School of Medicine, Qom University of Medical Sciences, Qom, Iran.
Student Research Committee, Qom University of Medical Sciences, Qom, Iran.
Department of Pediatrics Diseases, Arak University of Medical Sciences, Arak, Iran.
Septicemia is a serious condition in pediatric population which highly depends on immediate diagnosis and treatment in terms of mortality and morbidity rate. Developing adjunctive laboratory tests to help clinicians make appropriate decision is of great priority. In this study we aimed to evaluate the predictive value of each biomarker to find the most valuable one based of which a reasonable empiric therapy would be initiated prior to definite diagnosis by blood culture.
Materials and Methods
Hospital records of Patients who referred to the Hazrat-Masumeh hospital of Qom province were reviewed between March 2013 and March 2017. Diagnostic tests including blood culture and hematologic indices (WBC, ANC, ABC and Platelets) as well as inflammatory biomarkers (ESR, CRP) were measured for all participants. Patients over 6 year-old and those received antibiotic within a week prior to admission were excluded from the study.
Total number of 378 patients was enrolled in this retrospective study, of which 200 (52.91%) were boys. Positive blood culture was achieved in 171 (45.23%) patients. Significant increase observed in ANC, ABC, Platelets, ESR and CRP levels among patients with positive blood culture compared with negative blood culture (P-value of 0.0012, <0.0001, <0.0001, 0.03 and 0.018, respectively). However, there was no significant difference in WBC counts between two groups (P-value = 0.1344). The most sensitive hematologic parameter (88.89%) and the most specific parameter in our evaluations was CRP (92.27%).
Measuring the ANC, ABC, Platelet, ESR, CRP levels as initial evaluation in adjunction to confirmative blood culture is reasonable approach with acceptable diagnostic value for patients suspected to septicemia.