Articles

Evaluation of platelet indices as early biomarkers for bacterial infections in pediatric emergency departments

ABSTRACT
Discriminating bacterial from viral etiology of infectious diseases can be challenging in pediatric age, especially during the first year of life and even more in an emergency setting. Recent research has identified in platelet indices a potential biomarker for bacterial infections, nonetheless current results remain inconsistent. The primary objective of this retrospective observational study was to assess the ability of platelet indices to distinguish bacterial from viral infections in infants presenting to the emergency department. As secondary endpoints, it aimed to evaluate these indices in differentiating upper from lower urinary tract infections and bacterial from viral pneumonias. The present study included 236 patients younger than 12 months consecutively admitted for urinary tract infections, bronchiolitis, pneumonia or gastroenteritis to our Pediatric Emergency Department. Blood cells count was performed in each patient at admission and PLT indices (platelet count, mean platelet volume-MPV and platelet distribution width) were extracted from medical charts. Children with suspected bacterial diseases had slightly lower PLT and PLT/MPV ratio compared to those with suspected viral infections. None of the platelet indices showed significant differences between upper and lower urinary tract infections. A slight decrease in PLT, MPV and PLT/MPV was recorded in infants with bacterial pneumonias compared to those with viral forms. Platelet indices have not proved effective in defining the bacterial etiology of an infectious in children younger than 12 months. They do not discriminate between lower and upper urinary tract infections, nor between bacterial and viral pneumonias.

HIGHLIGHTS BOX
What is already known about this topic? Discriminating bacterial from viral etiology of infectious diseases can be challenging. Increasing evidence points out the role of platelet indices as biomarkers of bacterial infections. What does this article add to our knowledge? Platelet indices do not discriminate between lower and upper urinary tract infections, nor between bacterial and viral pneumonias. How does this study impact current management guidelines? The accuracy of the available biomarkers in discriminating the etiology of an infectious process in the paediatric population remains limited. More studies are needed to fill this gap.

Received: Jul 31, 2023
Accepted: Jan 12, 2024
Published: Mar 1, 2024

Table of Contents: Private: Vol. 2, n. 1, March 2024

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