Predictive value of cell population data with Sysmex XN-series hematology analyzer for culture-proven bacteremia

Yuki Miyajima; Hideki Niimi; Tomohiro Ueno; Atsushi Matsui; Yoshitsugu Higashi; Nozomi Kojima; Mari Kono; Yosuke Iwasaki; Kentaro Nagaoka; Yoshihiro Yamamoto; Isao Kitajima

doi:10.3389/fmed.2023.1156889

Predictive value of cell population data with Sysmex XN-series hematology analyzer for culture-proven bacteremia

Front Med (Lausanne). 2023 Jun 1:10:1156889. doi: 10.3389/fmed.2023.1156889. eCollection 2023.

Authors

Affiliations

¹ Department of Clinical Infectious Diseases, Toyama University Hospital, Toyama, Japan.
² Department of Clinical Laboratory and Molecular Pathology, Toyama University Hospital, Toyama, Japan.
³ First Department of Internal Medicine, Toyama University Hospital, Toyama, Japan.
⁴ Gene Technology Group, Reagent Engineering, Sysmex Corporation, Hyogo, Japan.
⁵ R&D Center Asia Pacific, Sysmex Asia Pacific Pte Ltd, Singapore, Singapore.
⁶ Scientific Research, Scientific Affairs, Sysmex Corporation, Hyogo, Japan.

Abstract

Background: Cell population data (CPD) parameters related to neutrophils, such as fluorescent light intensity (NE-SFL) and fluorescent light distribution width index (NE-WY), have emerged as potential biomarkers for sepsis. However, the diagnostic implication in acute bacterial infection remains unclear. This study assessed the diagnostic value of NE-WY and NE-SFL for bacteremia in patients with acute bacterial infections, and those associations with other sepsis biomarkers.

Methods: Patients with acute bacterial infections were enrolled in this prospective observational cohort study. For all patients, a blood sample, with at least two sets of blood cultures, were collected at the onset of infection. Microbiological evaluation included examination of the blood bacterial load using PCR. CPD was assessed using Automated Hematology analyzer Sysmex series XN-2000. Serum levels of procalcitonin (PCT), interleukin-6 (IL-6), presepsin, and CRP were also assessed.

Results: Of 93 patients with acute bacterial infection, 24 developed culture-proven bacteremia and 69 did not. NE-SFL and NE-WY were significantly higher in patients with bacteremia than in those without bacteremia (p < 0.005, respectively), and were significantly correlated with the bacterial load determined by PCR (r = 0.384 and r = 0.374, p < 0.005, respectively). To assess the diagnostic value for bacteremia, receiver operating characteristic curve analysis was used. NE-SFL and NE-WY showed an area under the curve of 0.685 and 0.708, respectively, while those of PCT, IL-6, presepsin, and CRP were 0.744, 0.778, 0.685, and 0.528, respectively. Correlation analysis showed that the levels of NE-WY and NE-SFL were strongly correlated with PCT and IL-6 levels.

Conclusion: This study demonstrated that NE-WY and NE-SFL could predict bacteremia in a manner that may be different from that of other indicators. These findings suggest there are potential benefits of NE-WY/NE-SFL in predicting severe bacterial infections.

Keywords: XN-series; bacteremia; cell population data; interleukin-6; presepsin; procalcitonin; sepsis.