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Updated: Apr 6, 2026
A Neonatal Imaging Model of Gram-Negative Bacterial Sepsis
Published on: August 12, 2020
Lab-score is a valuable predictor of serious bacterial infection in infants admitted to hospital
Josko Markic1, Tanja Kovacevic1, Vjekoslav Krzelj2
1Department of Pediatrics, University Hospital Centre Split, Spinciceva 1, 21000, Split, Croatia. jmarkic@mefst.hr.
Insights
The Lab-score effectively identifies serious bacterial infections (SBI) in infants with fever without apparent source (FWAS). This validated tool aids early diagnosis, improving outcomes for young children presenting to the Emergency Department (ED).
Area of Science:
- Pediatric Emergency Medicine
- Infectious Disease Diagnostics
- Biomarker Research
Background:
- Fever without apparent source (FWAS) is a common reason for pediatric Emergency Department (ED) visits.
- Early identification of serious bacterial infection (SBI) is crucial to prevent complications.
- Current diagnostic methods, including clinical scores, have limitations in definitively predicting SBI.
Purpose of the Study:
- To evaluate the performance of the Lab-score in predicting SBI in infants presenting with FWAS.
- To assess the diagnostic accuracy of the Lab-score in well-appearing infants hospitalized for suspected SBI.
Main Methods:
- The study assessed the Lab-score, a risk index based on procalcitonin (PCT), C-reactive protein (CRP), and urinary dipstick.
- Performance was evaluated in infants ≤ 180 days old with FWAS.
- Receiver operating characteristic (ROC) curve analysis was used to determine diagnostic utility.
Main Results:
- White blood cells count (WBC), CRP, PCT, and a Lab-score ≥ 3 were confirmed as useful biomarkers for differentiating SBI from non-SBI.
- The Lab-score demonstrated high diagnostic accuracy, with an Area Under the Curve (AUC) superior to other biomarkers.
- In infants ≤ 180 days, the Lab-score achieved 67.7% sensitivity and 98.6% specificity for SBI prediction.
- In infants ≤ 90 days, performance improved to 75% sensitivity and 97.7% specificity.
Conclusions:
- The Lab-score is a valuable tool for detecting SBI in infants under 6 months with FWAS.
- The study validates the Lab-score's high sensitivity and specificity in this pediatric population.
- This risk index aids clinicians in the early and accurate diagnosis of serious infections in infants.
Abstract:
Parents frequently bring their children to the Emergency Department (ED) because of the fever without apparent source (FWAS). To avoid possible complications, it is important to recognize serious bacterial infection (SBI) as early as possible. Various tests, including different clinical scores and scales, are used in the laboratory evaluation of patients. However, it is still impossible to predict the presence of SBI with complete certainty. Galetto-Lacour et al. developed and validated a risk index score, named Lab-score. Lab-score is based on the three predictive variables independently associated with SBI: procalcitonin (PCT), C-reactive protein (CRP), and urinary dipstick. The objective of this study was to assess the performance of the Lab-score in predicting SBI in well-appearing infants ≤ 180 days of age with FWAS, who presented to ED and were hospitalized with suspicion of having SBI. Based on this study findings, white blood cells count (WBC), CRP, PCT, and lab-score ≥ 3 were confirmed as useful biomarkers for differentiation between SBI and non-SBI. Also, receiver operating characteristic curve (ROC) analysis confirmed that all of them were useful for differentiation between SBI and non-SBI patients with the highest area under curve (AUC) calculated for the Lab-score. The results of this research confirmed its value, with calculated sensitivity of 67.7% and specificity of 98.6% in prediction of SBI in infants aged ≤ 180 days. Its value was even better in infants aged ≤ 90 days with sensitivity of 75% and specificity of 97.7%. In conclusion, we demonstrated the high value of lab-score in detecting SBI in infants under 6 months of age with FWAS.
