Leukocyte Populations and C-Reactive Protein as Predictors of Bacterial Infections in Febrile Outpatient Children

Kaya, Zuhre; KÜÇÜKCONGAR, Aynur; gürsel, türkiz; EMEKSİZ, Hamdi Cihan; VURALLI KARAOĞLAN, DOĞUŞ

Leukocyte Populations and C-Reactive Protein as Predictors of Bacterial Infections in Febrile Outpatient Children

Zühre KAYA, (Boş)

Aynur KÜÇÜKCONGAR, (Boş)

DOĞUŞ VURALLI KARAOĞLAN, (Boş)

Hamdi Cihan EMEKSİZ, (Boş)

Türkiz GÜRSEL (Boş)

Turkish Journal of Hematology

1 0

Yıl: 2014 Cilt: 31 Sayı: 1 Sayfa Aralığı: 49 - 55 Metin Dili: Türkçe İndeks Tarihi: 29-07-2022

Leukocyte Populations and C-Reactive Protein as Predictors of Bacterial Infections in Febrile Outpatient Children

Öz:

Amaç:Enfeksiyonlar pediatri polikliniklerinde gereksiz antibiyotik kullanımının en önemli nedeni olmaya devam etmektedir. Tam kan sayımı (CBC) enfeksiyonların tanısında kullanılan önemli bir testtir. C-reaktif protein (CRP) ise ciddi bakteriyel enfeksiyonu olan küçük çocukların değerlendirilmesinde yararlıdır. Bu çalışmanın amacı polikliniğe başvuran ateşli çocuklarda bakteriyel enfeksiyonu ayırdetmede CRP düzeyi ve lökosit popülasyonunun önemini değerlendirmektir. Gereç ve Yöntemler:Polikliniğe başvuran 120 ateşli çocukta Cell-DYn 4000 ile analiz edilen CBC değerleri ile CRP düzeyi, 74 bakteriyel, 46 viral ve 22 kontrol grubunda değerlendirildi. Bulgular: Ortalama CRP, nötrofil ve immature granulosit (IG) değerleri bakteriyel enfeksiyonlarda, viral enfeksiyon ve kontrol grubuna göre anlamlı yüksekti (p

Anahtar Kelime:

Konular: Hematoloji

Polikliniğe Başvuran Ateşli Çocuklarda Bakteriyel Enfeksiyonu Belirlemek için CRP Düzeyi ve Lökosit Popülasyonu

Öz:

Objective: Infections remain the major cause of unnecessary antibiotic use in pediatric outpatient settings. Complete blood count (CBC) is the essential test in the diagnosis of infections. C-reactive protein (CRP) is also useful for assessment of young children with serious bacterial infections. The purpose of the study was to evaluate leukocyte populations and CRP level to predict bacterial infections in febrile outpatient children.Materials and Methods:The values of CBC by Cell-DYn 4000 autoanalyzer and serum CRP levels were evaluated in 120 febrile patients with documented infections (n:74 bacterial, n:46 viral) and 22 healthy controls. Results:The mean CRP, neutrophil and immature granulocyte (IG) values were significantly higher in bacterial infections than in viral infections and controls (p

Anahtar Kelime:

