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the early detection and timely treatment are the most important factors for improving the outcome of patients with sepsis. Sepsis-related clinical score, such as SIRS, SOFA and LODS, were defined to identify patients with suspected infection and to predict severity and mortality. A few hematological parameters associated with organ dysfunction and infection were included in the score although various clinical pathology parameters (hematology, serum chemistry and plasma coagulation) in blood sample have been found to be associated with outcome in patients with sepsis. The investigation of the parameters facilitates the implementation of a complementary model for screening sepsis to existing sepsis clinical criteria and other laboratory signs. In this study, statistical analysis on the multiple clinical pathology parameters obtained from two groups, patients with sepsis and patients with fever, was performed and the complementary model was elaborated by stepwise parameter selection and machine learning. The complementary model showed statistically better performance (AUC 0.86 vs. 0.74-0.51) than models built up with specific hematology parameters involved in each existing sepsisrelated clinical score. Our study presents the complementary model based on the optimal combination of hematological parameters for sepsis screening in patients with fever.Sepsis, a dysregulated host response to infection, is a significant public health concern across the world, with more than >31 million cases annually and a mortality of 17% 1 . In the USA, the incidence rate of sepsis is 3 in 1000 individuals, which is 750,000 cases per year 2 . For each hour sepsis treatment is delayed, sepsis mortality increases by 7.6% 3 . Therefore, early intervention is important for patients with sepsis to increase the survival rates. However, the symptoms of sepsis are frequently non-specific, leading to a delay in diagnosis of sepsis. Fever, one of the symptoms, occurs in response to infection, inflammation and trauma. While it is often first manifestation of sepsis, it also is a sign of non-infectious etiology. Its non-specific response makes the early diagnosis of sepsis difficult. Given this difficulty with diagnosis, comparison study for two groups, patients with sepsis and patients with fever (abnormally high temperature), can therefore uncover set of (bio) markers which is sensitive and specific for sepsis screening in its early state.Studies on biomarkers, clinical criteria, and predictive models have been conducted for sepsis diagnosis. Many biomarkers have been evaluated for their utility in sepsis diagnosis. It was previously confirmed that procalcitonin (PCT), lactate, C-reactive protein (CRP), cytokines, D-dimer, and pro-adrenomedullin are elevated in patients

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BackgroundEarly and appropriate antibiotic treatment improves the clinical outcome of patients with septicemia; therefore, reducing the turn-around time for identification (ID) and antimicrobial susceptibility test (AST) results is essential. We established a method for rapid ID and AST using short-term incubation of positive blood culture broth samples on solid media, and evaluated its performance relative to that of the conventional method using two rapid ID systems and a rapid AST method.MethodsA total of 254 mono-microbial samples were included. Positive blood culture samples were incubated on blood agar plates for six hours and identified by the MicroFlex LT (Bruker Daltonics) and Vitek-MS (bioMeriéux) systems, followed by AST using the Vitek2 System (bioMeriéux).ResultsThe correct species-level ID rates were 82.3% (209/254) and 78.3% (199/254) for the MicroFlex LT and Vitek-MS platforms, respectively. For the 1,174 microorganism/antimicrobial agent combinations tested, the rapid AST method showed total concordance of 97.8% (1,148/1,174) with the conventional method, with a very major error rate of 0.5%, major error rate of 0.7%, and minor error rate of 1.0%.ConclusionsRoutine implementation of this short-term incubation method could provide ID results on the day of blood culture-positivity detection and one day earlier than the conventional AST method. This simple method will be very useful for rapid ID and AST of bacteria from positive blood culture bottles in routine clinical practice.

BackgroundEpstein-Barr Virus (EBV) is one of the most prevalent causes of viral infection in humans. EBV infection stage (acute, past, or absent infection) is typically determined using a combination of assays that detect EBV-specific markers, such as IgG and IgM antibodies against the EBV viral capsid antigen (VCA) and IgG antibodies against the EBV nuclear antigen (EBNA). We compared the diagnostic performance and agreement of results between three commercial EBV antibody assays using an EBV performance panel (SeraCare Life Science, Milford, MA, USA) as a reference.MethodsEBV antibody tests of EBV VCA IgM, VCA IgG, and EBNA IgG antibodies were performed by the Architect (Abbott Diagnostics, Wiesbaden, Germany), Liaison (DiaSorin, Saluggia, Italy), and Platelia (Bio-Rad, Marnes-la-Coquette, France) assays. Agreement between the three assays was evaluated using 279 clinical samples, and EBV DNA and antibody test results were compared.ResultsThe three EBV antibody assays showed good diagnostic performance with good and excellent agreement with the performance panel (kappa coefficient, >0.6). The overall VCA IgM positivity rate was higher in EBV DNA-positive samples than in EBV DNA-negative samples for all three EBV antibody assays (P=0.02). The three EBV antibody assays exhibited good agreement in results for the clinical samples.ConclusionsThe diagnostic performance of the three EBV antibody assays was acceptable, and they showed comparable agreement in results for the clinical samples.