Metwali WA, Elmashad AM, Hazzaa SME, Al-Beltagi M, Hamza MB. Salivary C-reactive protein and mean platelet volume as possible diagnostic markers for late-onset neonatal pneumonia. World J Clin Pediatr 2024; 13(1): 88645 [DOI: 10.5409/wjcp.v13.i1.88645]
Corresponding Author of This Article
Mohammed Al-Beltagi, MBChB, MD, PhD, Academic Editor, Chairman, Professor, Research Scientist, Department of Pediatric, Faculty of Medicine, Tanta University, Al-Bahr Street, Tanta 31511, Alghrabia, Egypt. mbelrem@hotmail.com
Research Domain of This Article
Pediatrics
Article-Type of This Article
Case Control Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Pediatr. Mar 9, 2024; 13(1): 88645 Published online Mar 9, 2024. doi: 10.5409/wjcp.v13.i1.88645
Salivary C-reactive protein and mean platelet volume as possible diagnostic markers for late-onset neonatal pneumonia
Wafaa Ahmed Metwali, Abdelrahman Mohamed Elmashad, Sahar Mohey Eldin Hazzaa, Mohammed Al-Beltagi, Mohamed Basiony Hamza
Wafaa Ahmed Metwali, Abdelrahman Mohamed Elmashad, Mohammed Al-Beltagi, Mohamed Basiony Hamza, Department of Pediatric, Faculty of Medicine, Tanta University, Tanta 31511, Algahrbia, Egypt
Sahar Mohey Eldin Hazzaa, Department of Clinical Pathology, Faculty of Medicine, Tanta University, Tanta 31511, Algahrbia, Egypt
Mohammed Al-Beltagi, Department of Pediatric, University Medical Center, Dr. Suliaman Al Habib Medical Group, Manama 26671, Manama, Bahrain
Mohammed Al-Beltagi, Department of Pediatric, University Medical Center, King Abdulla Medical City, Arabian Gulf University, Manama 26671, Manama, Bahrain
Author contributions: El-Mashad MA and Hamza MB provided the research idea and initiated the study design; Metwali WA and El-Mashad MA collected the patients and their information; Hamza M and El-Mashad MA were responsible for statistical analysis; Metwali WA and Hazzaa HM were responsible for the technical part of the study; Also, they performed data analysis; Al-Biltagi M analyzed the data and wrote the final manuscript; all authors revised and agreed on the final version of the manuscript.
Institutional review board statement: We performed the study according to the latest version of Helsinki's Declaration. The Institutional Ethical and Research Review Board of the Faculty of Medicine, Tanta University, approved the study.
Informed consent statement: All parents, guardians, or next of kin signed informed consent for the minors to participate in this study.
Conflict-of-interest statement: All the authors declare that they have no potential nor real conflicts to disclose.
Data sharing statement: Data are available upon reasonable request.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Mohammed Al-Beltagi, MBChB, MD, PhD, Academic Editor, Chairman, Professor, Research Scientist, Department of Pediatric, Faculty of Medicine, Tanta University, Al-Bahr Street, Tanta 31511, Alghrabia, Egypt. mbelrem@hotmail.com
Received: October 3, 2023 Peer-review started: October 3, 2023 First decision: November 2, 2023 Revised: November 3, 2023 Accepted: December 11, 2023 Article in press: December 11, 2023 Published online: March 9, 2024 Processing time: 155 Days and 16 Hours
Abstract
BACKGROUND
Neonatal sepsis, a formidable threat to newborns, is a leading cause of neonatal mortality, with late-onset sepsis manifesting after 72 hours post-birth being particularly concerning. Pneumonia, a prevalent sepsis presentation, poses a significant risk, especially during the neonatal phase when lung defenses are compromised. Accurate diagnosis of pneumonia is imperative for timely and effective interventions. Saliva, a minimally invasive diagnostic medium, holds great promise for evaluating infections, especially in infants.
AIM
To investigate the potential of serum C-reactive protein (CRP), salivary CRP (sCRP), and mean platelet volume (MPV) as diagnostic markers for late-onset neonatal pneumonia (LONP).
METHODS
Eighty full-term neonates were systematically examined, considering anthropometric measurements, clinical manifestations, radiology findings, and essential biomarkers, including serum CRP, sCRP, and MPV.
RESULTS
The study reveals noteworthy distinctions in serum CRP levels, MPV, and the serum CRP/MPV ratio between neonates with LONP and healthy controls. MPV exhibited a robust discriminatory ability [area under the curve (AUC) = 0.87] with high sensitivity and specificity at a cutoff value of > 8.8. Correlations between serum CRP, sCRP, and MPV were also identified. Notably, sCRP demonstrated excellent predictive value for serum CRP levels (AUC = 0.89), underscoring its potential as a diagnostic tool.
CONCLUSION
This study underscores the diagnostic promise of salivary and serum biomarkers, specifically MPV and CRP, in identifying and predicting LONP among neonates. These findings advocate for further research to validate their clinical utility in larger neonatal cohorts.
Core Tip: This prospective study explores the potential of salivary C-reactive protein (CRP) (sCRP) and mean platelet volume (MPV) as diagnostic markers for late-onset neonatal pneumonia (LONP). Analyzing 80 neonates, significant differences in serum CRP levels, MPV, and the serum CRP/MPV ratio were observed between LONP cases and healthy controls. MPV demonstrated strong discriminatory ability with high sensitivity and specificity at a cutoff value of > 8.8. sCRP displayed notable predictive value for serum CRP levels. These findings highlight the diagnostic potential of salivary and serum biomarkers in identifying and predicting LONP among neonates.
