Evaluation of the Diagnostic Value of Neutrophil-to-lymphocyte Count Ratio (NLR) and Platelet-to-lymphocyte Ratio (PLR) for Identifying Serious Infection (SI) and Serious Bacterial Infection (SBI) in Febrile Young Infants < 90 Days Old

2020 ◽  
Author(s):  
Khoo Zi Xean ◽  
Chong Shu Ling ◽  
Gene Ong Yong-Kwang
Keyword(s):  
Bacterial Infection ◽  
Bacterial Infections ◽  
Statistical Significance ◽  
Serum Levels ◽  
Diagnostic Value ◽  
Platelet To Lymphocyte Ratio ◽  
Clinical Value ◽  
Lymphocyte Ratio ◽  
Young Infants ◽  
Serious Infection

Abstract Background:Neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) are simple and easy to calculate biomarkers. They have been reported as a predictor of severity and prognosis in adult patients with bacteremia. However, there is a paucity of literature examining the use of NLR and PLR as a diagnostic biomarker in pediatrics. This study aims to evaluate the diagnostic value of the NLR and PLR for identifying serious infections (SI) and serious bacterial infections (SBI) in febrile young infants <90 days old. Methods: A retrospective review of neonates and infants who were admitted for evaluation of fever between 1st July 2018 and 31st December 2018 were reviewed retrospectively. Patients aged less than 90 days of life admitted for fever from the emergency department were included. Patient age, gender, comorbidities, body temperature, clinical findings and initial laboratory results including white blood cell (WBC) count, NLR, PLR, serum levels of C-Reactive Protein (CRP) were assessed, and the microbiological investigations and final clinical diagnoses were evaluated. Results: There were 561 patients identified for inclusion. SI and SBI were diagnosed in 166 (29.6%) and 98 (17.5%) patients. Mean absolute neutrophil count, NLR were significantly higher in the SI group compared to the non-SI group (1.39±1.04 vs 1.09±0.87, p=0.001). The NLR was also significantly different in the SBI compared to the non-SBI group (1.38±0.88 vs 1.13±0.94, p=0.019). PLR did not show statistical significance in differentiating SI or SBI from non SI or SBI group. For SI and SBI, the area under the Receiver Operating Characteristic (AUROC) curve value of NLR was 0.57 (95 % CI 0.46-0.69) and 0.61 (95% CI 0.48-0.73), respectively. Although we found significantly higher NLR values in infants with SI and SBI, our results indicate that CRP was more accurate at detecting SI and SBI. Conclusion: Our study provided initial evidence on the use of the NLR in combination with other biomarkers in the diagnosis of serious infection and serious bacterial infection in young infants < 90 days’ of life. Prospective evaluation of this finding is needed to assess further its clinical value in the evaluation of young febrile infants for SI and SBI.

scholarly journals THE COMPATIBILITY OF NEUTROPHIL TO LYMPHOCYTE COUNT RATIO WITH SERUM PROCALCITONIN AS BACTERIAL INFECTION MARKERS IN SEPSIS PATIENTS

2019 ◽  
Vol 25 (1) ◽  
pp. 58
Author(s):  
Elvinawaty Elvinawaty ◽  
Hanifah Maani ◽  
Zelly Dia Rofinda ◽  
Husni Husni
Keyword(s):  
Intensive Care ◽  
Bacterial Infection ◽  
Lymphocyte Count ◽  
Bacterial Infections ◽  
Statistical Significance ◽  
Clinical Signs ◽  
Public Hospitals ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Kappa Test

Bacterial infections and sepsis remain significant causes of morbidity and mortality in critical cases in Intensive Care Units (ICU) around the world. A quick and accurate diagnosis for sepsis is a challenge for clinicians and laboratory. The problem of an existing marker for sepsis with high sensitivity and specificity is still not satisfactory. Serum procalcitonin test is still widely used but cannot be supported by hospital laboratories especially in the regional public hospitals and needs more cost. Neutrophil-lymphocyte ratio is a potential index, easy, fast and cheap for bacteremia in patients with sepsis. This study aimed to determine the agreement of neutrophil-lymphocyte ratio with serum procalcitonin as a bacterial infection marker in sepsis patients. This study was an observational, analytical study with a cross-sectional design of 30 patients who had been diagnosed as sepsis by clinicians based on clinical signs of sepsis in the Intensive Care Unit of the Dr. M. Djamil Hospital Padang. The study was conducted from February to July 2016. Neutrophil and lymphocyte count was performed by flow cytometry method and procalcitonin test with Enzyme Linked Fluorescent Assay (ELFA). Results were analyzed by Kappa test with a statistical significance if p < 0.05. There were 30 subjects, consisting of 15 females (50%) and 15 males (50%) with the age mean of 48 years. Based on the Kappa test, the value obtained was kappa=0.634 (p=0.001) for the ratio neutrophil lymphocyte with procalcitonin. There was a substantial agreement between ratio neutrophil lymphocyte with procalcitonin test.

