PMID- 26520627
OWN - NLM
STAT- MEDLINE
DCOM- 20160516
LR  - 20181202
IS  - 1735-9694 (Electronic)
IS  - 0044-6025 (Linking)
VI  - 53
IP  - 7
DP  - 2015 Jul
TI  - Diagnostic value of IL-6, CRP, WBC, and absolute neutrophil count to predict 
      serious bacterial infection in febrile infants.
PG  - 408-11
AB  - 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 ((3)20pg/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.
FAU - Zarkesh, Marjaneh
AU  - Zarkesh M
AD  - Pediatrics growth disorders research center, 17 Shahrivar Hospital, School of 
      Medicine, Guilan University of Medical Sciences, Rasht, Iran.
FAU - Sedaghat, Fatemeh
AU  - Sedaghat F
AD  - Pediatrics growth disorders research center, 17 Shahrivar Hospital, School of 
      Medicine, Guilan University of Medical Sciences, Rasht, Iran.
FAU - Heidarzadeh, Abtin
AU  - Heidarzadeh A
AD  - Department of Social Medicine, School of Medicine, Guilan University of Medical 
      Sciences, Rasht, Iran.
FAU - Tabrizi, Manizheh
AU  - Tabrizi M
AD  - Pediatrics growth disorders research center, 17 Shahrivar Hospital, School of 
      Medicine, Guilan University of Medical Sciences, Rasht, Iran.
FAU - Bolooki-Moghadam, Kobra
AU  - Bolooki-Moghadam K
AD  - Pediatrics growth disorders research center, 17 Shahrivar Hospital, School of 
      Medicine, Guilan University of Medical Sciences, Rasht, Iran.
FAU - Ghesmati, Soheil
AU  - Ghesmati S
AD  - Pediatrics growth disorders research center, 17 Shahrivar Hospital, School of 
      Medicine, Guilan University of Medical Sciences, Rasht, Iran.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - Iran
TA  - Acta Med Iran
JT  - Acta medica Iranica
JID - 14540050R
RN  - 0 (Anti-Bacterial Agents)
RN  - 0 (Biomarkers)
RN  - 0 (IL6 protein, human)
RN  - 0 (Interleukin-6)
RN  - 9007-41-4 (C-Reactive Protein)
SB  - IM
MH  - Anti-Bacterial Agents/therapeutic use
MH  - Bacterial Infections/blood/complications/*diagnosis
MH  - Biomarkers/blood
MH  - C-Reactive Protein/analysis
MH  - Enzyme-Linked Immunosorbent Assay
MH  - Female
MH  - Fever/*etiology
MH  - Humans
MH  - Infant
MH  - Infant, Newborn
MH  - Interleukin-6/blood
MH  - Leukocyte Count
MH  - Male
MH  - *Neutrophils
MH  - Prospective Studies
MH  - Sensitivity and Specificity
MH  - Sepsis
MH  - Urinary Tract Infections/blood/complications/*diagnosis
MH  - Virus Diseases/diagnosis
OTO - NOTNLM
OT  - CRP
OT  - Febrile infants
OT  - IL-6
OT  - Serious bacterial infection
EDAT- 2015/11/02 06:00
MHDA- 2016/05/18 06:00
CRDT- 2015/11/02 06:00
PHST- 2015/10/06 00:00 [received]
PHST- 2015/10/06 00:00 [accepted]
PHST- 2015/11/02 06:00 [entrez]
PHST- 2015/11/02 06:00 [pubmed]
PHST- 2016/05/18 06:00 [medline]
PST - ppublish
SO  - Acta Med Iran. 2015 Jul;53(7):408-11.