ArticleCureus2024
Neutrophil-to-Lymphocyte Ratio and Other Complete Blood Count Parameters in the Diagnosis of Serious Bacterial Infections in Febrile Infants Under Three Months.
Article in Cureus, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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1 citing paper in PubMed.
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5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe 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.
objectivesThis 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.
methodsA 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.
resultsIn 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.
conclusionsThe 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.
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