Pediatr Infect Vaccine.  2017 Apr;24(1):1-6. 10.14776/piv.2017.24.1.1.

Diagnostic Significance of the Delta Neutrophil Index and Other Conventional Parameters in Neonatal Bacteremia

• Koh ID
• Jeon IS
• Kim HM

• KMID: 2390875
• DOI: http://doi.org/10.14776/piv.2017.24.1.1

Abstract

PURPOSE
We investigated the effectiveness of the delta neutrophil index (DNI) for the prediction of neonatal bacteremia and compared it to other indices.
METHODS
A total of 146 pediatric patients, aged less than 31 days, admitted to the neonatal intensive care unit of Wonju Severance Christian Hospital with fever before or during hospitalization were enrolled in this study. We divided the patients into two groups based on the existence of neonatal bacteremia and performed blood culture tests on both groups. We examined white blood cell count, absolute neutrophil count, DNI, platelet count, and C-reactive protein (CRP) test. We used a receiver operating characteristic (ROC) curve to evaluate their diagnostic significance.
RESULTS
Seventy-seven patients were diagnosed with neonatal bacteremia. The mean gestational age was 38.74 weeks and the mean birth weight was 3.20 kg. The mean gestational age of the control group was 33.34 weeks and the mean birth weight was 2.20 kg. Causative organisms of bacteremia included Staphylococcus aureus (n=22), Staphylococcus epidermidis (n=18), and Streptococcus agalactiae (n=8). Both DNI and CRP were significantly associated with neonatal bacteremia after adjusting for gestational age and birth weight. The area under the ROC curve (AUC) for DNI (0.70) was higher than that for CRP (0.68).
CONCLUSIONS
The DNI can be used to effectively predict neonatal bacteremia. The prediction will be more accurate if DNI is used in conjunction with other indices. In future, it will be useful to compare DNI with other indices and investigate its relationship with prognosis.

Keyword

Delta neutrophil index; Neonatal bacteremia

MeSH Terms

Bacteremia*
Birth Weight
C-Reactive Protein
Fever
Gangwon-do
Gestational Age
Hospitalization
Humans
Infant, Newborn
Intensive Care, Neonatal
Leukocyte Count
Neutrophils*
Platelet Count
Prognosis
ROC Curve
Staphylococcus aureus
Staphylococcus epidermidis
Streptococcus agalactiae
C-Reactive Protein

Figure

• 

  Fig. 1 Receiver operating characteristic (ROC) curves of delta neutrophil index and other conventional parameters predicting neonatal bacteremia. The irregular form of the curve is due to the smaller sample size in the validation dataset. Abbreviations: DNI, delta neutrophil index; CRP, C-reactive protein.

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