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. 2023 Jun 1:10:1156889.
doi: 10.3389/fmed.2023.1156889. eCollection 2023.

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

Yuki Miyajima  1 , Hideki Niimi  2 , Tomohiro Ueno  2 , Atsushi Matsui  3 , Yoshitsugu Higashi  1 , Nozomi Kojima  4 , Mari Kono  5 , Yosuke Iwasaki  6 , Kentaro Nagaoka  1 , Yoshihiro Yamamoto  1 , Isao Kitajima  2
Affiliations

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

Yuki Miyajima et al. Front Med (Lausanne). .

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.

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Conflict of interest statement

NK and YI were employed by the company Sysmex Corporation. Author MK was employed by the company Subsidiary of Sysmex Corporation. The authors declare that this study received funding from Sysmex Corporation. The funder had the following involvement in the study: study design, analysis, interpretation of data. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Flow chart showing patient selection.
Figure 2
Figure 2
Value of the neutrophil parameters (NE-SFL and NE-WY) in patients who developed bacterial infection with or without bacteremia. NE-SFL (A) and NE-WY (B) in the patients with or without bacteremia. Data are presented as Tukey box-plots and individual values. **p < 0.005. ROC, AUCs of NE-SFL (C) and NE-WY (D) for detecting bacteremia.
Figure 3
Figure 3
Correlations between the neutrophil parameters and bacterial load (determined by PCR) in patients who developed bacterial infection with or without bacteremia. Correlation between the bacterial load in blood and NE-SFL (A)/NE-WY (B). Spearman correlation test was used, and Spearman correlation coefficient is shown. Corresponding logarithmic trendlines are shown.
Figure 4
Figure 4
Correlation matrix of sepsis biomarkers and blood bacterial load in patients who developed acute bacterial infection. Results are presented as a correlation matrix. Spearman correlation coefficients are plotted. Cells were colored according to the strength and trend of correlations (shades of red = positive, shades of blue = negative correlations). *p < 0.05. **p < 0.001.
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