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Metwali WA, Elmashad AM, Hazzaa SME, Al-Beltagi M, Hamza MB. Salivary C-reactive protein and mean platelet volume as possible diagnostic markers for late-onset neonatal pneumonia. World J Clin Pediatr 2024; 13:88645. [PMID: 38596438 PMCID: PMC11000053 DOI: 10.5409/wjcp.v13.i1.0000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 11/03/2023] [Accepted: 12/11/2023] [Indexed: 04/11/2024] Open
Abstract
BACKGROUND Neonatal sepsis, a formidable threat to newborns, is a leading cause of neonatal mortality, with late-onset sepsis manifesting after 72 hours post-birth being particularly concerning. Pneumonia, a prevalent sepsis presentation, poses a significant risk, especially during the neonatal phase when lung defenses are compromised. Accurate diagnosis of pneumonia is imperative for timely and effective interventions. Saliva, a minimally invasive diagnostic medium, holds great promise for evaluating infections, especially in infants. AIM To investigate the potential of serum C-reactive protein (CRP), salivary CRP (sCRP), and mean platelet volume (MPV) as diagnostic markers for late-onset neonatal pneumonia (LONP). METHODS Eighty full-term neonates were systematically examined, considering anthropometric measurements, clinical manifestations, radiology findings, and essential biomarkers, including serum CRP, sCRP, and MPV. RESULTS The study reveals noteworthy distinctions in serum CRP levels, MPV, and the serum CRP/MPV ratio between neonates with LONP and healthy controls. MPV exhibited a robust discriminatory ability [area under the curve (AUC) = 0.87] with high sensitivity and specificity at a cutoff value of > 8.8. Correlations between serum CRP, sCRP, and MPV were also identified. Notably, sCRP demonstrated excellent predictive value for serum CRP levels (AUC = 0.89), underscoring its potential as a diagnostic tool. CONCLUSION This study underscores the diagnostic promise of salivary and serum biomarkers, specifically MPV and CRP, in identifying and predicting LONP among neonates. These findings advocate for further research to validate their clinical utility in larger neonatal cohorts.
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Affiliation(s)
- Wafaa Ahmed Metwali
- Department of Pediatric, Faculty of Medicine, Tanta University, Tanta 31511, Algahrbia, Egypt
| | | | - Sahar Mohey Eldin Hazzaa
- Department of Clinical Pathology, Faculty of Medicine, Tanta University, Tanta 31511, Algahrbia, Egypt
| | - Mohammed Al-Beltagi
- Department of Pediatric, Faculty of Medicine, Tanta University, Tanta 31511, Algahrbia, Egypt
- Department of Pediatric, University Medical Center, Dr. Suliaman Al Habib Medical Group, Manama 26671, Manama, Bahrain
- Department of Pediatric, University Medical Center, King Abdulla Medical City, Arabian Gulf University, Manama 26671, Manama, Bahrain.
| | - Mohamed Basiony Hamza
- Department of Pediatric, Faculty of Medicine, Tanta University, Tanta 31511, Algahrbia, Egypt
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Metwali WA, Elmashad AM, Hazzaa SME, Al-Beltagi M, Hamza MB. Salivary C-reactive protein and mean platelet volume as possible diagnostic markers for late-onset neonatal pneumonia. World J Clin Pediatr 2024; 13:88645. [DOI: 10.5409/wjcp.v13.i1.88645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 11/03/2023] [Accepted: 12/11/2023] [Indexed: 03/06/2024] Open
Abstract
BACKGROUND Neonatal sepsis, a formidable threat to newborns, is a leading cause of neonatal mortality, with late-onset sepsis manifesting after 72 hours post-birth being particularly concerning. Pneumonia, a prevalent sepsis presentation, poses a significant risk, especially during the neonatal phase when lung defenses are compromised. Accurate diagnosis of pneumonia is imperative for timely and effective interventions. Saliva, a minimally invasive diagnostic medium, holds great promise for evaluating infections, especially in infants.
AIM To investigate the potential of serum C-reactive protein (CRP), salivary CRP (sCRP), and mean platelet volume (MPV) as diagnostic markers for late-onset neonatal pneumonia (LONP).
METHODS Eighty full-term neonates were systematically examined, considering anthropometric measurements, clinical manifestations, radiology findings, and essential biomarkers, including serum CRP, sCRP, and MPV.
RESULTS The study reveals noteworthy distinctions in serum CRP levels, MPV, and the serum CRP/MPV ratio between neonates with LONP and healthy controls. MPV exhibited a robust discriminatory ability [area under the curve (AUC) = 0.87] with high sensitivity and specificity at a cutoff value of > 8.8. Correlations between serum CRP, sCRP, and MPV were also identified. Notably, sCRP demonstrated excellent predictive value for serum CRP levels (AUC = 0.89), underscoring its potential as a diagnostic tool.
CONCLUSION This study underscores the diagnostic promise of salivary and serum biomarkers, specifically MPV and CRP, in identifying and predicting LONP among neonates. These findings advocate for further research to validate their clinical utility in larger neonatal cohorts.
