Case Control Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
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
ARTICLE HIGHLIGHTS
Research background

Neonatal sepsis is a significant cause of neonatal mortality, and late-onset pneumonia (LOP) is a challenging form of sepsis to diagnose. Saliva has been identified as a potential diagnostic fluid for neonates. C-reactive protein (CRP) and mean platelet volume (MPV) are biomarkers that can indicate inflammation and are of interest in diagnosing neonatal infections.

Research motivation

The research is motivated by the need to improve the diagnosis of LOP in newborns, a serious condition that can lead to high mortality rates. Current diagnostic methods for neonatal infections, including pneumonia, can be challenging. The motivation is to find non-invasive and effective diagnostic tools that can aid in the early and accurate identification of LOP. Salivary CRP (sCRP) and MPV are being investigated as potential biomarkers to enhance the diagnosis and management of LOP, aiming to improve clinical outcomes for affected newborns.

Research objectives

We aimed to assess the diagnostic accuracy of sCRP and MPV biomarkers, analyzing their temporal trends, considering demographic factors, and exploring their clinical implications in diagnosing LOP in newborns.

Research methods

The study involved 80 full-term neonates divided into a group with LOP and a control group. Clinical assessments, blood tests, and imaging were conducted to diagnose LOP. Salivary and serum CRP levels, as well as MPV, were measured. Statistical analysis was performed to determine the diagnostic validity of these markers.

Research results

Neonates with LOP showed differences in weight, length, head circumference, serum CRP, MPV, and the CRP/MPV ratio compared to the control group. Clinical and radiological features of LOP were observed, including fever, cough, respiratory distress, and abnormal auscultatory findings. MPV, serum CRP, and sCRP exhibited good discriminative power for diagnosing LOP. Positive correlations were found between serum CRP, sCRP, and MPV.

Research conclusions

The study provides insights into the clinical, radiological, and biomarker profiles in neonates with LOP. MPV, serum CRP, and sCRP show potential for non-invasive diagnostic approaches. Integrating these biomarkers into clinical practice may enhance diagnostic accuracy and improve outcomes for neonates with LOP.

Research perspectives

Further research in neonatal LOP is needed to validate findings and assess generalizability across different populations and healthcare settings, investigate temporal trends and longitudinal studies, explore multi-marker approaches, assess ethnic and geographic variations, analyze the kinetics of sCRP and MPV, conduct studies on preterm neonates, compare diagnostic performance with other modalities, examine clinical implications, develop point-of-care testing methods, and investigate therapeutic implications. These research perspectives can lead to improved clinical practices and outcomes for affected neonates.