C-reactive Protein Versus Neutrophil/lymphocyte Ratio in Differentiating Bacterial and Non-bacterial Pneumonia in Children.
BACKGROUND
Pneumonia is a leading cause of childhood mortality in a low resource country. Simple laboratory markers can help differentiate between bacterial and non-bacterial pneumonias for appropriate management.


METHODS
In children aged one to 60 months with features of lower respiratory infection, C-reactive protein (CRP) and neutrophil-lymphocyte ratio (NLR) were used to differentiate between bacterial and non-bacterial pneumonias. The cutoff values for detecting bacterial pneumonias were evaluated by statistical tools.


RESULTS
Bacterial pneumonia was diagnosed in 285 (43.6%) children out of 654 studied. At a cut-off value of 36 mg/L CRP was predictive of bacterial pneumonias with sensitivity and specificity of 61.8% and 91.3% respectively while the sensitivity and specificity for predicting bacterial pneumonia using NLR was 45.6% and 64% respectively with 1.28 used as a cut-off.


CONCLUSIONS
Our study shows that CRP is superior to NLR in differentiating bacterial from non-bacterial pneumonias in children.
Department of Pediatrics, Manipal Teaching Hospital, Pokhara, Nepal.
E
E
Gauchan
Department of Pediatrics, Manipal Teaching Hospital, Pokhara, Nepal.
S
S
Adhikari
D015415:Biomarkers; D002097:C-Reactive Protein / Q000032:analysis*; D002675:Child, Preschool; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007223:Infant; D018655:Lymphocyte Count; D008297:Male; D009390:Nepal; D009504:Neutrophils; D011014:Pneumonia / Q000175:diagnosis / Q000382:microbiology; D018410:Pneumonia, Bacterial / Q000175:diagnosis*; D012372:ROC Curve; D012680:Sensitivity and Specificity
D015415:Biomarkers; D002097:C-Reactive Protein
Bacterial and non-bacterial pneumonia; C-reactive protein; neutrophil to lymphocyte ratio.