scholarly journals Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio and Their Role as Predictors of Disease Severity of Coronavirus Disease 2019 (COVID-19)

2021 ◽  
Author(s):  
Rohit Jain ◽  
Arun Gopal ◽  
Basant Kumar Pathak ◽  
Sourya Sourabh Mohakuda ◽  
TVSVGK Tilak ◽  
...  
Keyword(s):  
Disease Severity ◽  
Complete Blood Count ◽  
Wide Spectrum ◽  
Statistical Significance ◽  
Severe Disease ◽  
Neutrophil To Lymphocyte Ratio ◽  
Screening Tools ◽  
Platelet To Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Time Of Admission

Abstract Context Due to the wide spectrum of clinical illness in coronavirus disease 2019 (COVID-19) patients, it is important to stratify patients into severe and nonsevere categories. Neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) have been evaluated rapidly by a few studies worldwide for its association with severe disease, but practically none have been conducted in the Indian population. This study was undertaken to examine the role of NLR and PLR in predicting severe disease in Indian patients. Objectives The objective was to study the association of NLR and PLR observed at the time of admission with maximum disease severity during hospitalization and to study their role in predicting disease severity. Material and Methods A total of 229 COVID-19 patients were admitted at the center during the study period. After applying inclusion and exclusion criteria, 191 patients were included in the study. The demographic, clinical, and laboratory (complete blood count, NLR, and PLR) data of all patients were obtained at the time of admission. Maximum disease severity of all patients was assessed during hospitalization. Statistical Analysis Chi-square and Mann–Whitney U tests were used to assess statistical significance. Receiver operating characteristic curve (ROC) was plotted for NLR and PLR to estimate the cutoff values and sensitivity and specificity using Youden’s index for predicting severe disease. Logistic regression analysis was used to estimate the odds ratios (OR) and 95% confidence intervals. Results Mean NLR and PLR were significantly higher in severe patients (NLR = 7.41; PLR = 204) compared with nonsevere patients (NLR = 3.30; PLR = 121). ROC analysis showed that NLR, in comparison to PLR, had a higher area under the curve (AUC) of 0.779, with a larger OR of 1.237 and cutoff of 4.1, and showed 69% sensitivity and 78% specificity in predicting severe disease. Cut off for PLR was 115.3, which showed 79% sensitivity and 62% specificity in predicting severe disease. Conclusion NLR and PLR, both showing acceptable AUCs, can be used as screening tools to predict disease severity. However, NLR was a better predictor of disease severity.

scholarly journals Usefulness of procalcitonin (PCT), C-reactive protein (CRP), and white blood cell (WBC) levels in the differential diagnosis of acute bacterial, viral, and mycoplasmal respiratory tract infections in children

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yang Li ◽  
Lanfang Min ◽  
Xin Zhang
Keyword(s):  
Differential Diagnosis ◽  
Respiratory Tract ◽  
Bacterial Infection ◽  
Bacterial Infections ◽  
Respiratory Tract Infections ◽  
Respiratory Infections ◽  
Diagnostic Value ◽  
Significant Difference ◽  
Group A ◽  
Tract Infections

Abstract Background There is a lack of studies comparing PCT, CRP and WBC levels in the differential diagnosis of acute bacterial, viral, and mycoplasmal respiratory tract infections. It is necessary to explore the correlation between above markers and different types of ARTI. Methods 108 children with confirmed bacterial infection were regarded as group A, 116 children with virus infection were regarded as group B, and 122 children with mycoplasmal infection were regarded as group C. The levels of PCT, CRP and WBC of the three groups were detected and compared. Results The levels of PCT, CRP and WBC in group A were significantly higher than those in groups B and C (p < 0.05). The positive rate of combined detection of PCT, CRP and WBC was significant higher than that of single detection. There was no significant difference in PCT, CRP and WBC levels between the group of G+ bacterial infection and G− bacterial infection (p > 0.05). ROC curve results showed that the AUC of PCT, CRP and WBC for the diagnosis of bacterial respiratory infections were 0.65, 0.55, and 0.58, respectively. Conclusions PCT, CRP and WBC can be combined as effective indicators for the identification of acute bacterial or no-bacterial infections in children. The levels of PCT and CRP have higher differential diagnostic value than that of WBC in infection, and the combined examination of the three is more valuable in clinic.

