Exploring Inflammatory Status in Febrile Seizures Associated with Urinary Tract Infections: A Two-Step Cluster Approach
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 com...
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doaj-d981c706e1b24e27a8a47b2460ad5d912021-09-25T23:48:32ZengMDPI AGBrain Sciences2076-34252021-09-01111168116810.3390/brainsci11091168Exploring Inflammatory Status in Febrile Seizures Associated with Urinary Tract Infections: A Two-Step Cluster ApproachRaluca Maria Costea0Ionela Maniu1Luminita Dobrota2Rubén Pérez-Elvira3Maria Agudo4Javier Oltra-Cucarella5Andrei Dragomir6Ciprian Bacilă7Adela Banciu8Daniel Dumitru Banciu9Călin Remus Cipăian10Roxana Crișan11Bogdan Neamtu12Pediatric Research Department, Pediatric Clinical Hospital Sibiu, 550166 Sibiu, RomaniaPediatric Research Department, Pediatric Clinical Hospital Sibiu, 550166 Sibiu, RomaniaFaculty of Medicine, Lucian Blaga University of Sibiu, 550024 Sibiu, RomaniaNeuropsychophysiology Laboratory, NEPSA Rehabilitación Neurológica, 37003 Salamanca, SpainNeuropsychophysiology Laboratory, NEPSA Rehabilitación Neurológica, 37003 Salamanca, SpainDepartment of Health Psychology, Universidad Miguel Hernández de Elche, 03202 Elche, SpainN.1 Institute for Health, National University of Singapore, Singapore 117575, SingaporeFaculty of Medicine, Lucian Blaga University of Sibiu, 550024 Sibiu, RomaniaDepartment of Bioengineering and Biotechnology, Faculty of Medical Engineering, Politechnic University of Bucharest, 011061 Bucharest, RomaniaDepartment of Bioengineering and Biotechnology, Faculty of Medical Engineering, Politechnic University of Bucharest, 011061 Bucharest, RomaniaFaculty of Medicine, Lucian Blaga University of Sibiu, 550024 Sibiu, RomaniaFaculty of Medicine, Lucian Blaga University of Sibiu, 550024 Sibiu, RomaniaPediatric Research Department, Pediatric Clinical Hospital Sibiu, 550166 Sibiu, RomaniaBackground: 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/mm<sup>3</sup> 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.https://www.mdpi.com/2076-3425/11/9/1168febrile seizuresurinary tract infectionsinflammatory biomarkerscluster analysislaboratory dataCRP |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Raluca Maria Costea Ionela Maniu Luminita Dobrota Rubén Pérez-Elvira Maria Agudo Javier Oltra-Cucarella Andrei Dragomir Ciprian Bacilă Adela Banciu Daniel Dumitru Banciu Călin Remus Cipăian Roxana Crișan Bogdan Neamtu |
spellingShingle |
Raluca Maria Costea Ionela Maniu Luminita Dobrota Rubén Pérez-Elvira Maria Agudo Javier Oltra-Cucarella Andrei Dragomir Ciprian Bacilă Adela Banciu Daniel Dumitru Banciu Călin Remus Cipăian Roxana Crișan Bogdan Neamtu Exploring Inflammatory Status in Febrile Seizures Associated with Urinary Tract Infections: A Two-Step Cluster Approach Brain Sciences febrile seizures urinary tract infections inflammatory biomarkers cluster analysis laboratory data CRP |
author_facet |
Raluca Maria Costea Ionela Maniu Luminita Dobrota Rubén Pérez-Elvira Maria Agudo Javier Oltra-Cucarella Andrei Dragomir Ciprian Bacilă Adela Banciu Daniel Dumitru Banciu Călin Remus Cipăian Roxana Crișan Bogdan Neamtu |
author_sort |
Raluca Maria Costea |
title |
Exploring Inflammatory Status in Febrile Seizures Associated with Urinary Tract Infections: A Two-Step Cluster Approach |
title_short |
Exploring Inflammatory Status in Febrile Seizures Associated with Urinary Tract Infections: A Two-Step Cluster Approach |
title_full |
Exploring Inflammatory Status in Febrile Seizures Associated with Urinary Tract Infections: A Two-Step Cluster Approach |
title_fullStr |
Exploring Inflammatory Status in Febrile Seizures Associated with Urinary Tract Infections: A Two-Step Cluster Approach |
title_full_unstemmed |
Exploring Inflammatory Status in Febrile Seizures Associated with Urinary Tract Infections: A Two-Step Cluster Approach |
title_sort |
exploring inflammatory status in febrile seizures associated with urinary tract infections: a two-step cluster approach |
publisher |
MDPI AG |
series |
Brain Sciences |
issn |
2076-3425 |
publishDate |
2021-09-01 |
description |
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/mm<sup>3</sup> 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. |
topic |
febrile seizures urinary tract infections inflammatory biomarkers cluster analysis laboratory data CRP |
url |
https://www.mdpi.com/2076-3425/11/9/1168 |
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