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Title: Exploring inflammatory status in febrile seizures associated with urinary tract infections: A two-step cluster approach
Authors: Costea, Raluca Maria
Maniu, Ionela
Dobrota, Luminita
Pérez-Elvira, Rubén
Agudo, Maria
Oltra-Cucarella, Javier
Dragomir, Andrei 
Bacil?, Ciprian
Banciu, Adela
Banciu, Daniel Dumitru
Cip?ian, C?lin Remus
Cri?an, Roxana
Neamtu, Bogdan
Keywords: Cluster analysis
Cut-off values
Febrile seizures
Inflammatory biomarkers
Laboratory data
Urinary tract infections
Urine leukocyte and nitrite stick test
Issue Date: 3-Sep-2021
Publisher: MDPI
Citation: Costea, Raluca Maria, Maniu, Ionela, Dobrota, Luminita, Pérez-Elvira, Rubén, Agudo, Maria, Oltra-Cucarella, Javier, Dragomir, Andrei, Bacil?, Ciprian, Banciu, Adela, Banciu, Daniel Dumitru, Cip?ian, C?lin Remus, Cri?an, Roxana, Neamtu, Bogdan (2021-09-03). Exploring inflammatory status in febrile seizures associated with urinary tract infections: A two-step cluster approach. Brain Sciences 11 (9) : 1168. ScholarBank@NUS Repository.
Rights: Attribution 4.0 International
Abstract: Background: Urinary tract infections (UTIs) are considered common facilitating factors, along with other infections, in triggering febrile seizures (FS). The main purpose of our study was to identify specific inflammatory patterns of UTI cases from other infections in a specific cluster, using a combination of inflammatory biomarkers to differentiate UTIs from other bacterial diseases triggering FS. Method: This prospective study included a number of 136 patients with 197 distinct FS events, from patients hospitalized in the Pediatric Clinical Hospital Sibiu, among which 10.2% were diagnosed with UTIs. Results: In one-third of the patients with UTIs (20 cases), the symptoms were limited to fever and FS. Using two-step cluster analysis, a distinct UTI inflammatory pattern has emerged: highest platelet values (PLT), median value 331 × 103/mm3 and intermediate C-reactive protein (CRP), median value 15 mg/dL, platelet distribution width (PDW), median value 9.65%, platelet-large cell ratio (P-LCR), median value 14.45%, mean platelet volume (MPV), median value 8.60 fL and neutrophil-to-lymphocyte values (NLR), median value 3.64. Furthermore, higher PDW (median value 12.25%), P-LCR (median value 28.55%), MPV (median value 10.40 fL), CRP (median value 74.00 mg/dL) and NLR values (median value 4.11) were associated mainly (85.7%) with bacterial lower respiratory infections. UTIs were highly unlikely in these patients with significantly increased CRP values and normal values of platelet indices. Conclusions: Considering the nonspecific clinical picture of UTIs at an early age, to optimize the management of FS, a fast diagnosis of UTI is mandatory. The analysis of the inflammatory biomarker clusters (rather than individual parameters) correlated with urine leukocyte and nitrite stick evaluation for specific age groups could help in identifying even oligosymptomatic UTIs patients. The study limitation (20 UTI cases) recommends future multicentric trials on larger datasets to validate the model. © 2021 by the authors. Licensee MDPI, Basel, Switzerland.
Source Title: Brain Sciences
ISSN: 2076-3425
DOI: 10.3390/brainsci11091168
Rights: Attribution 4.0 International
Appears in Collections:Staff Publications

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