scholarly journals The Diagnostic Value of Eosinophil Count And Platelet-To-Lymphocyte Ratio In Eosinophilic Gastroenteritis

2021 ◽  
Author(s):  
Qiong Lin ◽  
Renmin Zhou ◽  
Hao Wujuan ◽  
Zhumeng Ni ◽  
Xiaozhong Li
Keyword(s):  
Blood Cell ◽  
Roc Curve ◽  
Diagnostic Value ◽  
Eosinophilic Gastroenteritis ◽  
Control Group ◽  
Platelet To Lymphocyte Ratio ◽  
Roc Curve Analysis ◽  
Record System ◽  
Lymphocyte Ratio ◽  
The Difference

Abstract Objective: To evaluate the diagnostic value of eosinophil (EO) count and platelet-to-lymphocyte ratio (PLR) in eosinophilic gastroenteritis (EGE). Methods: In total, 91 patients with EGE and 83 age–sex matched patients without EGE were selected as study subjects during January 2018 to December 2020. Data on blood cell count, and serum, C-reactive protein (CRP), and albumin levels were obtained from the Wuxi children's hospital electronic medical record system; the neutrophil-to-lymphocyte ratio (NLR), PLR, and CRP-to-albumin ratio (CAR) in the peripheral blood were recorded. Independent sample t-test, non-parametric test, or χ2 test was used according the data type to compare the difference between two groups, and receiver operating characteristic (ROC) curve analysis was performed to evaluate the diagnostic value for EGE. Results: The EO counts and PLR were significantly higher in the EGE group than those in the control group, whereas differences in the white blood cell, lymphocyte, neutrophil, and platelet counts, and the CRP level, NLR, and CAR were not significant. After treatment(Corticosteroids, 1mg/kg.d, lasting for 2 weeks）, the EO counts and PLR in the EGE group decreased gradually and the difference was significant. The diagnostic value of EO counts and PLR was determined with an area under the ROC curve as 0.756 and 0.616, sensitivity was 75.00% and 34.29%, and specificity was 74.29% and 92.31%, respectively. Conclusions EO and PLR represent potential predictive markers for diagnosing EGE.

scholarly journals Diagnostic Value of Serum Procalcitonin in Patients with Convulsion in Emergency Department, an Observational Study

Antibiotics ◽  
2020 ◽  
Vol 9 (10) ◽  
pp. 683
Author(s):  
Hisashi Murakami ◽  
Hiromu Naraba ◽  
Takashi Gondo ◽  
Masaki Mochizuki ◽  
Hidehiko Nakano ◽  
...  
Keyword(s):  
Emergency Department ◽  
Bacterial Infection ◽  
Likelihood Ratio ◽  
Bacterial Infections ◽  
Care Center ◽  
Positive Likelihood Ratio ◽  
Diagnostic Value ◽  
Control Group ◽  
Diagnostic Values ◽  
Group Members

Procalcitonin (PCT), a widely used biomarker for bacterial infections, is sometimes measured in convulsion patients to distinguish bacterial infections including bacterial meningitis. However, serum PCT elevation is reported in several other conditions. This study assessed the diagnostic value of serum PCT concentrations in convulsion patients. This study examined a convulsion group: patients admitted to our critical care center during April 2018 through September 2019 via the emergency department presenting with convulsions. Randomly sampled patients admitted without convulsions were categorized as a non-convulsion group. Serum PCT analysis was performed with consideration of whether or not the patient had an infection. Diagnostic values of serum PCT for bacterial infection were evaluated for convulsion and non-convulsion patients using the positive likelihood ratio of PCT. This study found 84 patients as eligible for the convulsion group; 1:2 matched 168 control patients were selected as non-convulsion group members. The positive likelihood ratio for bacterial infection was found to be significantly lower in the convulsion group than in the control group (1.94 vs. 2.65) when setting the positive cut-off for PCT as 0.5 ng/mL. Convulsion patients had a higher PCT value. The positive likelihood ratio for patients without bacterial infection was lower.

