Diagnostic Value of IL-6, CRP, WBC, and Absolute Neutrophil Count to Predict Serious Bacterial Infection in Febrile Infants
Since clinical manifestations of most febrile infants younger than three months old are nonspecific, differentiation of Serious Bacterial Infection (SBI) from self-limiting viral illness is a significant challenge for pediatricians. This study was performed to assess the diagnostic value...
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| Format: | Article |
| Language: | English |
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Tehran University of Medical Sciences
2015-10-01
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| Series: | Acta Medica Iranica |
| Subjects: | |
| Online Access: | https://acta.tums.ac.ir/index.php/acta/article/view/4272 |
| _version_ | 1818083299364438016 |
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| author | Marjaneh Zarkesh Fatemeh Sedaghat Abtin Heidarzadeh Manizheh Tabrizi Kobra Bolooki Moghadam Soheil Ghesmati |
| author_facet | Marjaneh Zarkesh Fatemeh Sedaghat Abtin Heidarzadeh Manizheh Tabrizi Kobra Bolooki Moghadam Soheil Ghesmati |
| author_sort | Marjaneh Zarkesh |
| collection | DOAJ |
| description | Since clinical manifestations of most febrile infants younger than three months old are nonspecific, differentiation of Serious Bacterial Infection (SBI) from self-limiting viral illness is a significant challenge for pediatricians. This study was performed to assess the diagnostic value of white blood cell count (WBC), Absolute Neutrophil Count (ANC), Interleukin -6 (IL-6) and C-reactive protein (CRP) level to predict SBI in febrile infants younger than three months old who were hospitalized. This was a diagnostic test validation study. In this prospective study, 195 febrile infants admitted to 17 Shahrivar Hospital underwent a full sepsis workup including blood, urine, cerebrospinal fluid cultures and chest radiography. WBC count, ANC and CRP and Il-6 level were measured in all patients. Serum IL-6 concentration was measured by Enzyme-linked Immunosorbent Assay test. Then diagnostic, values of these tests for predicting SBI was compared with each other. Of total cases, 112 (57.4%) infants were male. SBI was diagnosed in 29 (14.9%) patients. The most common type of SBI was Urinary Tract Infection (UTI). Serum IL-6 (³20pg/dl) had sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of 79/1%, 91.6%,75.4%, 60.3%, respectively and for CRP (³ 10mg/l) values were 81.6%, 89.8%, 78.2%, and 52%,respectively. The predictive values of CRP and IL-6 were higher than WBC and ANC. IL-6 and CRP are more valid and better diagnostic markers for predicting SBI than WBC count and ANC. CRP level seems to be an accessible and cost-effective marker for early diagnosis of SBI. Since by no marker we can totally rule out SBI in febrile infants < three months of age, it is recommended to administer systemic antibiotics until culture results become available. |
| first_indexed | 2024-12-10T19:35:47Z |
| format | Article |
| id | doaj.art-ef62d17f41e641d8a836f085f8431ba8 |
| institution | Directory Open Access Journal |
| issn | 0044-6025 1735-9694 |
| language | English |
| last_indexed | 2024-12-10T19:35:47Z |
| publishDate | 2015-10-01 |
| publisher | Tehran University of Medical Sciences |
| record_format | Article |
| series | Acta Medica Iranica |
| spelling | doaj.art-ef62d17f41e641d8a836f085f8431ba82022-12-22T01:36:08ZengTehran University of Medical SciencesActa Medica Iranica0044-60251735-96942015-10-015374248Diagnostic Value of IL-6, CRP, WBC, and Absolute Neutrophil Count to Predict Serious Bacterial Infection in Febrile InfantsMarjaneh Zarkesh0Fatemeh Sedaghat1Abtin Heidarzadeh2Manizheh Tabrizi3Kobra Bolooki Moghadam4Soheil Ghesmati5Pediatrics growth disorders research center, 17 Shahrivar Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, IranPediatrics growth disorders research center, 17 Shahrivar Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, IranDepartment of Social Medicine, School of Medicine, Guilan University of Medical Sciences, Rasht, IranPediatrics growth disorders research center, 17 Shahrivar Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, IranPediatrics growth disorders research center, 17 Shahrivar Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, IranPediatrics growth disorders research center, 17 Shahrivar Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, IranSince clinical manifestations of most febrile infants younger than three months old are nonspecific, differentiation of Serious Bacterial Infection (SBI) from self-limiting viral illness is a significant challenge for pediatricians. This study was performed to assess the diagnostic value of white blood cell count (WBC), Absolute Neutrophil Count (ANC), Interleukin -6 (IL-6) and C-reactive protein (CRP) level to predict SBI in febrile infants younger than three months old who were hospitalized. This was a diagnostic test validation study. In this prospective study, 195 febrile infants admitted to 17 Shahrivar Hospital underwent a full sepsis workup including blood, urine, cerebrospinal fluid cultures and chest radiography. WBC count, ANC and CRP and Il-6 level were measured in all patients. Serum IL-6 concentration was measured by Enzyme-linked Immunosorbent Assay test. Then diagnostic, values of these tests for predicting SBI was compared with each other. Of total cases, 112 (57.4%) infants were male. SBI was diagnosed in 29 (14.9%) patients. The most common type of SBI was Urinary Tract Infection (UTI). Serum IL-6 (³20pg/dl) had sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of 79/1%, 91.6%,75.4%, 60.3%, respectively and for CRP (³ 10mg/l) values were 81.6%, 89.8%, 78.2%, and 52%,respectively. The predictive values of CRP and IL-6 were higher than WBC and ANC. IL-6 and CRP are more valid and better diagnostic markers for predicting SBI than WBC count and ANC. CRP level seems to be an accessible and cost-effective marker for early diagnosis of SBI. Since by no marker we can totally rule out SBI in febrile infants < three months of age, it is recommended to administer systemic antibiotics until culture results become available.https://acta.tums.ac.ir/index.php/acta/article/view/4272CRPFebrile infantsIL-6Serious bacterial infection |
| spellingShingle | Marjaneh Zarkesh Fatemeh Sedaghat Abtin Heidarzadeh Manizheh Tabrizi Kobra Bolooki Moghadam Soheil Ghesmati Diagnostic Value of IL-6, CRP, WBC, and Absolute Neutrophil Count to Predict Serious Bacterial Infection in Febrile Infants Acta Medica Iranica CRP Febrile infants IL-6 Serious bacterial infection |
| title | Diagnostic Value of IL-6, CRP, WBC, and Absolute Neutrophil Count to Predict Serious Bacterial Infection in Febrile Infants |
| title_full | Diagnostic Value of IL-6, CRP, WBC, and Absolute Neutrophil Count to Predict Serious Bacterial Infection in Febrile Infants |
| title_fullStr | Diagnostic Value of IL-6, CRP, WBC, and Absolute Neutrophil Count to Predict Serious Bacterial Infection in Febrile Infants |
| title_full_unstemmed | Diagnostic Value of IL-6, CRP, WBC, and Absolute Neutrophil Count to Predict Serious Bacterial Infection in Febrile Infants |
| title_short | Diagnostic Value of IL-6, CRP, WBC, and Absolute Neutrophil Count to Predict Serious Bacterial Infection in Febrile Infants |
| title_sort | diagnostic value of il 6 crp wbc and absolute neutrophil count to predict serious bacterial infection in febrile infants |
| topic | CRP Febrile infants IL-6 Serious bacterial infection |
| url | https://acta.tums.ac.ir/index.php/acta/article/view/4272 |
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