The value of delta neutrophil index in young infants with febrile urinary tract infection.
Delta neutrophil index (DNI) is the fraction of circulating immature granulocytes, which reflects severe bacterial infections and septic condition but has not been studied in urinary tract infection (UTI). Here, we evaluated the value of DNI in predicting acute pyelonephritis (APN) or vesicoureteral reflux (VUR) using the data of 288 patients. Conventional inflammatory markers (white blood cell [WBC] count, erythrocyte sedimentation rate [ESR], C-reactive protein [CRP]), and DNI were measured. WBC, CRP, ESR and DNI were higher in APN than in lower UTI (p < 0.01). Multiple logistic-regression analyses showed that DNI was a predictive factor for areas of lack of uptake on dimercaptosuccinic acid (DMSA) scans (P < 0.01). The area under the receiver operating characteristic (AUC) was also high for DNI (0.622, 95% CI 0.558-0.687, P < 0.01) as well as for CRP (0.731, 95% CI 0.673-0.789, P < 0.01) for the prediction of DMSA defects. DNI demonstrated the highest area under the ROC curve for diagnosis of VUR (0.620, 95% CI 0.542-0.698, P < 0.01). To the best of our knowledge, this is a first study demonstrating that DNI can be used as a diagnostic marker to distinguish APN from lower UTI and function as a diagnostic marker indicative of VUR compared to other conventional markers.
Department of Pediatrics, Ewha Womans University School of Medicine, Seoul, Korea.
Jung Won
JW
Lee
Department of Pediatrics, Pusan National University Children's Hospital, Yangsan, Korea.
Seong Heon
SH
Kim
Department of Pediatrics, Geoje Children's Hospital, Geoje, Korea.
Se Jin
SJ
Park
Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea.|Department of Pediatric Nephrology, Severance Children's Hospital, Seoul, Korea.
Keum Hwa
KH
Lee
Yonsei University College of Medicine, Seoul, Korea.
Jae Hyon
JH
Park
Medical University Innsbruck, Department of Internal Medicine IV (Nephrology and Hypertension), Innsbruck, Austria.
Andreas
A
Kronbichler
Luton &Dunstable University Hospital NHS Foundation Trust, Luton, United Kingdom.
Michael
M
Eisenhut
Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea.
Ji Hong
JH
Kim
Department of Laboratory Medicine, Jincheon Sungmo Hosipital, Jincheon, Korea.|Research Institute of Bacterial Resistance, Yonsei University college medicine, Seoul, Korea.
Jong Wook
JW
Lee
Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea.|Department of Pediatric Nephrology, Severance Children's Hospital, Seoul, Korea.|Institute of Kidney Disease Research, Yonsei University College of Medicine, Seoul, Korea.
Jae Il
JI
Shin
D019540:Area Under Curve; D001799:Blood Sedimentation; D002097:C-Reactive Protein / Q000378:metabolism; D005260:Female; D005334:Fever / Q000150:complications* / Q000473:pathology* / Q000503:physiopathology; D006801:Humans; D007223:Infant; D016015:Logistic Models; D008297:Male; D009504:Neutrophils / Q000473:pathology*; D012372:ROC Curve; D012018:Reflex; D004113:Succimer / Q000378:metabolism; D014552:Urinary Tract Infections / Q000150:complications* / Q000000981:diagnostic imaging / Q000473:pathology* / Q000503:physiopathology
D002097:C-Reactive Protein; D004113:Succimer