scholarly journals Diagnostic Value of the Neutrophil/Lymphocyte Ratio, Platelet/Lymphocyte Ratio, and Thrombocytosis in the Preoperative Investigation of Ovarian Masses

2020 ◽  
Vol 42 (07) ◽  
pp. 397-403
Author(s):  
Adriana Yoshida ◽  
Luís Otavio Sarian ◽  
Marcos Marangoni ◽  
Isis Caroline Firmano ◽  
Sophie Françoise Derchain
Keyword(s):  
Clinical Utility ◽  
Complete Blood Count ◽  
Diagnostic Value ◽  
Tertiary Hospital ◽  
Cancer Antigen 125 ◽  
Platelet To Lymphocyte Ratio ◽  
Decision Curve Analysis ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Ovarian Masses

Abstract Objective To evaluate the diagnostic accuracy of cancer antigen 125 (CA125) and complete blood count (CBC) parameters, such as the neutrophil to lymphocyte ratio (NLR), the platelet to lymphocyte ratio (PLR), and thrombocytosis in patients with ovarian masses. Methods The present is a retrospective study conducted at a single tertiary hospital from January 2010 to November 2016. We included consecutive women referred due to suspicious adnexal masses. The CBC and CA125 were measured in the serum of 528 women with ovarian masses before surgery or biopsy. We evaluated the diagnostic performance of the NLR, PLR, platelets (PLTs), CA125, and the associations between them. We tested the clinical utility of the CBC parameters and CA125 in the discrimination of ovarian masses through decision curve analysis (DCA). Results The best balance between sensitivity and specificity was obtained by the associations of CA125 or PLTs ≥ 350/nL, with 70.14% and 71.66%, CA125 or PLTs ≥ 400/nL, with 67.30% and 81.79%, CA125 or PLR, with 76.3% and 64.87%, and CA125 or NLR, with 71.09% and 73.89% respectively. In the DCA, no isolated CBC parameter presented a higher clinical utility than CA125 alone. Conclusion We showed that no CBC parameter was superior to CA125 in the prediction of the malignancy of ovarian tumors in the preoperative scenario.

scholarly journals Fever and laboratory profiles as predictors of serious bacterial infection in children

2012 ◽  
Vol 52 (6) ◽  
pp. 313
Author(s):  
Ni Putu Veny Kartika Yantie ◽  
BNP Arhana ◽  
Purnomo Suryantoro
Keyword(s):  
Bacterial Infection ◽  
Bacterial Infections ◽  
Statistical Significance ◽  
Controlled Study ◽  
Control Group ◽  
Case Group ◽  
Bacterial Gastroenteritis ◽  
Leukocyte Counts ◽  
Serious Bacterial Infections ◽  
Tract Infections

Background There is a debate on the use of high fever \\lith othermorbidities to predict serious bacterial infection (SBI). Bacterialinfection occurs in 3􀁉15% of children with fever of 2: 39°C.Various laboratory parameters including increased C􀁉reactiveprotein (CRP) levels, leukocyte counts, and absolute neutrophilcounts (AN C) have been studied for their usefulness in predictingthe occurrence of SBI, but with varied results. The ability todiscriminate whether a patient has a SBI can lead to improvedpatient management.Objective To evaluate fever of 2: 39°C, leukocyte counts of2: 15,000/mm3, ANC of 2: 1O,000/mm3 and CRP of 2: 10 mgiL aspredictors of SBI in children aged 1 month􀁉 18 years.Methods A case􀁉controlled study was conducted by collectingdata from medical records at Sanglah Hospital, Denpasar. Subjectsin the case group were diagnosed \\lith SBls (bacterial meningitis,bacterial pneumonia, bacteremia or sepsis, urinary tract infections,or bacterial gastroenteritis), and subjects in the control group nonserious bacterial infections (non􀁉SBI). Data was analyzed usingbivariate and multivariate methods \\lith 95% confidence intervalsand a statistical significance value ofP <0.05.Results Sixty subjects were studied, \\lith 30 subjects in the casegroup and 30 in the control group. Baseline characteristics ofsubjects were similar between the two groups. Fever and CRP werepredictors ofSBI [OR8.71 (95% CI 1.61 t046.98), P 􀀁 0.009; andOR 6.20 (95% CI 1.58 to 24.24), P 􀀁 0.012, respectively].Conclusion Fever 2: 39°C and CRP 2: 10 mgiL were significantpredictors of serious bacterial infections in children. [Paediatrrndones, 2012;52:313-6].

