Research Article

Mean platelet volume count as a risk factor for bloodstream infection in Pediatric Ward Sanglah General Hospital Denpasar, Bali-Indonesia

Ni Putu Wirantari , I Wayan Gustawan, Made Gede Dwilingga Utama, Bagus Ngurah Putu Arhana, Ni Nengah Dwi Fatmawati, Ni Made Adi Tarini

Ni Putu Wirantari
Departement of Child Health, Faculty of Medicine Udayana University/Sanglah Hospital Denpasar, Bali-Indonesia. Email: ariwirantari@yahoo.co.id

I Wayan Gustawan
Departement of Child Health, Faculty of Medicine Udayana University/Sanglah Hospital Denpasar, Bali-Indonesia

Made Gede Dwilingga Utama
Departement of Child Health, Faculty of Medicine Udayana University/Sanglah Hospital Denpasar, Bali-Indonesia

Bagus Ngurah Putu Arhana
Departement of Child Health, Faculty of Medicine Udayana University/Sanglah Hospital Denpasar, Bali-Indonesia

Ni Nengah Dwi Fatmawati
Departement of Clinical Microbiology, Faculty of Medicine Udayana University/Sanglah Hospital Denpasar, Bali-Indonesia

Ni Made Adi Tarini
Departement of Clinical Microbiology, Faculty of Medicine Udayana University/Sanglah Hospital Denpasar, Bali-Indonesia
Online First: March 03, 2020 | Cite this Article
Wirantari, N., Gustawan, I., Utama, M., Arhana, B., Fatmawati, N., Tarini, N. 2020. Mean platelet volume count as a risk factor for bloodstream infection in Pediatric Ward Sanglah General Hospital Denpasar, Bali-Indonesia. Intisari Sains Medis 11(1): 55-59. DOI:10.15562/ism.v11i1.553


Background: Mean platelet volume (MPV) is a potentially interesting parameter in predicting bacteremia in patients admitted with suspected community-acquired  infections. The incidence of bacteremia, defined as the presence of viable bacteria in the bloodstream, in patients who were being admitted to hospital. Multiple recent studies have confirmed that low-level bacteremia is more common than previously thought, occurring in 38% to 68% of all pediatric patients with a positive blood culture. The mortality rate is 25%–30%, increases to 50% when associated with severe sepsis. The objective of this study is to investigate whether MPV as a risk factor for bloodstream infection.

Methods: This was a hospital-based case-control study, review of the medical record from January 2016 until December 2018. We collect age, gender, MPV, platelet and blood culture. We analyze the association between MPV to bloodstream infection.

Result: Between January 1st 2016 and December 31st 2018, there were 86 patients with positive blood cultures and 89 negative blood cultures. In the case group, there were 48 (53.9%) male and 41 (46.1%) female subjects, while in the control group there were 63 (73.3%) male and 23 (26.1%) female subjects. The median age for case group was 14 months while the median age for control group was 23 months. From the ROC curve, the optimal cutoff value for MPV was determined as 5.59. The odd ratio determined the relationship between MPV to blood stream infection was 2,26 with 95% CI 1.13-4.52. The adjusted odds ratio was 2.24 95% CI (1.10-4.57). The majority diagnosis was pneumonia (46.1%) in case group then early onset neonatal sepsis (28.1%) and meningitis (7.9%).

Conclusion: The MPV ≥5.59 is a risk factor for developed bloodstream infection. This result can be used as a cutoff point to initially administered antibiotic to prevent the worse prognosis (sepsis, multiple organ failure, and death).

References

Latief A, Chairulfatah A, Alam A, Pudjiadi AH, Malisie RF, Hadinegoro SRS. National Guide of Indonesian Pediatrician: Guideline for Sepsis in Children. Jakarta: Badan Penerbit Ikatan Dokter Anak Indonesia; 2016.

Shime N, Kawasaki T, Saito O, et al. Incidence and risk factors for mortality in pediatric severe sepsis: results from the national pediatric intensive care registry in Japan. Intensive Care Med. 2012;38:1191-7.

Watson RS, Carcillo JA, Zwirble WT, Clermont G, Lidicker J, Angus DC. The epidemiology of severe sepsis in children in the United States. Am J Respir Crit Care Med. 2013;167:695-701.

Prihardi MT, Hanafie A, Harto S. Hubungan nilai mean platelet volume (MPV) dengan skor APACHE II sebagai prediktor mortalitas pada pasien sepsis berat di Rumah Sakit Umum Pusat Haji Adam Malik Medan. JAP. 2016;4(3):177-82.

Becchi C, Malyan MA, Fabbri, LP, Marsili M, Boddi V, Boncinelli S. Mean platelet volume in sepsis: is it a useful parameter?. Minerva Anastesiol. 2006;72:749-56.

Bard JD, Tekippe EM. Diagnosis of bloodstream infections in children. J Clin Microbiol. 2016;54(6):1418-24.

Chalupa P, Beran O, Herwald H, Kaspříková N, Holub M. Evaluation of potential biomarkers for the discrimination of bacterial and viral infections. Infection 2011;39:411-7.

Kim CH, Kim SJ, Lee MJ, Kwon YE, Kim YL, Park KS, et al. An increase in mean platelet volume from baseline is associated with mortality in patients with severe sepsis or septic shock. Plos One. 2015;10(3):1-13.

Catal F, Tayman C, Tonbul A, et al. Mean Platelet Volume (MPV) may simply predict the severity of sepsis in preterm infants. Clin Lab. 2014;60(7):1193-200.

Ates S, Oksuz H, Dogu B, Bozkus F, Ucmak H, Yanit F. Can mean platelet volume and mean platelet volume/platelet count ratio be used as a diagnostic marker for sepsis and systemic inflammatory response syndrome?. Saudi Med J 2015;36(10):1186-90.

Dursun A, Ozsoylu S, Akyildiz BN. Neutrophil to lymphocyte ratio and mean platelet volume can be useful markers to predict sepsis in children. Pak J Med Sci. 2018;34(4):918-22.

Randolph AG, McCulloh R. Pediatric sepsis. Virulence. 2014;5:179-89.

Cho SY, Yang JJ, Nam YS, Suh JT, Park TS, Lee HJ. Mean platelet volume in patients with increased procalcitonin level. Platelets. 2013;24(3):246-7.

Eberhardt A, Lessig F, Schreiter K, Kellner N, Fuchs M, Sablotzki A. Mean platelet volume (MPV) is an outcome marker in sepsis patients. Intern J Infect Dis. 2013;41:12.

Kukukardali Y, Onem Y, Terekeci H, Tangi F, Sahan B, Akyol A, et al. Mean Platelet Volume (MPV) in Intensive Care Unit (ICU) Patients: Is it a useful parameter in assessing prediction for mortality?. J Med MedSci. 2010;1(3):61- 64.

Aktas G, Kocak M, Taslamacioglu Duman T, Erkus E, Atak B, Sit M, Savli H. Mean Platelet Volume (MPV) as an inflammatory marker in type 2 diabetes mellitus and obesity. Bali Medical Journal. 2018;7(3):650-653. DOI:10.15562/bmj.v7i3.806.


No Supplementary Material available for this article.
Article Views      : 128
PDF Downloads : 60