Evaluation of mean neutrophil volume and immature to total neutrophil ratio as a biomarker for bacterial sepsis in adult patients.

IF 0.6 4区医学 Q4 PATHOLOGY

Malaysian Journal of Pathology Pub Date : 2023-04-01

S N A Md Shahid, A Ithnin, R Z A Raja Sabudin, H Alauddin, T L Tan

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引用次数: 0

Abstract

Introduction: Mean neutrophil volume (MNV) and immature to total neutrophil ratio (IT Ratio) has been found to support the detection of sepsis in elderly and neonates. This study aimed to assess the diagnostic significance of MNV and IT ratio in adult sepsis population.

Materials and methods: Sixty-four adult patients presented with suspected bacterial sepsis were included in this study. Relevant cultures and/or pertinent serology tests were performed. Full blood counts were analysed for MNV and IT ratio.

Results: Fifty-one patients out of 64 recruited subjects were confirmed sepsis. Twentyfour patients had confirmed bacterial infection by cultivation and two were positive for leptospiral serology. MNV was very good in distinguishing sepsis from non-sepsis group (AUC = 0.80, 95% confidence interval (CI) = 0.69-0.91, Accuracy = 0.72, Kappa = 0.40) with a cut-off value of 153.5 (sensitivity = 67%, specificity = 92%). There was no significant difference in IT ratio between sepsis and non-sepsis group (p-value > 0.05). MNV was superior over IT ratio (AUC = 0.85, 95%CI = 0.76-0.95, and AUC = 0.70, 95% CI = 0.56-0.85, respectively) in diagnosing bacterial infection. The optimum cut-off value for MNV in bacterial infection was 154.5 (sensitivity = 67%, specificity = 89%) and for IT ratio was 0.035 (sensitivity = 45%, specificity = 67%).

Conclusion: MNV appears to be a very good marker for diagnosing sepsis and bacterial infection. We recommend including MNV into sepsis workup in ED setting, since it can be determined without additional specimen.

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评价中性粒细胞平均体积和未成熟中性粒细胞与总中性粒细胞的比值作为成人患者细菌性脓毒症的生物标志物。

研究发现，平均中性粒细胞体积(MNV)和未成熟中性粒细胞与总中性粒细胞的比值(IT ratio)支持老年和新生儿败血症的检测。本研究旨在探讨MNV和IT比值在成人脓毒症人群中的诊断意义。材料与方法:本研究纳入64例疑似细菌性脓毒症的成人患者。进行相关培养和/或相关血清学检测。分析全血细胞计数MNV和IT比率。结果:在所招募的64名受试者中，51名患者确诊为败血症。24例患者经培养证实有细菌感染，2例患者钩端螺旋体血清学阳性。MNV在区分脓毒症和非脓毒症组方面有很好的效果(AUC = 0.80, 95%可信区间(CI) = 0.69-0.91，准确率= 0.72,Kappa = 0.40)，临界值为153.5(敏感性= 67%，特异性= 92%)。脓毒症组与非脓毒症组的IT比值差异无统计学意义(p值> 0.05)。MNV诊断细菌感染优于IT (AUC = 0.85, 95%CI = 0.76 ~ 0.95, AUC = 0.70, 95%CI = 0.56 ~ 0.85)。细菌感染中MNV的最佳临界值为154.5(敏感性= 67%，特异性= 89%)，IT比值为0.035(敏感性= 45%，特异性= 67%)。结论:MNV是诊断脓毒症和细菌感染的良好指标。我们建议在ED的脓毒症检查中包括MNV，因为它可以在没有额外标本的情况下确定。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Malaysian Journal of Pathology PATHOLOGY-

CiteScore

3.60

自引率

5.60%

发文量

期刊介绍： The Malaysian Journal of Pathology is the official journal of the College of Pathologists, Academy of Medicine Malaysia. The primary purpose of The Journal is to publish the results of study and research in Pathology, especially those that have particular relevance to human disease occurring in Malaysia and other countries in this region. The term PATHOLOGY will be interpreted in its broadest sense to include Chemical Pathology, Cytology, Experimental Pathology, Forensic Pathology, Haematology, Histopathology, Immunology, Medical Microbiology and Parasitology. The Journal aims to bring under one cover publications of regional interest embracing the various sub-specialities of Pathology. It is expected that the articles published would be of value not only to pathologists, but also to medical practitioners in search of a scientific basis for the problems encountered in their practice, and to those with an interest in diseases which occur in the tropics.