Konular: Hematoloji

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

1. Dosh SA, Hickner JM, Mainous AG, Ebell MH. Predictors of antibiotic prescribing for nonspecific upper respiratory infections, acute bronchitis, and acute sinusitis. An UPRNet Study. J Fam Pract 2000;49:407-414.
2. Mangione-Smith R, Elliott MN, Stivers T, McDonald L, Heritage J, McGlynn EA. Racial/Ethnic variation in parent expectations for antibiotics: implications for Public Health Campaigns. Pediatrics 2004;113:385-394.
3. Mangione-Smith R, Elliott MN, Stivers T, McDonald LL, Heritage J. Ruling out the need for antibiotics: are we sending the right message? Arch Pediatr Adolesc Med 2006;160:945-952.
4. Linder JA, Schnipper JL, Tsurikova R, Volk LA, Middleton B. Self reported familiarity with acute respiratory infection quidelines and antibiotic prescribing in primary care. Int J Qual Health Care 2010;22:469-475.
5. Lorrot M, Moulin F, Coste J, Ravilly S, Guerin S, Lebon P, Lacombe C, Raymond J, Bohuon C, Gendrel D. Procalcitonin in pediatric emergencies: comparison with C-reactive protein, interleukin 6 and interferon alpha in the differentation between bacterial and viral infections. Presse Med 2000;29:128-134.
6. Putto A, Ruuskanen O, Meurman O, Ekblad H, Korvenranta H, Mertsola J, Peltola H, Sarkkinen H, Vijanen MK, Halonen P. C-reactive protein in the evaluation of febrile illness. Arch Dis Child 1986;61:24-29.
7. Isaacman DJ, Burke BL. Utility of the serum C-reactive protein for detection of occult bacterial infection in children. Arch Pediatr Adolesc Med 2002;156:905-909.
8. Al-Gwaiz LA, Babay HH. The diagnostic value of absolute neutrophil count, band count and morphologic changes of neutrophils in predicting bacterial infections. Med Princ Pract 2007;16:344-347.
9. Peltola V, Toikka P, Irjala K, Mertsola J, Ruuskanen O. Discrepancy between total white blood cell counts and serum C-reactive protein levels in febrile children. Scand J Infect Dis 2007;39:560-565.
10.Isaacman DJ, Shults J, Gross TK, Davis PH, Harper M. Predictors of bacteriemia in febrile children 3 to 36 months of age. Pediatrics 2000;106:977-982.
11. Pulliam PN, Attia MW, Cronan KM. C-reactive protein in febrile children 1 to 36 months of age with clinically undetectable serious bacterial infection. Pediatrics 2001;108:1275-1279.
12. Pratt A, Attia MW. Duration of fever and markers of serious bacterial infection in young febrile children. Pediatr Int 2007;49:31-35.
13.Chan YK, Tsai MH, Huang DC, Zheng ZH, Hung KD. Leukocyte nucleus segmentation and nucleus lobe counting. BMC Bioinformatics 2010;11.558.
14. Roehrl MH, Lantz D, Sylvester C, Wang JY. Age dependent reference ranges for automated assessment of immature granulocytes and clinical significance in an outpatient setting. Arch Pathol Lab Med 2011;135:471-477.
15. Senthilnayagam B, Kumar T, Sukumaran J, MJ, Rao KR. Automated measurement of immature granulocytes: performance characteristics and utility in routine clinical practice. Patholog Res Int. 2012; DOI:10.1155/2012/483670.
16.Chaves F, Tierno B, Xu D. Quantitative determination of neutrophil VCS parameters by the Coulter automated hematology analyzer: new and reliable indicators for acute bacterial infection. Am J Clin Pathol 2005;124:440- 444.
17. HPA. Management of infection guidance for primary care for consultation and local adaptation.http://www.hpa.org. uk/webc/HPAwebFile/HPAweb_C/1279888711402 (5 July 2010, date last accessed).
18.Dallman PR. Blood and blood-forming tissues, In Rudolph AM, editor. Pediatrics. 16th ed. New York, AppletonCentury-Crofts, 1977. p. 1178.
19. Baraff LJ. Management of fever without source in infants and children. Ann Emerg Med. 2000;36.602-614.
20. Friedman JF, Lee GM, Kleinman KP, Finkelstein JA. Acute care and antibiotic seeking for upper respiratory tract infections for children in day care. Parental knowledge and day care center policies. Arch Pediatr Adolesc Med 2003;157:369-374.
21. Brent AJ, Lakhanpaul M, Thompson M, Collier J, Ray S, Ninis N, Levin M, MacFaul R. Risk score to stratify children with suspected serious bacterial infection: observational cohort study. Arch Dis Child 2011;96:361-367.
22. Hatherill M, Tibby SM, Sykes K, Turner C, Murdoch IA. Diagnostic markers of infection: Comparison of procalcitonin with C reactive protein and leucocyte count. Arch Dis Child 1999;81:417-421.
23. Andreola B, Bressan S, Callegaro S, Liverani A, Plebani M, Da Dalt L. Procalcitonin and C-reactive protein as diagnostic markers of severe bacterial infections in febrile infants and children in the emergency department. Pediatr Infect Dis J 2007;26:672-677.
24. Pourakbari B, Mamishi S, Zafari J, Khairkhah H, Ashtiani MH, Abedini M, Afsharpairman S, Rad SS. Evaluation of procalcitonin and neopterin level in serum of patients with acute bacterial infection. Braz J Infect Dis 2010;14:252-255.
25. Sanders S, Barnett A, Correa-Velez I, Coulthard M, Doust J. Systematic review of the diagnostic accuracy of C reactive protein to detect bacterial infection in nonhospitalized infants and children with fever. J Pediatr 2008;153:570- 574.
26. McCarthy PL, Jekel JF, Dolan TF Jr. Comparison of acute phase reactants in pediatric patients with fever. Pediatrics 1978;62:716-720.
27. Tejani NR, Chonmaitree T, Rassin DK, Howie VM, Owen MJ, Goldman AS. Use of C-reactive protein in differentiation between acute bacterial and viral otitis media. Pediatrics 1995;95:664-669.
28. dos Anjos BL, Grotto HZ. Evaluation of C-reactive protein and serum amyloid A in the detection of inflammatory and infectious disease in children. Clin Chem Lab Med 2010;48:493-499.
29. Nixon DF, Parsons AJ, Elgin RP. Routine full blood counts as indicators of acute viral infections. J Clin Pathol 1987;40:673-675.
30. Van den Bruel A, Thompson MJ, Haj-Hassan T, Stevens R, Moll H, Lakhanpaul M, Mant D. Diagnostic value of laboratory tests in identifying serious infections in febrile children: systematic review. BMJ. 2011; 342:3082.

