Elevated mean neutrophil volume+<scp>CRP</scp> is a highly sensitive and specific predictor of neonatal sepsis

Bhargava, Manorama; Saluja, Satish; Sindhuri, Upadrasta; Saraf, Amrita; Sharma, Parul

doi:10.1111/ijlh.12120

Cited by 24 publications

(18 citation statements)

References 9 publications

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“…This increase in neutrophil volume may be due to the toxic changes and left shift. Although the sensitivity of our study was comparable to other studies, the specificity in our study is higher [8,9]. The conductivity (MN-C-NE) and scatter (MN-S-NE) of neutrophils were not very good parameters individually to predict sepsis; however, a combination of both can be used effectively as conductivity is more sensitive and scatter is more specific.…”

Section: Discussionsupporting

confidence: 53%

Evaluation of Various Diagnostic Markers for Early Detection of Neonatal Sepsis

Jacob¹,

D²,

Cn³

et al. 2018

J Med Surg Pathol

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Background: Prompt diagnosis of neonatal sepsis at an early stage is essential to initiate therapy as well as to avoid unnecessary usage of antibiotics. Therefore the search for an ideal marker including antigenic expression on inflammatory cells is still continuing. The aim of the study was to identify an ideal early laboratory marker for diagnosis of neonatal sepsis. Methods: The samples sent for complete blood count were processed for Haematologic Scoring System (HSS) and flow cytometry for expression of CD64. The volume, conductivity and scatter of neutrophils and monocytes were retrieved from the analyzer. C Reactive protein (CRP) and culture reports were retrieved from Lab Information System. The samples were grouped as controls from normal babies, suspected sepsis with negative blood culture and proven sepsis with positive blood culture. Statistical analysis was done and compared among groups. A score of 3 and above HSS had sensitivity of 87% and specificity of 85%. Results: Mean fluorescent nCD64 at a cutoff of >105 can be considered as an ideal marker for early diagnosis of neonatal sepsis. It showed a higher sensitivity (97%) and higher specificity (>95%) for detecting neonatal sepsis. Conclusion: HSS and mean volume of neutrophils or a combination of mean scatter and conductivity of neutrophils may be utilized as markers when flow cytometry facility is not available.

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Section: Discussionsupporting

confidence: 53%

Evaluation of Various Diagnostic Markers for Early Detection of Neonatal Sepsis

Jacob¹,

D²,

Cn³

et al. 2018

J Med Surg Pathol

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“…In addition, lymphocytes are also an important cellular component of immune response. Volume increases are an early manifestation that these immune cells respond to severe infections and as such have been shown to serve as potential human biomarkers for latent sepsis [8][9][10][11][12]. Our results show changes in the volume of circulating immune cells, especially the increased mean neutrophil volume (MNV), mean monocyte volume (MMV), mean lymphocyte volume (MLV), and monocyte distribution width (MDW).…”

Section: Discussionmentioning

confidence: 71%

“…In addition to detecting routine blood cell parameters, it can also provide quantitative WBC volume, conductivity, and light scatter to reflect the morphological changes of them. Recent studies have shown that the increase in the volume of rudimentary immune cells reflected in the VCS parameter may help detect sepsis [8][9][10][11][12]. However, the application of VCS parameters in sepsis for patients with cirrhosis was less studied.…”

Section: Introductionmentioning

confidence: 99%

The Leukocyte VCS Parameters Compared with Procalcitonin, Interleukin-6, and Soluble Hemoglobin Scavenger Receptor sCD163 for Prediction of Sepsis in Patients with Cirrhosis

et al. 2019

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Background. Patients with liver cirrhosis have a high risk of sepsis and a poor prognosis. Recently, a new standard for sepsis (Sepsis-3) has been proposed in the general population. The Coulter Lh 750 hematology analyzer can evaluate mean volume, conductivity, scatter, and distribution width of leukocyte. We tried to use Sepsis-3 criteria to study the diagnostic value of volume, conductivity, and scattering (VCS) parameters in sepsis and infection in patients with liver cirrhosis compared with traditional infection markers (PCT, IL-6, sCDl63). Methods. A blinded, cohort study was conducted in three different ED populations within three affiliated hospitals. A total of 249 patients with liver cirrhosis were enrolled in the study. According to the "Sepsis-3" consensus criteria, clinical history, and laboratory examination, the subjects were divided into sepsis (n = 54), patients with infections (n = 95), and patients without systemic infections (n = 100). The blood samples of the patients were collected at the time of ED admission and were evaluated for the detection of sepsis. Results. The differences of MNV, MNS, MMV, MMS, MLV, NDW, and MDW in the three groups were statistically significant. In the diagnosis of sepsis in patients with liver cirrhosis, the sensitivity of combined detection of MMV and MDW was 88.89%; the specificity was 74%. This sensitivity was significantly better than the 83.3% achieved using 0.97 mg/L as the cutoff for sCD163. In the diagnosis of infection in cirrhosis, the sensitivity of combination of MNV and MMS was increased to 86.32%; the specificity was 92%. The sensitivity was the same as that achieved by using 0.31 ng/mL as the cutoff value of PCT, but the specificity increased. Conclusion. The leukocyte VCS parameter could be potential parameters for indicating sepsis and infection in patients with liver cirrhosis. The combined detection of MMV and MDW seemed to be helpful for the diagnosis of sepsis in these patients, and the combination of MNV and MMS could better indicate infection for them.

