Department of Pediatric Emergency Medicine, Dr. Sami Ulus Maternity and Child Health and Diseases Training and Research Hospital, Ankara, Turkey.
Int J Lab Hematol. 2021 Aug;43(4):632-637. doi: 10.1111/ijlh.13474. Epub 2021 Feb 1.
Serious bacterial infections (SBI) are major causes of mortality and morbidity in children. The aim of this study was to determine the accuracy of the immature granulocyte (IG) percentage in predicting SBI.
Patients admitted to the pediatric emergency department with fever were divided into two groups: with SBI and with non-SBI. White blood cell (WBC) count, absolute neutrophil count (ANC), C-reactive protein (CRP), and the percentage of IG value were recorded, and their accuracy in predicting SBI was evaluated.
Sixty-one (14.3%) patients fell into the SBI group and 367 (85.7%) were with non-SBI. Mean IG percentage among SBI patients was 0.84 ± 1.21 and 0.27 ± 0.20 for with non-SBI patients (P = .001). Based on disease, the highest IG percentage was found in patients diagnosed with sepsis (IG 3.7 ± 3.5%) and with bacterial meningitis (IG 1.6 ± 1.3%). The area under the curve (AUC) of IG percentage to predict SBI was 0.83 with 95% confidence interval (CI) [0.78-0.88]; WBC was 0.76 (95% CI 0.70-0.83); ANC was 0.73 (95% CI 0.67-0.80), and CRP was 0.79 (95% CI 0.73-0.85). When infection markers were compared to the most appropriate cut-off values in predicting SBI, IG percentage showed the highest sensitivity and specificity. When the cut-off value was determined as >0.35 for IG percentage, sensitivity was 75.4% and specificity was 76.6% in predicting SBI.
Patients with SBI had a higher IG percentage. Compared to other biomarkers, IG percentage had higher sensitivity and specificity in predicting SBI.
严重细菌感染（SBI）是儿童死亡和发病的主要原因。本研究旨在确定不成熟粒细胞（IG）百分比预测 SBI 的准确性。
将因发热而入住儿科急诊的患者分为 SBI 组和非 SBI 组。记录白细胞（WBC）计数、绝对中性粒细胞计数（ANC）、C 反应蛋白（CRP）和 IG 值百分比，并评估其预测 SBI 的准确性。
61 例（14.3%）患者为 SBI 组，367 例（85.7%）为非 SBI 组。SBI 患者的平均 IG 百分比为 0.84±1.21，非 SBI 患者为 0.27±0.20（P=0.001）。根据疾病类型，IG 百分比最高的是诊断为脓毒症的患者（IG 3.7±3.5%）和细菌性脑膜炎患者（IG 1.6±1.3%）。IG 百分比预测 SBI 的曲线下面积（AUC）为 0.83，95%置信区间（CI）为[0.78-0.88]；WBC 为 0.76（95%CI 0.70-0.83）；ANC 为 0.73（95%CI 0.67-0.80），CRP 为 0.79（95%CI 0.73-0.85）。当将感染标志物与预测 SBI 的最佳临界值进行比较时，IG 百分比显示出最高的敏感性和特异性。当确定 IG 百分比的截断值为>0.35 时，预测 SBI 的敏感性为 75.4%，特异性为 76.6%。
SBI 患者的 IG 百分比较高。与其他生物标志物相比，IG 百分比在预测 SBI 方面具有更高的敏感性和特异性。
