'Modest at best' discriminatory ability for CBC test in infants

September 12, 2017

(HealthDay)—Complete blood cell count parameters at commonly used or optimal thresholds do not offer high accuracy in identifying invasive bacterial infections (IBIs) in febrile infants (≤60 days of age), according to a study published online Sept. 11 in JAMA Pediatrics.

Andrea T. Cruz, M.D., from the Baylor College of Medicine in Houston, and colleagues conducted planned secondary analysis of a prospective observational cohort study that included 4,313 febrile (≥38 C), previously healthy, full-term infants (≤60 days) from 26 emergency departments in the Pediatric Emergency Care Applied Research Network (from 2008 to 2013). The accuracies of the white , absolute neutrophil , and platelet count were assessed for detecting IBIs.

The researchers found that 2.2 percent had IBIs. Sensitivities were low for common complete blood cell count thresholds: white blood cell count <5,000/µL, 10 percent; white blood cell count ≥15,000/µL, 27 percent; absolute neutrophil count ≥10,000/µL, 18 percent; and platelets <100 × 10³/µL, 7 percent. Optimal thresholds (with corresponding areas under the receiver operating characteristic) for white blood cell count were 11,600/µL (0.57), absolute neutrophil count of 4,100/µL (0.70), and platelet count of 362 × 103/µL (0.61).

"Physicians who use CBC thresholds in an attempt to risk stratify febrile young infants may be falsely reassured by normal CBC parameters. When used in isolation, either at commonly used thresholds or at the optimal thresholds identified here, CBC parameters have at best modest discriminatory ability," the authors write. "In an era where better screening tests exist to identify infants with IBIs, we need to question our continual reliance on a test whose greatest strength may simply be in its ready availability in clinical practice."

Explore further: Low platelet count linked to thrombosis in aPL carriers

More information: Abstract/Full Text
Editorial (subscription or payment may be required)

Related Stories

Low platelet count linked to thrombosis in aPL carriers

July 10, 2017
(HealthDay)—For antiphospholipid antibody (aPL) carriers, low platelet count is associated with increased risk of developing thrombosis, according to a study published online June 29 in the Journal of Thrombosis and Haemostasis.

Drop-to-drop variation seen with fingerprick blood

February 29, 2016
(HealthDay)—There is drop-to-drop variation in blood component measures from fingerprick blood that is greater than variation in drops of venous blood, according to a study published recently in the American Journal of ...

Step-by-step approach valid for febrile infants

July 6, 2016
(HealthDay)—The Step-by-Step approach is valid for identifying febrile infants at risk for invasive bacterial infection (IBI), according to a study published online July 5 in Pediatrics.

Immunosuppressant response predicts aplastic anemia survival

September 7, 2017
(HealthDay)—Response to immunosuppressive therapy (IST) predicts overall survival (OS) in aplastic anemia (AA), according to a study published online Aug. 29 in the American Journal of Hematology.

New treatment approved for deadly blood cancer

August 17, 2017
(HealthDay)—The U.S. Food and Drug Adminstration on Thursday approved the anti-cancer drug Besponsa (inotuzumab ozogamicin) to treat B-cell acute lymphoblastic leukemia (ALL).

Recommended for you

Asthma drug tied to nightmares, depression

September 20, 2017
(HealthDay)—The asthma medication Singulair (montelukast) appears linked to neuropsychiatric side effects, such as depression, aggression, nightmares and headaches, according to a new review by Dutch researchers.

Parents not confident schools can assist child with chronic disease, mental health

September 18, 2017
If your child had an asthma attack during the school day, would school personnel know how to respond?

Premature infants may get metabolic boost from mom's breast milk

September 14, 2017
The breast milk of mothers with premature babies has different amounts of microRNA than that of mothers with babies born at term, which may help premature babies catch up in growth and development, according to researchers.

Explaining bursts of activity in brains of preterm babies

September 12, 2017
The source of spontaneous, high-amplitude bursts of activity seen in the brains of preterm babies, which are vital for healthy development, has been identified by a team led by researchers at UCL and King's College London.

Why one teenager may need more—or less—sleep than another

August 30, 2017
Sleep problems contribute to a number of mental health issues in adolescents, researchers say. But a lingering question is whether some teens need more—or less—sleep than others to be healthy and at their best.

Study shows probiotics can prevent sepsis in infants

August 17, 2017
A research team at the University of Nebraska Medical Center College of Public Health has determined that a special mixture of good bacteria in the body reduced the incidence of sepsis in infants in India by 40 percent at ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.