Predictive value of platelet count-related ratios for severity in biliary Escherichia coli and Klebsiella pneumonia bloodstream infections.

PURPOSE: To explore whether platelet count-related ratios can predict the prognosis of patients with cholangitis- and cholecystitis-associated bloodstream infections caused by Escherichia coli and Klebsiella pneumoniae.

METHODS

A total of 169 patients with biliary bloodstream infections caused by E. coli and K. pneumoniae were included. The patients were categorized into severe and non-severe groups based on the severity of prognosis. Comparisons and analyses were conducted on the differences in platelet counts and associated parameters between the two groups. Regression analysis was conducted to determine independent predictive factors for the severity of platelet-related parameters in the prognosis. Receiver operating characteristic (ROC) curve analysis was employed to evaluate the predictive efficacy.

RESULTS

The neutrophil-to-lymphocyte to platelet count ratio (NLR/PC), mean platelet volume to platelet count ratio (MPV/PC), and red blood cell distribution width to platelet count ratio (RDW/PC) in the severe group were significantly higher compared to in the non-severe group, and the platelet count was significantly lower relative to in the non-severe group (p < 0.05). Multivariate logistic stepwise regression analysis showed that NLR/PC (OR: 1.038, 95% CI: 1.014-1.063, p = 0.002), MPV/PC (OR: 1.744, 95% CI: 1.388-2.191, p < 0.001), and RDW/PC (OR: 1.655, 95% CI: 1.367-2.004, p < 0.001) were all risk factors affecting the prognosis of patients with biliary bloodstream infections caused by E. coli and K. pneumoniae. The ROC curve indicated that these three biomarkers had varying predictive values, but the three biomarkers combined with SOFA score had a better predictive value. The area under the curve (AUC) of NLR/PC with SOFA score for predicting severe biliary bloodstream infections caused by E. coli and K. pneumoniae was 0.916 (95% CI: 0.869-0.964), MPV/PC + SOFA score was 0.958 (95% CI: 0.920-0.996), and RDW/PC + SOFA score was 0.959 (95% CI: 0.922-0.997).

CONCLUSION

Our study identified elevated NLR/PC, MPV/PC, and RDW/PC as independent risk factors for severe biliary bloodstream infections. Moreover, MPV/PC and RDW/PC combined with SOFA score demonstrate notable utility in predicting the severity and prognosis of biliary bloodstream infections caused by E. coli and K. pneumoniae.