scholarly journals Predictive value of Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio in Patients with Vaginitis

2020 ◽  
Vol 37 (1) ◽  
Author(s):  
Eren Pek ◽  
Fatma Beyazit ◽  
Nilay Sen Korkmaz
Keyword(s):  
Bacterial Vaginosis ◽  
Predictive Value ◽  
Inflammatory Marker ◽  
Diagnostic Value ◽  
Neutrophil To Lymphocyte Ratio ◽  
Platelet To Lymphocyte Ratio ◽  
Cross Sectional ◽  
Distribution Width ◽  
Lymphocyte Ratio ◽  
Significant Difference

Objectives: This study was conducted to evaluate the diagnostic value of platelet-to-lymphocyte ratio (PLR) and neutrophil-to-lymphocyte ratio (NLR) in vaginitis patients. Methods: This cross-sectional retrospective study was performed in Afyon Dinar State Hospital between July 2016 to August 2017. A total of 64 bacterial vaginosis (BV) patients, 66 vulvovaginal candidiasis (VVC) patients and 65 age-matched control subjects were enrolled. NLR, PLR, mean platelet volume (MPV), red cell distribution width (RDW) and other conventional inflammatory marker values were recorded for all patients before and after treatment. Results: In the BV group, NLR values were found to be elevated compared to VVC and healthy controls [2.9 (1.2-14.7), 2.1 (1.1-11.7) and 2.1 (0.8-7.0), respectively] (p=0.008). Although not found to be statistically significant, the median NLR levels of BV patients decreased from 2.9 (1.2-14.7) to 2.4 (1.2-7.0) after treatment. PLR levels did not show a statistically significant difference between the three groups (p=0.970). The cut-off value of the NLR for BV was 2.19, with 67.2% sensitivity and 63.8% specificity. Conclusions: The present study demonstrated that NLR levels are elevated in bacterial vaginosis and NLR levels can be used as a reflection of systemic inflammatory response in vaginosis patients. doi: https://doi.org/10.12669/pjms.37.1.2774 How to cite this:Pek E, Beyazit F, Korkmaz NS. Predictive value of Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio in Patients with Vaginitis. Pak J Med Sci. 2021;37(1):250-255. doi: https://doi.org/10.12669/pjms.37.1.2774 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals Approach to Neonates and Young Infants with Fever without a Source Who Are at Risk for Severe Bacterial Infection

2018 ◽  
Vol 2018 ◽  
pp. 1-11 ◽  
Author(s):  
Susanna Esposito ◽  
Victoria Elisa Rinaldi ◽  
Alberto Argentiero ◽  
Edoardo Farinelli ◽  
Marta Cofini ◽  
...  
Keyword(s):  
At Risk ◽  
Bacterial Infection ◽  
Bacterial Infections ◽  
Laboratory Data ◽  
Unknown Origin ◽  
Clinical Findings ◽  
Reactive Protein ◽  
Young Infants ◽  
High Risk Infants ◽  
The Impact

Introduction. Among neonates and infants <3 months of age with fever without a source (FWS), 5% to 15% of cases are patients with fever caused by a serious bacterial infection (SBI). To favour the differentiation between low- and high-risk infants, several algorithms based on analytical and clinical parameters have been developed. The aim of this review is to describe the management of young infants with FWS and to discuss the impact of recent knowledge regarding FWS management on clinical practice. Materials and Methods. PubMed was used to search for all of the studies published over the last 35 years using the keywords: “fever without source” or “fever of unknown origin” or “meningitis” or “sepsis” or “urinary tract infection” and “neonate” or “newborn” or “infant <90 days of life” or “infant <3 months”. Results and Discussion. The selection of neonates and young infants who are <3 months old with FWS who are at risk for SBI remains a problem without a definitive solution. The old Rochester criteria remain effective for identifying young infants between 29 and 60 days old who do not have severe bacterial infections (SBIs). However, the addition of laboratory tests such as C-reactive protein (CRP) and procalcitonin (PCT) can significantly improve the identification of children with SBI. The approach in evaluating neonates is significantly more complicated, as their risk of SBIs, including bacteremia and meningitis, remains relevant and none of the suggested approaches can reduce the risk of dramatic mistakes. In both groups, the best antibiotic must be carefully selected considering the clinical findings, the laboratory data, the changing epidemiology, and increasing antibiotic resistance of the most common infectious bacteria.

Sign in / Sign up

Export Citation Format

Share Document