Performance of an Automated Immature Granulocyte Count as a Predictor of Neonatal Sepsis

Abstract

Neonatologists use immature granulocytes (IG) in manual differential counts as an indicator of sepsis. This study was designed to compare the predictive ability of automated vs manual IG counts for neonatal sepsis. Infants undergoing sepsis evaluation were identified prospectively for study if a CBC count was obtained in temporal proximity to the blood culture. Automated IG counts were obtained from the research software of the Sysmex XE-2100 (Sysmex, Kobe, Japan). Manual average IG counts were obtained from two 100-cell manual differential counts independently performed by a technologist and a hematopathology resident. A comparative analysis of manual and automated IG counts showed considerable overlap of ranges. The highest positive blood culture rate occurred in the nonneutropenic preterm subset of infant older than 7 days (21/55 [38%]). For these infants, elevated IG counts by manual and automated methods were associated significantly with positive blood culture results (odds ratio, manual, 3.74; odds ratio, automated, 3.63), albeit with low sensitivity.

The Role of Immature Granulocyte Count and Immature Myeloid Information in the Diagnosis of Neonatal Sepsis

“…Also in preterm hospitalized infants elevations of IGs were associated with positive blood culture results. In this study, values exceeding 0.5% showed a more than three-fold increased likelihood of a positive blood culture (Nigro et al, 2005).…”

Immature granulocyte count on the new Sysmex XN-9000: performance and diagnosis of sepsis in the intensive care unit

“…Interestingly, the imprecision of IG on the XN-9000 seems even better than that of IG compared with the previous generation Sysmex analyzers and OM. (6,7,10) The analysis of bias shows that the XN-9000 exhibits a trend towards overestimation of both IG# and IG% compared to OM, an aspect that was previously described by Maenhout et al (9) However, unlike data reported by Maenhout, in our study the diagnostic accuracy of IG# and IG% on XN-9000 was characterized by significantly better AUC (p <0.0001) than those exhibited by the same parameters obtained with OM (OM-IG # and OM-IG% ) (table 4 and 5).…”

Delta neutrophil index: A reliable marker to differentiate perforated appendicitis from non‐perforated appendicitis in the elderly

“…[22][23][24][25][26][27] Recent studies have examined its ability to predict infectious conditions. 22,23,28,29 In this study, we investigated the usefulness of DNI as an early predictor of appendiceal perforation in elderly patients. (Figure 1).…”