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Affiliation(s)
- Wafaa Ahmed Metwali
- Department of Pediatric, Faculty of Medicine, Tanta University, Tanta 31511, Algahrbia, Egypt
| | | | - Sahar Mohey Eldin Hazzaa
- Department of Clinical Pathology, Faculty of Medicine, Tanta University, Tanta 31511, Algahrbia, Egypt
| | - Mohammed Al-Beltagi
- Department of Pediatric, Faculty of Medicine, Tanta University, Tanta 31511, Algahrbia, Egypt
- Department of Pediatric, University Medical Center, Dr. Suliaman Al Habib Medical Group, Manama 26671, Manama, Bahrain
- Department of Pediatric, University Medical Center, King Abdulla Medical City, Arabian Gulf University, Manama 26671, Manama, Bahrain
| | - Mohamed Basiony Hamza
- Department of Pediatric, Faculty of Medicine, Tanta University, Tanta 31511, Algahrbia, Egypt
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Mahabee-Gittens EM, Matt GE, Mazzella MJ, Doucette JT, Ratnani P, Merianos AL. Inflammatory marker levels in children with tobacco smoke exposure. Cytokine 2024; 173:156448. [PMID: 37980882 PMCID: PMC10843711 DOI: 10.1016/j.cyto.2023.156448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 11/12/2023] [Accepted: 11/14/2023] [Indexed: 11/21/2023]
Abstract
BACKGROUND Tobacco smoke exposure (TSE) has inflammatory and immunosuppressive effects which may be associated with altered levels of inflammatory markers and pediatric illnesses. OBJECTIVE The primary objective was to examine the associations of cotinine-confirmed and parent-reported child TSE patterns and discharge diagnoses with C-reactive protein (CRP), IL-8, and IL-10 in 0-11-year-old pediatric emergency department (PED) patients who lived with ≥ 1 smoker. METHODS Saliva samples were obtained from 115 children with a mean (SD) age of 3.5 (3.1) years during the PED visit (T0). Saliva was analyzed for cotinine, CRP, IL-8, and IL-10. Parents self-reported their children's TSE patterns; children's medical records were reviewed to identify and categorize discharge diagnoses. Linear regression models were utilized to find T0 associations of cotinine-confirmed and parent-reported child TSE patterns, and PED diagnoses with each inflammatory marker. All models were adjusted for child race/ethnicity, child sex, annual household income, and housing type. The TSE models also adjusted for child discharge diagnosis. RESULTS At T0, the geometric mean (GeoM) of cotinine was 4.1 ng/ml [95 %CI = 3.2-5.2]; the GeoMs of CRP, IL-8, and IL-10 were 3,326 pg/ml [95 %CI = 2,696-4,105], 474 pg/ml [95 %CI = 386-583], and 1.1 pg/ml [95 %CI = 0.9-1.3], respectively. Parent-reported child TSE patterns were positively associated with ln-transformed CRP levels, while adjusting for the covariates (β^ = 0.012 [95 %CI:0.004-0.020], p = 0.037). In the parent-reported child TSE pattern model, there were significant positive associations between the covariate of child age with CRP and IL-8 levels (p = 0.028 and p < 0.001, respectively). Children with a bacterial diagnosis had higher IL-8 levels (p = 0.002) compared to the other diagnosis groups. CONCLUSIONS Results indicate that parent-reported child TSE increases the expression of CRP in ill children and supports prior work demonstrating that IL-8 is higher in children with TSE who have bacterial infections. These findings should be examined in future research with ill children with and without TSE.
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Affiliation(s)
- E Melinda Mahabee-Gittens
- Division of Emergency Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
| | - Georg E Matt
- Department of Psychology, San Diego State University, San Diego, CA, USA
| | - Matthew J Mazzella
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - John T Doucette
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Parita Ratnani
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Omran A, Awad H, Ibrahim M, El-Sharkawy S, Elfiky S, Rezk AR. Lung Ultrasound and Neutrophil Lymphocyte Ratio in Early Diagnosis and Differentiation between Viral and Bacterial Pneumonia in Young Children. CHILDREN 2022; 9:children9101457. [PMID: 36291392 PMCID: PMC9600537 DOI: 10.3390/children9101457] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Revised: 09/18/2022] [Accepted: 09/20/2022] [Indexed: 11/16/2022]
Abstract
Lung ultrasound (LUS) is a crucial diagnostic tool for identifying pneumonia in the pediatric age group. However, it plays a limited role in the early distinction between viral and bacterial pneumonia in children. The objectives of our study were to determine if LUS and the neutrophil-lymphocyte ratio (NLR) were useful in identifying and distinguishing between viral and bacterial pneumonia in Egyptian children under the age of two. Within the first 12 h of being admitted to our department, 52 children with clinical symptoms and signs suggestive of community-acquired pneumonia (CAP) underwent LUS and the NLR. LUS and the NLR strongly differentiated children with viral from those with bacterial pneumonia. For the early diagnosis and differentiation between viral and bacterial pneumonia in young Egyptian children, LUS was proven to be a noninvasive and reliable method. Combining the NLR with LUS increased the diagnostic accuracy when evaluating children suspected of having pneumonia.
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Affiliation(s)
- Ahmed Omran
- Department of Pediatrics & Neonatology, Faculty of Medicine, Suez Canal University, Ismailia 41522, Egypt
- Correspondence: ; Tel.: +20-10067-76278
| | - Heba Awad
- Department of Pediatrics & Neonatology, Faculty of Medicine, Suez Canal University, Ismailia 41522, Egypt
| | - Mostafa Ibrahim
- Department of Radiodiagnosis, Faculty of Medicine, Suez Canal University, Ismailia 41522, Egypt
| | - Sonya El-Sharkawy
- Department of Pediatrics & Neonatology, Faculty of Medicine, Port Said University, Port Said 42526, Egypt
| | - Samar Elfiky
- Department of Pediatrics & Neonatology, Faculty of Medicine, Suez Canal University, Ismailia 41522, Egypt
| | - Ahmed R. Rezk
- Department of Pediatrics, Ain Shams University, Cairo 11566, Egypt
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