Neutrophil Cell Population Data biomarkers for Acute Bacterial Infection

Abstract

Introduction: Cell population data (CPD) reported by Sysmex XN analyzer provide quantitative information on morphological and functional characteristics of leukocytes. We aimed to evaluate the value of CPD in the clinical decision-making in patients with fever and to assess the clinical value for the early diagnosis of acute bacterial infection, in comparison with classical markers. Methods: A total of 215 consecutive patients with fever (bacterial or viral) and 212 healthy subjects without alterations in the hemogram were studied. The analysis was performed within 24–36 h from the onset of fever. Mann–Whitney U-test and Kruskal–Wallis ANOVA were applied to detect statistical differences of group, statistically significant P < 0.05. Receiver operating characteristic (ROC) curve analysis was utilized to establish the diagnostic performance of CPDs in the diagnosis of bacterial infection in a group of patients with fever. Results: The values of neutrophil granularity intensity and neutrophil reactive intensity showed increasing values from healthy, viral, to bacterial infections. NEUT-WY was the CPD with the best performance for the diagnosis of bacterial infection. Area under curve (AUC) 0.916 (95 % confidence interval 0.883–0.942) for a cutoff >616 the sensitivity was 87.1 % and the specificity was 85.4 %. This AUC presented no differences with those of percentage of neutrophils (P = 0.4451) nor neutrophil/lymphocyte ratio (0.2769). Conclusions: NEUT-WY reflects an increase in the nucleic acid content of neutrophils in response to bacteria, and it is a reliable test for the diagnosis of acute bacterial infection and could aid in discriminating the etiology of fever