Elevated PCT and NLR identify pediatric IPD patients at higher risk for purulent meningitis.
This retrospective cohort study analyzed data from 56 pediatric patients admitted to a hospital setting between January 2016 and December 2024 with invasive pneumococcal disease (IPD). The primary objective was to identify risk factors for IPD complicated by purulent meningitis, comparing patients with the condition against those without it.
The analysis revealed that patients with purulent meningitis had a significantly higher prevalence of underlying diseases (53.84% or 7 of 13) compared to those without (4.65% or 2 of 43). Additionally, antibiotic resistance was more frequent in meningitic strains, with penicillin resistance observed in 73.21% of cases versus 60.71% in non-meningitic cases, and ceftriaxone resistance in 28.57% versus 10.71%.
Elevated procalcitonin (PCT) levels greater than 4.215 ng/mL and a neutrophil-to-lymphocyte ratio (NLR) exceeding 12.94 were identified as independent risk factors. A combined predictive model using these thresholds demonstrated a sensitivity of 84.60% and a specificity of 86%. No specific safety data, adverse events, or discontinuations were reported in the provided text.
The study's primary limitation is the small sample size of 56 patients, which restricts the statistical power and generalizability of the findings. While the results suggest a potential role for PCT and NLR in early diagnosis and treatment enhancement, clinicians should interpret these biomarkers cautiously given the observational nature of the data and the lack of reported p-values for the biomarker thresholds.
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