APA	Kaya Z, KÜÇÜKCONGAR A, VURALLI KARAOĞLAN D, EMEKSİZ H, gürsel t (2014). Leukocyte Populations and C-Reactive Protein as Predictors of Bacterial Infections in Febrile Outpatient Children. , 49 - 55.
Chicago	Kaya Zuhre,KÜÇÜKCONGAR Aynur,VURALLI KARAOĞLAN DOĞUŞ,EMEKSİZ Hamdi Cihan,gürsel türkiz Leukocyte Populations and C-Reactive Protein as Predictors of Bacterial Infections in Febrile Outpatient Children. (2014): 49 - 55.
MLA	Kaya Zuhre,KÜÇÜKCONGAR Aynur,VURALLI KARAOĞLAN DOĞUŞ,EMEKSİZ Hamdi Cihan,gürsel türkiz Leukocyte Populations and C-Reactive Protein as Predictors of Bacterial Infections in Febrile Outpatient Children. , 2014, ss.49 - 55.
AMA	Kaya Z,KÜÇÜKCONGAR A,VURALLI KARAOĞLAN D,EMEKSİZ H,gürsel t Leukocyte Populations and C-Reactive Protein as Predictors of Bacterial Infections in Febrile Outpatient Children. . 2014; 49 - 55.
Vancouver	Kaya Z,KÜÇÜKCONGAR A,VURALLI KARAOĞLAN D,EMEKSİZ H,gürsel t Leukocyte Populations and C-Reactive Protein as Predictors of Bacterial Infections in Febrile Outpatient Children. . 2014; 49 - 55.
IEEE	Kaya Z,KÜÇÜKCONGAR A,VURALLI KARAOĞLAN D,EMEKSİZ H,gürsel t "Leukocyte Populations and C-Reactive Protein as Predictors of Bacterial Infections in Febrile Outpatient Children." , ss.49 - 55, 2014.
ISNAD	Kaya, Zuhre vd. "Leukocyte Populations and C-Reactive Protein as Predictors of Bacterial Infections in Febrile Outpatient Children". (2014), 49-55.

APA	Kaya Z, KÜÇÜKCONGAR A, VURALLI KARAOĞLAN D, EMEKSİZ H, gürsel t (2014). Leukocyte Populations and C-Reactive Protein as Predictors of Bacterial Infections in Febrile Outpatient Children. Turkish Journal of Hematology, 31(1), 49 - 55.
Chicago	Kaya Zuhre,KÜÇÜKCONGAR Aynur,VURALLI KARAOĞLAN DOĞUŞ,EMEKSİZ Hamdi Cihan,gürsel türkiz Leukocyte Populations and C-Reactive Protein as Predictors of Bacterial Infections in Febrile Outpatient Children. Turkish Journal of Hematology 31, no.1 (2014): 49 - 55.
MLA	Kaya Zuhre,KÜÇÜKCONGAR Aynur,VURALLI KARAOĞLAN DOĞUŞ,EMEKSİZ Hamdi Cihan,gürsel türkiz Leukocyte Populations and C-Reactive Protein as Predictors of Bacterial Infections in Febrile Outpatient Children. Turkish Journal of Hematology, vol.31, no.1, 2014, ss.49 - 55.
AMA	Kaya Z,KÜÇÜKCONGAR A,VURALLI KARAOĞLAN D,EMEKSİZ H,gürsel t Leukocyte Populations and C-Reactive Protein as Predictors of Bacterial Infections in Febrile Outpatient Children. Turkish Journal of Hematology. 2014; 31(1): 49 - 55.
Vancouver	Kaya Z,KÜÇÜKCONGAR A,VURALLI KARAOĞLAN D,EMEKSİZ H,gürsel t Leukocyte Populations and C-Reactive Protein as Predictors of Bacterial Infections in Febrile Outpatient Children. Turkish Journal of Hematology. 2014; 31(1): 49 - 55.
IEEE	Kaya Z,KÜÇÜKCONGAR A,VURALLI KARAOĞLAN D,EMEKSİZ H,gürsel t "Leukocyte Populations and C-Reactive Protein as Predictors of Bacterial Infections in Febrile Outpatient Children." Turkish Journal of Hematology, 31, ss.49 - 55, 2014.
ISNAD	Kaya, Zuhre vd. "Leukocyte Populations and C-Reactive Protein as Predictors of Bacterial Infections in Febrile Outpatient Children". Turkish Journal of Hematology 31/1 (2014), 49-55.