Hamiel U, et al. - Herein, researchers pursued an exploration of the potential markers of serious bacterial infections (SBIs) in young febrile infants. Findings disclosed that C reactive protein (CRP) was the best single discriminatory marker of SBI among young febrile infants. It was determined that absolute neutrophil count (ANC) was the best marker for invasive bacterial infection. Hence, in order to analyze this study cohort, ANC and NLR could serve as contributory factors.

Methods

• During this study, authors assessed the white cell count (WBC), absolute neutrophil count (ANC), neutrophil to lymphocyte count ratio (NLR) and C reactive protein (CRP) of infants aged 1 week to 90 days.
• They analyzed infants admitted for fever to one medical centre during 2012-2014.

Results

• Findings identified SBI in 111 (10.6%) of 1,039 infants.
• Substantially higher median values were reported of all investigated diagnostic markers in infants with rather than without SBI: WBC (14.4 vs 11.4 K/μL, P < 0.001), ANC (5.8 vs 3.7 K/μL, P < 0.001), CRP (19 vs 5 mg/L, P < 0.001) and NLR (1.2 vs 0.7, P < 0.001).
• The following served as areas under the receiver operating characteristic curve (AUC) for discriminating SBI: 0.65 (95% CI 0.59 to 0.71), 0.69 (95% CI 0.63 to 0.74), 0.71 (95% CI 0.65 to 0.76) and 0.66 (95% CI 0.60 to 0.71) for WBC, ANC, CRP and NLR, respectively.
• The best discriminative ability for the combination of CRP and ANC, with AUC: 0.73 (95% CI 0.67 to 0.78) was illustrated by the logistic regression.
• Data disclosed that AUCs were 0.70 (95% CI 0.56 to 0.85), 0.80 (95% CI 0.67 to 0.92), 0.78 (95% CI 0.68 to 0.89) and 0.78 (95% CI 0.66 to 0.90), respectively for invasive bacterial infection.
• The inference drawn was that CRP plus NLR or ANC served as the best discriminators of infection, AUCs: 0.82 (95% CI 0.70 to 0.95) and 0.82 (95% CI 0.68 to 0.95), respectively.