title: CD15s is a potential biomarker of serious bacterial infection in infants admitted to hospital.
abstract: Early recognition of serious bacterial infection (SBI) in children is essential for better treatment outcome. Flow cytometry analysis of neutrophil surface molecules has been more frequently utilized as a tool for diagnosis of infection. The infants (n = 105) under 6 months of age presenting to the pediatric emergency department with fever without apparent source who were hospitalized with suspicion of having SBI were enrolled in this prospective study. Sixty-nine infants were included into the training pool and were classified into bacterial or viral infection group. Validation pool consisted of 36 infants. The values of white blood cells counts, absolute neutrophil count (ANC), C-reactive protein (CRP), procalcitonin (PCT), neutrophil CD11b, CD15s and CD64 expression, and the percentage (%CD15s+) and absolute count (AC-CD15s+) of CD15s+ neutrophils were determined. In infants with SBI, %CD15s+ was 10.5 times more likely to be higher than the cut-off value. ANC, CRP, PCT, CD64, and AC-CD15s+ were also found as useful biomarkers for differentiation between bacterial and viral infection. The best fit multivariate logistic regression model included CRP, PCT, and %CD15s+ as strong predictors of SBI. The model's sensitivity (87 %) and specificity (83 %) indicated high model's accuracy. After validation on independent dataset, model's accuracy maintained high: 86 % sensitivity and 93 % specificity, confirming its reliability and supporting CRP, PCT, and %CD15s+ as real predictors. The findings of this study support assumption made in the literature on significance of CD15s in inflammation processes. Also, this study demonstrated for the first time that CD15s is potentially valuable biomarker of SBI in infants.
authors.affiliation: Department of Pediatrics, Pediatric Intensive Care Unit, University Hospital of Split, Spinciceva 1, 21000, Split, Croatia, jmarkic@mefst.hr.
authors.forename: Josko
authors.initials: J
authors.lastname: Markic
authors.forename: Ana
authors.initials: A
authors.lastname: Jeroncic
authors.forename: Denis
authors.initials: D
authors.lastname: Polancec
authors.forename: Nada
authors.initials: N
authors.lastname: Bosnjak
authors.forename: Anita
authors.initials: A
authors.lastname: Markotic
authors.forename: Julije
authors.initials: J
authors.lastname: Mestrovic
authors.forename: Vedrana Cikes
authors.initials: VC
authors.lastname: Culic
mesh_terms: D019540:Area Under Curve; D001424:Bacterial Infections / Q000097:blood / Q000175:diagnosis*; D015415:Biomarkers / Q000097:blood*; D002097:C-Reactive Protein / Q000032:analysis; D039481:CD11b Antigen / Q000097:blood; D004636:Emergency Service, Hospital; D005260:Female; D005647:Fucosyltransferases / Q000097:blood*; D006760:Hospitalization; D006801:Humans; D007223:Infant; D016256:Lewis X Antigen / Q000097:blood*; D016015:Logistic Models; D008297:Male; D011446:Prospective Studies; D017452:Receptors, IgG / Q000097:blood; D012680:Sensitivity and Specificity
chemical_list: D015415:Biomarkers; D039481:CD11b Antigen; C509295:ITGAM protein, human; D016256:Lewis X Antigen; D017452:Receptors, IgG; D002097:C-Reactive Protein; C066693:FUT4 protein, human; D005647:Fucosyltransferases