Maad Rayan Publishing Company Biomedicine Advances 3080-0382 3 4 2026 10 01 CBC-Derived Inflammatory Indices in Pediatric Acute Gastroenteritis: Association with Stool Culture Status, Disease Severity, and Length of Hospital Stay 149 154 10.34172/bma.89 EN Maryam Mohammadi https://orcid.org/0009-0007-1865-2858 Rojin Mousavi Somayeh Janani Malihe Safari Mohammad Moradi Ali Pourvali https://orcid.org/0000-0002-1529-8175 Journal Article 10.34172/bma.89 2026 07 26 2026 09 06 Introduction: Acute gastroenteritis (AGE) is a leading cause of pediatric hospitalization worldwide. Early identification of pediatric patients at risk for prolonged hospitalization or severe disease remains an important challenge in clinical practice. CBC-derived inflammatory indices are simple, low-cost markers that may support routine clinical assessment and reduce reliance on advanced diagnostic tests. Methods: This prospective observational cohort study included 385 children hospitalized with acute gastroenteritis. We classified patients as culture-positive or culture-negative based on stool culture results. Disease severity was assessed using the Vesikari scoring system. CBC-derived inflammatory indices, including neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), eosinophil-to-lymphocyte ratio (ELR), eosinophil-to-neutrophil ratio (ENR), and mean platelet volume-to-platelet count ratio (MPV/PLT), were calculated. Associations with stool culture status and disease severity were evaluated using group-comparison analyses, whereas associations with hospitalization duration were assessed using correlation analysis and exploratory multivariable linear regression. Results: Among 385 children, 262 (68.1%) were culture-negative, and 123 (31.9%) were culture-positive. The mean age was 2.79±0.71 years, and the mean hospital stay was 3.11±1.3 days. All inflammatory indices were significantly higher in the culture-negative group (P<0.01). NLR and PLR showed significant inverse correlations with hospitalization duration, while ELR, ENR, and MPV/PLT were not. Most inflammatory indices tended to decrease with increasing disease severity, whereas ENR showed no significant association with severity. In the exploratory multivariable analysis, NLR was the only CBC-derived index that remained significantly associated with hospitalization duration (β=−0.14, P=0.01). Conclusion: CBC-derived inflammatory indices, including NLR, were associated with stool culture status and hospitalization duration in pediatric acute gastroenteritis. However, associations with disease severity were limited, and culture-negative status should not be interpreted as confirmed viral etiology in the absence of virologic testing. These findings are exploratory and hypothesis-generating; prospective multicenter studies with formal evaluation of discrimination, calibration, and clinical utility are required before clinical implementation.