Observational studyArchives of disease in childhood2025
The value of white blood cell count in predicting serious bacterial infections in children presenting to the emergency department: a multicentre observational study.
Observational study in Archives of disease in childhood, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed.
- Pediatric tracheostomy-associated respiratory infections: an evolving paradigm.Current opinion in pediatrics · 2026Review
- Role of biomarkers in pediatric sepsis: What evidence says?World journal of clinical pediatrics · 2026Review
- Development and multicenter validation of an explainable machine learning diagnostic criteria for pediatric abdominal sepsis.NPJ digital medicine · 2026Article
- C-reactive protein, white blood cell counts and sequential interpretation of PfHRP2/pLDH for antibiotic stewardship in children under 5 years of age.BMC infectious diseases · 2026Article
- Article
- Clinical and Laboratory Characteristics of Neonates Treated Due to Suspected Serious Bacterial Infection: Single Center Cross-Sectional Study.Pediatric reports · 2025Article
- Diagnostic testing and antibiotic stewardship for pneumonia in children worldwide: current developments and next steps.Current opinion in pediatrics · 2025Review
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23 authors.
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Abstract
backgroundWhite blood cell count (WBC) is a widely used marker for the prediction of serious bacterial infection (SBI); however, previous research has shown poor performance. This study aims to assess the value of WBC in the prediction of SBI in children at the emergency department (ED) and compare its value with C reactive protein (CRP) and absolute neutrophil count (ANC).
methodsThis study is an observational multicentre study including febrile children aged 0-18 years attending 1 of 12 EDs in 8 European countries. The association between WBC and SBI was assessed by multivariable logistic regression, adjusting for age, CRP and duration of fever. Additionally, diagnostic performance was assessed by sensitivity and specificity. Results were compared with CRP and ANC.
resultsWe included 17 082 children with WBC measurements, of which 1854 (10.9%) had an SBI. WBC >15 had an adjusted OR of 1.9 (95% CI 1.7 to 2.1) for prediction of SBI, after adjusting for confounders. Sensitivity and specificity were 0.56 (95% CI 0.54 to 0.58) and 0.74 (0.73 to 0.75) for WBC >15, and 0.32 (0.30 to 0.34) and 0.91 (0.91 to 0.91) for WBC >20, respectively. In comparison, CRP >20 mg/L had a sensitivity of 0.87 (95% CI 0.85 to 0.88) and a specificity of 0.59 (0.58 to 059). For CRP >80 mg/L, the sensitivity was 0.55 (95% CI 0.52 to 057) and the specificity was 0.91 (0.90 to 0.91). Additionally, for ANC >10, the sensitivity was 0.55 (95% CI 0.53 to 0.58) and the specificity was 0.75 (0.75 to 0.76). The combination of WBC and CRP did not improve performance compared with CRP alone.
conclusionWBC does not have diagnostic benefit in identifying children with an SBI compared with CRP and should only be measured for specific indications.
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