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Early Blood Biomarkers to Improve Sepsis/Bacteremia Diagnostics in Pediatric Emergency Settings

Emilija Tamelytė1, Gineta Vaičekauskienė2, Algirdas Dagys3,4

  • 1Lithuanian University of Health Sciences, Medical Academy, 44307 Kaunas, Lithuania. emilijatam@gmail.com.

Medicina (Kaunas, Lithuania)
|April 13, 2019
PubMed

Insights

The Platelet-MPV ratio (PLT/MPV) shows promise in distinguishing pediatric sepsis from viral infections, especially when symptoms are early. Neutrophil-Lymphocyte Ratio (NLR) and Mean Platelet Volume (MPV) may help rule out sepsis in later stages.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Hematology

Background:

  • Sepsis is a leading cause of childhood mortality globally.
  • Early diagnosis and treatment are critical for improving outcomes.
  • Current biomarkers like CRP and CBC have limitations in early sepsis detection.

Purpose of the Study:

  • To evaluate the diagnostic utility of Neutrophil-Lymphocyte Ratio (NLR), Mean Platelet Volume (MPV), and Platelet-MPV ratio (PLT/MPV) in differentiating pediatric sepsis/bacteremia from viral infections.
  • To assess these markers in early versus late presentations of illness.

Main Methods:

  • Retrospective analysis of 115 children (1 month to 5 years) diagnosed with sepsis/bacteremia (n=68) or viral infection (n=47).
  • Patients categorized by symptom onset to fever: early (≤12h) or late (12-48h).
  • Analysis included Complete Blood Count (CBC), C-reactive protein (CRP), calculated NLR, and PLT/MPV.

Main Results:

  • Sepsis/bacteremia group showed significantly higher platelet counts, NLR, and PLT/MPV compared to viral infections (p<0.001).
  • PLT/MPV was elevated in early-presenting sepsis/bacteremia cases (p=0.008).
  • NLR and MPV were lower in infants with late-presenting viral infections, suggesting potential for sepsis exclusion.

Conclusions:

  • PLT/MPV, alongside standard biomarkers like CRP and platelet counts, is a valuable tool for discriminating between sepsis/bacteremia and viral infections in children, particularly in early symptom stages.
  • NLR and MPV may aid in excluding sepsis/bacteremia in cases presenting later after fever onset.

Keywords:
NLRPLT/MPVbiomarkersdiagnosticsemergencypediatricsepsis

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