in predicting serious bacterial infections (SBIs). Paediatric patients admitted to our hospital with fever were divided into four groups: SBI, non-SBI, COVID-19 and control group. White blood cell count, absolute neutrophil count, C-reactive protein and the DNI were recorded, and their accuracy in predicting SBI was evaluated. Mean DNI was 4.96 ± 8.38 in the SBI group (150 patients), 0.67 ± 1.68 in the non-SBI group (397 patients), 0.29 ± 0.99 in the COVID-19 group (112 patients) and 0.14 ± 0.21 in the control group (102 patients). The DNI was significantly higher in the SBI group compared with the non-SBI (P < 0.001); the non-SBI group also had higher levels than the COVID-19 group (P = 0.005). One percent increase in the DNI increased the SBI rate 1.36 times (odds ratio 1.36 (95% confidence interval 1.23-1.49), P < 0.001). Based on the determined cut-off value (>2.5%), the DNI (odds ratio 6.27 (95% confidence interval 3.85-10.21), P < 0.001) significantly predicted SBIs with 90.4% specificity and 47.7% sensitivity. SBIs in childrenare associated with an increase in DNI levels. Compared to other biomarkers, the DNI had higher specificity in predicting SBIs. The DNI may also be usefulin differentiating bacterial and non-bacterial infections in individualclinical syndromes. Currently, there is no evidence that serum DNI aids indifferentiating COVID-19 and upper respiratory tract infection.
Substances chimiques
Biomarkers
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1623-1628Informations de copyright
© 2022 Paediatrics and Child Health Division (The Royal Australasian College of Physicians).
Références
Craig JC, Williams GJ, Jones M et al. The accuracy of clinical symptoms and signs for the diagnosis of serious bacterial infection in young febrile children: Prospective cohort study of 15 781 febrile illnesses. BMJ 2010; 340: 1015.
Baker MD, Bell LM. Unpredictability of serious bacterial illness in febrile infants from birth to 1 month of age. Arch. Pediatr. Adolesc. Med. 1999; 153: 508-11.
Van den Bruel A, Haj-Hassan T, Thompson M, Buntinx F, Mant D. Diagnostic value of clinical features at presentation to identify serious infection in children in developed countries: A systematic review. Lancet 2010; 375: 834-45.
Greenhow TL, Hung YY, Pantell RH. Management and outcomes of previously healthy, full-term, febrile infants ages 7 to 90 days. Pediatrics 2016; 138: e20160270.
Nijman RG, Moll HA, Smit FJ et al. C-reactive protein, procalcitonin and the lab-score for detecting serious bacterial infections in febrile children at the emergency department: A prospective observational study. Pediatr. Infect. Dis. J. 2014; 33: e273-9.
Nijman RG, Vergouwe Y, Thompson M et al. Clinical prediction model to aid emergency doctors managing febrile children at risk of serious bacterial infections: Diagnostic study. BMJ 2013; 346: f1706.
Andreola B, Bressan S, Callegaro S, Liverani A, Plebani M, Da Dalt L. Procalcitonin and C-reactive protein as diagnostic markers of severe bacterial infections in febrile infants and children in the emergency department. Pediatr. Infect. Dis. J. 2007; 26: 672-7.
Galetto-Lacour A, Zamora SA, Andreola B et al. Validation of a laboratory risk index score for the identification of severe bacterial infection in children with fever without source. Arch. Dis. Child. 2010; 95: 968-73.
Chung HN, Jong WC, Lee J. Delta neutrophil index in automated immature granulocyte counts for assessing disease severity of patients with sepsis. Ann. Clin. Lab. Sci. 2008; 38: 241-6.
Celik IH, Arifoglu I, Arslan Z, Aksu G, Bas AY, Demirel N. The value of delta neutrophil index in neonatal sepsis diagnosis, follow-up and mortality prediction. Early Hum. Dev. 2019; 131: 6-9.
Park JH, Byeon HJ, Lee KH et al. Delta neutrophil index (DNI) as a novel diagnostic and prognostic marker of infection: A systematic review and meta-analysis. Inflamm. Res. 2017; 66: 863-70.
Lee SM, Eun HS, Namgung R, Park MS, Park KI, Lee C. Usefulness of the delta neutrophil index for assessing neonatal sepsis. Acta Paediatr. 2013; 102: e13-6.
Goldstein B, Giroir B, Randolph A. International pediatric sepsis consensus conference: Definitions for sepsis and organ dysfunction in pediatrics. Pediatr. Crit. Care Med. 2005; 6: 2-8.
Seok Y, Choi JR, Kim J et al. Delta neutrophil index: A promising diagnostic and prognostic marker for sepsis. Shock 2012; 37: 242-6.
Sol IS, Bin PH, Kim MJ et al. Delta neutrophil index as a prognostic marker in the pediatric intensive care unit. Korean J. Crit. Care Med. 2016; 31: 351-8.
Güngör A, Göktuğ A, Tekeli A et al. Evaluation of the accuracy of immature granulocyte percentage in predicting pediatric serious bacterial infection. Int. J. Lab. Hematol. 2021; 43: 632-7.
Nam M, Son BH, Seo JE, Kim IR, Park CK, Kim HK. Improved diagnostic and prognostic power of combined delta neutrophil index and mean platelet volume in pediatric sepsis. Ann. Clin. Lab. Sci. 2018; 48: 223-30.
Ahn C, Kim W, Lim TH, Cho Y, Choi KS, Jang BH. The delta neutrophil index (DNI) as a prognostic marker for mortality in adults with sepsis: A systematic review and meta-analysis. Sci. Rep. 2018; 8: 6621.
Yoon SH, Shin HD, Lee KH et al. Predictive factors for bacteremia in febrile infants with urinary tract infection. Sci. Rep. 2020; 10: 1-8.
Lee JW, Kim SH, Park SJ et al. The value of delta neutrophil index in young infants with febrile urinary tract infection. Sci. Rep. 2017; 7: 1-9.
Pavare J, Grope I, Gardovska D. Assessment of immature granulocytes percentage to predict severe bacterial infection in Latvian children: An analysis of secondary data. Medicina 2018; 54: 56.
Shin DH, Cho YS, Cho GC et al. Delta neutrophil index as an early predictor of acute appendicitis and acute complicated appendicitis in adults. World J. Emerg. Surg. 2017; 12: 32.