Analysis of new potential biomarkers from CBC in distinguishing SBI versus bacterial

Abstract

Background. Sepsis is the leading cause of morbidity and mortality in children worldwide. Primary diagnostics and treatment are crucial for preventing progression to more severe forms and lethal outcomes. Specific early SIRS markers are still missing. Aim. The aim of the current study was to investigate the diagnostics value for standard infection biomarkers, such as CRP, WBC, neutrophils, monocytes, platelets (PLT) as well as PLT/MPV to discriminate between bacterial and viral infections. Methods. We performed a perspective single-centre study. Children with SIRS criteria and fever of <48h were enrolled into the study. Exclusion criteria: chronic conditions, immunodeficiency, recent antibiotic use or if complete blood count (CBC), CRP were not performed. Finally, 179 children from 1 to 5 years of age were enrolled and further divided into three groups: severe bacterial infection (SBI) (n=22), bacterial infection (BI) (n=37) and viral infection (VI) (n=120) patients. For all study participants, blood was drawn, CBC and CRP levels were assessed and PLT/MPV was calculated. Data analysis was performed using GraphPad Prism. P value of <0.05 was considered significant. Results. There was no significant difference in children’s age or gender between SBI, BI and VI groups (median- 30 months, male (55.86%)). SBI and BI participants demonstrated significantly higher white blood cells (WBC) than VI patients (18.7±8.55×109/l vs. 15.4±5.46×109/l vs. 10.91±7.47 p<0.001) and neutrophils count (13.17±7.08×109/l vs. 11.06±4.78×109/l vs. 7.152±3.82) p<0.001). CRP level were significantly higher in SBI and BI vs. VI patients (56.61±61.32 mg/l vs. 54.52±41.9 mg/l vs. 16.84±28.35 p<0.001). We observed a significant difference in monocytes count between SBI, BI and VI (2.11±0.98×109/l; 1.64±0.63×109 vs. 1.37±0.66×109/l p<0.0002). Also, PLT showed to be significantly higher between SBI compared to BI and VI [...].