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“…There are many studies which have evaluated the role of VCS parameters in the diagnosis of sepsis [3][4][5][6]8 . In most of these studies MNV has shown to have maximum diagnostic value.…”

Section: Discussionmentioning

confidence: 99%

“…Some of the studies have also investigated the use of combination of VCS parameters along with other parameters of sepsis screen, CRP and IL-6 3,6 . This combination increased the sensitivity in these studies for diagnosis of sepsis 3,6,8 . In the present study we also analysed combination of VCS parameters with abnormal blood counts to improve the diagnostic accuracy.…”

Section: Discussionmentioning

confidence: 99%

Neutrophil Volume, conductivity and scatter (VCS) as a screening tool in neonatal sepsis

Nesargi

Niranjan

Bandiya

et al. 2020

Sci Rep

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neutrophil Volume, conductivity and scatter (VcS) as a screening tool in neonatal sepsis prerana nesargi 1 , H. S. niranjan 2 , prathik Bandiya 2* & naveen Benakappa 2 the initial evaluation of a suspected sepsis in a neonate is always challenging. there are many methods to screen a neonate with suspected sepsis. one of newer method is to assess the changes in neutrophil volume conductivity and scatter. the objective of this study was to establish changes in neutrophil volume conductivity scatter (VCS) in neonatal sepsis and to determine appropriate cut off levels using receiver operating characteristic (Roc) curves. neonates with suspected sepsis were evaluated with blood counts, culture and neutrophil VcS parameters. Based on these parameters neonates were classified into sepsis group (Blood culture positive), Probable sepsis group (clinical course consistent with sepsis and positive sepsis screen and negative blood culture), no sepsis group (clinical course not suggestive of sepsis with negative sepsis screen and blood culture). A total of 304 neonates were included in the study of which 144 were in sepsis group and 160 in no sepsis group respectively. Among the neutrophil VCS parameters there was significant difference between the groups with respect to mean neutrophil volume (MNV) and volume distribution width (VDW) (180 vs 163 vs 150) (p < 0.01). MNV and VDW had good sensitivity (95%, 82%) and specificity (86%, 74%) for diagnosis of sepsis. In conclusion, neutrophil VcS parameters, especially MnV, can be incorporated with other sepsis screen parameters in diagnosis of neonatal sepsis. Neonatal sepsis is one of the leading cause of mortality in developing countries 1. One of the most important challenges faced by neonatologists is accurate early diagnosis of neonatal sepsis. Improper diagnosis has led to unnecessary abuse of antibiotics and alarmingly increase in antibiotic resistance in developing countries 2. The conventional tests, commonly called sepsis screen, most often ordered in this scenario are labour intensive time consuming and subjective because of human interpretation 3. The Volume, Conductivity and Scatter (VCS) technology of coulter LH780 haematology analyser (Beckman coulter, fullerton, CA) can obtain data from WBCs and these VCS parameters can detect morphological changes in immature and reactive neutrophils. This technology is similar to evaluation of peripheral blood smear by microscope but it evaluates more than a microscope 4. It measures cell volume (mean neutrophil volume, MNV), conductivity (mean neutrophil conductivity, MNC) and scatter using direct current impedence, radiofrequency opacity and laser beam respectively 5. The information about cell size is given by MNV and internal chemical composition of the cell, especially the nuclear density and cytoplasmic granularity by MNC 5. This technology gives results in minutes with no additional blood needed than for the Complete Blood Count 6. Neutrophil VCS parameters were evaluated to diagnose sepsis and were found useful in adult pop...

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Elevated mean neutrophil volume+CRP is a highly sensitive and specific predictor of neonatal sepsis

Cited by 24 publications

References 9 publications

Evaluation of Various Diagnostic Markers for Early Detection of Neonatal Sepsis

Evaluation of Various Diagnostic Markers for Early Detection of Neonatal Sepsis

The Leukocyte VCS Parameters Compared with Procalcitonin, Interleukin-6, and Soluble Hemoglobin Scavenger Receptor sCD163 for Prediction of Sepsis in Patients with Cirrhosis

Neutrophil Volume, conductivity and scatter (VCS) as a screening tool in neonatal sepsis

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