DIAGNOSTIC AND CLINICAL SIGNIFICANCE OF LABORATORY PARAMETERS IN PEDIATRIC BRUCELLOSIS FOR PREDICTING BACTEREMIA

Abstract

Objective: Brucellosis is a prevalent zoonotic infection globally, and bacteremia serves as a significant indicator of disease severity. However, the intracellular localization and slow growth of Brucella spp. frequently result in delayed blood culture outcomes. This study sought to assess the diagnostic efficacy of standard laboratory parameters in forecasting bacteremia in pediatric patients diagnosed with brucellosis. Methods: A retrospective analysis was conducted on 774 children diagnosed with acute brucellosis from 2022 to 2025. Out of these, 227 patients who had blood culture tests were put into two groups: bacteremic and nonbacteremic. This was based on whether or not Brucella spp. grew in the blood cultures. We looked at the hematological and biochemical parameters of both groups. ROC analysis was used to find the best cutoff values and diagnostic performance for parameters that were strongly linked to bacteremia. Results: In patients with bacteremia, AST, ALT, CRP, ESR, and Coombs titers were significantly elevated, whereas hemoglobin and platelet levels were significantly diminished (p<0.05). ROC analysis showed that AST (AUC=0.89, p=0.002) and CRP (AUC=0.83, p=0.009) were the best indicators of bacteremia. The Youden index showed that the best cutoff values were AST ≥40 U/L (sensitivity 84%, specificity 82%) and CRP ≥10.5 mg/L (sensitivity 81%, specificity 78%). Conclusion: AST and CRP levels are reliable diagnostic markers for predicting bacteremia in pediatric brucellosis cases. Assessing these standard laboratory tests can facilitate the early detection of bacteremic cases prior to the availability of blood culture results, thereby enabling the prompt commencement of suitable antibiotic treatment and potentially mitigating complications.