DIAGNOSTIC AND CLINICAL SIGNIFICANCE OF LABORATORY PARAMETERS IN PEDIATRIC BRUCELLOSIS FOR PREDICTING BACTEREMIA

Abstract

Objective: Brucellosis is a prevalent zoonotic infection globally, and bacteremia serves as a significant indicator of disease severity. However, the intracellular localization and slow growth of Brucella spp. frequently result in delayed blood culture outcomes. This study sought to assess the diagnostic efficacy of standard laboratory parameters in forecasting bacteremia in pediatric patients diagnosed with brucellosis. Methods: A retrospective analysis was conducted on 774 children diagnosed with acute brucellosis from 2022 to 2025. Out of these, 227 patients who had blood culture tests were put into two groups: bacteremic and nonbacteremic. This was based on whether or not Brucella spp. grew in the blood cultures. We looked at the hematological and biochemical parameters of both groups. ROC analysis was used to find the best cutoff values and diagnostic performance for parameters that were strongly linked to bacteremia. Results: In patients with bacteremia, AST, ALT, CRP, ESR, and Coombs titers were significantly elevated, whereas hemoglobin and platelet levels were significantly diminished (p<0.05). ROC analysis showed that AST (AUC=0.89, p=0.002) and CRP (AUC=0.83, p=0.009) were the best indicators of bacteremia. The Youden index showed that the best cutoff values were AST ≥40 U/L (sensitivity 84%, specificity 82%) and CRP ≥10.5 mg/L (sensitivity 81%, specificity 78%). Conclusion: AST and CRP levels are reliable diagnostic markers for predicting bacteremia in pediatric brucellosis cases. Assessing these standard laboratory tests can facilitate the early detection of bacteremic cases prior to the availability of blood culture results, thereby enabling the prompt commencement of suitable antibiotic treatment and potentially mitigating complications.

Keywords

• Brucellosis
• Bacteremia
• C-Reactive Protein
• Aspartate Aminotransferase

Supporting Institution

There is no supporting institution

Ethical Statement

Ethical approval was obtained for this study (GOKAEK-2025-04-10)

Thanks

Thank you for evaluating this study

TEMELİ BAKTERİYEMİYİ ÖNGÖRMEK OLAN PEDİATRİK BRUSELLOZDA LABORATUVAR PARAMETRELERİNİN TANI VE KLİNİK AÇIDAN ÖNEMİ

Abstract

Amaç: Bruselloz dünya genelinde yaygın bir zoonotik enfeksiyondur ve bakteriyemi hastalık şiddetinin önemli bir göstergesidir. Ancak, Brucella türlerinin hücre içi yerleşimi ve yavaş üremesi, kan kültürü sonuçlarının gecikmesine sıkça neden olur. Bu çalışmada, bruselloz tanısı konmuş pediatrik hastalarda bakteriyemiyi öngörmede standart laboratuvar parametrelerinin tanısal etkinliğinin değerlendirilmesi amaçlanmıştır. Yöntem: 2022–2025 yılları arasında akut bruselloz tanısı almış 774 çocuk retrospektif olarak incelendi. Bunlardan kan kültürü yapılan 227 hasta, kültürde Brucella üremesi olup olmamasına göre bakteriyemik ve bakteriyemik olmayan olarak iki gruba ayrıldı. Her iki grubun hematolojik ve biyokimyasal parametreleri karşılaştırıldı. Bakteriyemi ile güçlü ilişkili parametreler için ROC analizi kullanılarak en uygun kesim değerleri ve tanısal performans belirlendi. Bulgular: Bakteriyemik hastalarda AST, ALT, CRP, ESR ve Coombs titreleri anlamlı derecede yüksek bulunurken; hemoglobin ve trombosit düzeyleri anlamlı derecede düşüktü (p<0.05). ROC analizine göre AST (AUC=0.89, p=0.002) ve CRP (AUC=0.83, p=0.009) bakteriyeminin en güçlü belirteçleri olarak saptandı. Youden indeksine göre en uygun kesim değerleri AST ≥40 U/L (duyarlılık %84, özgüllük %82) ve CRP ≥10.5 mg/L (duyarlılık %81, özgüllük %78) olarak belirlendi. Sonuç: AST ve CRP düzeyleri, pediatrik bruselloz olgularında bakteriyemiyi öngörmede güvenilir tanısal belirteçlerdir. Bu standart laboratuvar testlerinin değerlendirilmesi, kan kültürü sonuçları çıkmadan önce bakteriyemik olguların erken tespitine olanak sağlayarak uygun antibiyotik tedavisinin hızlı başlanmasını ve olası komplikasyonların azaltılmasını mümkün kılabilir. Anahtar Kelimeler: Bruselloz, bakteriyemi, öngörü, AST, CRP

Keywords

• Bruselloz
• Bakteriyemi
• C-Reaktif Protein
• Aspartat Aminotransferaz

Supporting Institution

Destekleyen kurum yoktur

Ethical Statement

Çalışma için etik kurul onayı alınmıştır (GOKAEK-2025-04-10)

Thanks

Çalışmamızı değerlendireceğiniz için teşekkür ederiz.

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