ArticleBMC pediatrics2025
Exploring the clinical value of procalcitonin, c-reactive protein, white blood cell count, and neutrophil-to-lymphocyte ratio in the early diagnosis of bloodstream infections in children.
Article in BMC pediatrics, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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5 citing papers in PubMed.
- Neutrophil-Lymphocyte-Platelet Ratio for Predicting Bacteremia in Immunosuppressed Cancer Patients: A Retrospective Diagnostic Accuracy Study.Biomedicines · 2026Article
- Epidemiology, Risk Factors, and Routine Blood Biomarkers of Aspergillosis in Cancer Patients in Jiangxi, China.Infection and drug resistance · 2026Article
- Clinical and laboratory indicators predicting coagulase-negative staphylococci as a cause of bloodstream infection among children below five years of age admitted at a tertiary hospital in Dar es Salaam, Tanzania.Annals of medicine · 2025Article
- The V-shaped association between the ratio of neutrophil counts to prognostic nutritional index and 30-, 60-, and 90-day mortality in elderly critically ill patients aged 65 and older with sepsis: a retrospective study based on the MIMIC database.Frontiers in nutrition · 2025Article
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Abstract
backgroudIn the diagnosis of bloodstream infections (BSI) in children, compared to the gold standard of blood culture, markers in the blood offer advantages such as rapid results and cost-effectiveness. Therefore, we investigated the clinical value of procalcitonin (PCT), C-reactive protein (CRP), white blood cell count (WBC), and neutrophil-to-lymphocyte ratio (NLR) in the early diagnosis of BSI in children.
methodsThis study included a retrospective analysis of 309 suspected BSI cases and patients were categorized into 2 groups based on blood culture results: blood culture-positive group, and blood culture-negative group. The blood culture-positive group was further partitioned into 3 sub-groups based on the type of pathogen: Gram-positive (G +) bacteria, Gram-negative (G-) bacteria, and fungi. Changes in PCT, CRP, WBC, and NLR were evaluated, and pathogen infections among these aforementioned groups were further determined. Moreover, the study employed the receiver operating characteristic (ROC) curve to evaluate the diagnostic value of these indicators in identifying BSI in pediatric patients at an early stage.
resultsAmong the 98 strains of pathogens detected in blood culture, 58 (58.2%) strains were G- bacteria, 33 (33.7%) strains were G + bacteria, and 7 (7.1%) strains were fungi. The levels of PCT, CRP, WBC, and NLR were found to be significantly higher in the blood culture-positive group than the blood culture-negative group (p < 0.01). Upon comparing the levels of PCT and CRP in the three pathogen infections, it was found that the fungi group exhibited higher levels than the G- and G + bacteria groups (p < 0.01). The G- bacteria group exhibited higher levels of PCT, CRP, and WBC than the blood culture-negative group (p < 0.05). Similarly, the G + bacteria group exhibited higher levels of PCT, WBC, and NLR than the blood culture-negative group (p < 0.01). Besides, PCT presented the highest diagnostic efficiency among the single-item detections, with an AUC of 0.862 (95% CI: 0.819-0.906). The simultaneous detection of multiple parameters does not necessarily improve diagnostic performance but can enhance detection sensitivity.
conclusionsPCT and CRP can provide important complementary information for the etiological diagnosis of BSI in children. Elevated levels of PCT and CRP were often associated with fungal or G- bacterial infections, with PCT showing particularly significant effects. Combined use of serum PCT, CRP, WBC, and NLR testing can improve the diagnostic sensitivity of pediatric BSI, reducing the risk of missed diagnoses, thereby enhancing the early diagnostic value of pediatric BSI.
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