Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2017 Feb 7:7:41265.
doi: 10.1038/srep41265.

The value of delta neutrophil index in young infants with febrile urinary tract infection

Jung Won Lee  1 , Seong Heon Kim  2 , Se Jin Park  3 , Keum Hwa Lee  4   5 , Jae Hyon Park  6 , Andreas Kronbichler  7 , Michael Eisenhut  8 , Ji Hong Kim  4 , Jong Wook Lee  9   10 , Jae Il Shin  4   5   11
Affiliations

The value of delta neutrophil index in young infants with febrile urinary tract infection

Jung Won Lee et al. Sci Rep. .

Abstract

Delta neutrophil index (DNI) is the fraction of circulating immature granulocytes, which reflects severe bacterial infections and septic condition but has not been studied in urinary tract infection (UTI). Here, we evaluated the value of DNI in predicting acute pyelonephritis (APN) or vesicoureteral reflux (VUR) using the data of 288 patients. Conventional inflammatory markers (white blood cell [WBC] count, erythrocyte sedimentation rate [ESR], C-reactive protein [CRP]), and DNI were measured. WBC, CRP, ESR and DNI were higher in APN than in lower UTI (p < 0.01). Multiple logistic-regression analyses showed that DNI was a predictive factor for areas of lack of uptake on dimercaptosuccinic acid (DMSA) scans (P < 0.01). The area under the receiver operating characteristic (AUC) was also high for DNI (0.622, 95% CI 0.558-0.687, P < 0.01) as well as for CRP (0.731, 95% CI 0.673-0.789, P < 0.01) for the prediction of DMSA defects. DNI demonstrated the highest area under the ROC curve for diagnosis of VUR (0.620, 95% CI 0.542-0.698, P < 0.01). To the best of our knowledge, this is a first study demonstrating that DNI can be used as a diagnostic marker to distinguish APN from lower UTI and function as a diagnostic marker indicative of VUR compared to other conventional markers.

PubMed Disclaimer

Conflict of interest statement

The authors declare no competing financial interests.

Figures

Figure 1
Figure 1. Receiver operating characteristic (ROC) curve of DNI and other inflammatory markers for the prediction of USG abnormalities.
DNI: delta neutrophil index, USG: ultrasonography, WBC: white blood cell, ESR: erythrocyte sedimentation rate, CRP: C-reactive protein.
Figure 2
Figure 2. Receiver operating characteristic (ROC) curve of DNI and other inflammatory markers for the prediction of DMSA abnormalities.
DNI: delta neutrophil index, DMSA: dimercaptosuccinic acid, WBC: white blood cell, ESR: erythrocyte sedimentation rate, CRP: C-reactive protein.
Figure 3
Figure 3. Receiver operating characteristic (ROC) curve of DNI and other inflammatory markers for the prediction of VUR.
DNI: delta neutrophil index, VUR: vesicoureteral reflux, WBC: white blood cell, ESR: erythrocyte sedimentation rate, CRP: C-reactive protein.
Figure 4
Figure 4. Receiver operating characteristic (ROC) curve of DNI and other inflammatory markers for the prediction of severe VUR.
DNI: delta neutrophil index, VUR: vesicoureteral reflux, WBC: white blood cell, ESR: erythrocyte sedimentation rate, CRP: C-reactive protein.
See this image and copyright information in PMC

References

    1. National Collaborating Centre for, W. s. & Children’s, H. In Urinary Tract Infection in Children: Diagnosis, Treatment and Long-term Management (RCOG Press National Collaborating Centre for Women’s and Children’s Health., 2007). - PubMed
    1. Han S. Y., Lee I. R., Park S. J., Kim J. H. & Shin J. I. Usefulness of neutrophil-lymphocyte ratio in young children with febrile urinary tract infection. Korean J Pediatr 59, 139–144 (2016). - PMC - PubMed
    1. Okazaki Y. & Matsukawa A. Pathophysiology of sepsis and recent patents on the diagnosis, treatment and prophylaxis for sepsis. Recent PatIinflamm Allergy Drug Discov 3, 26–32 (2009). - PubMed
    1. Lowsby R. et al.. Neutrophil to lymphocyte count ratio as an early indicator of blood stream infection in the emergency department. Emerg Med J 32, 531–534 (2015). - PubMed
    1. Nahm C. H., Choi J. W. & Lee J. Delta neutrophil index in automated immature granulocyte counts for assessing disease severity of patients with sepsis. Ann Clin Lab Sci 38, 241–246 (2008). - PubMed