1032. Usefulness of delta neutrophil index in automated immature granulocyte counts for assessing prognosis of patients with bacteremia
Session: Poster Abstract Session: Diagnostic Procedures in Clinical Practice
Saturday, October 22, 2011
Room: Poster Hall B1
Handouts
  • delta-IDSA poster.pdf (173.0 kB)
  • Background:  Recent models of automatic cell analyzers provide delta neutrophil index(DNI), which corresponds to the fraction of immature granulocytes in circulating blood. This study investigated the significance of DNI as a prognostic marker in patients with bacteremia.

    Methods: We retrospectively collected data on adult patients who admitted between November, 2009 and April, 2010 with significant bacteremia. DNIs were calculated by a blood cell analyzer (ADVIA 2120i, Siemens) Factors associated with 28 days’ mortality were assessed.

    Results:  A total of 102 patients were included in the analysis. Among them, 24 patients died within 28 days. In univariate analysis, appropriate antibiotic treatment, multidrug resistant bacterial infection, ICU stay before the onset of bacteremia, nosocomial infection, DNI at 72 hours after bacteremia and platelet count at the time of bacteremia were significantly associated with survival. In multivate analysis, DNI at 72 hours after bacteremia and platelet count at the time of bacteremia were the independent factors associated with survival.

    Table 1.Factors associated with survival in patients with bacteremia

     

    Survivor

    Non-survivor

    p-value

    Appropriate antibiotic treatment, %

    92.3

    75.0

    0.032

    Multidrug resistant bacterial infection, %

    34.6

    66.7

    0.009

    ICU stays before the onset of bacteremia, %

    17.9

    54.2

    0.001

    Nosocomial infection, %

    32.1

    66.7

    0.004

    SIRS, %

    61.5

    70.8

    0.473

    Septic shock, %

    9.0

    8.3

    1.000

    DNI, mean

    3.4

    6.2

    0.073

    DNI-24hr, mean

    3.5

    6.2

    0.098

    DNI-72hr, mean

    1.9

    6.2

    0.005

    WBC, mean

    12821

    14856

    0.340

    Neutrophil, mean

    85.8

    90.4

    0.008

    Platelet, mean

    223240

    120540

    0.000

    CRP, mean

    136.1

    158.4

    0.414

    Table 2. Multivariate analysis of the factors associated with survival in patients with bacteremia

     

    Odds ratio

    p-value

    95% CI

    Lower

    Upper

    DNI-72hr

    1.25

    0.023

    1.03

    1.51

    Platelet

    0.99

    0.003

    0.98

    0.99

    Neutrophil

    1.10

    0.107

    0.98

    1.22

    Appropriate antibiotic treatment

    0.24

    0.124

    0.04

    1.48

    Multidrug resistant bacterial infection

    1.95

    0.379

    0.44

    8.61

    ICU stay before the onset of bacteremia

    4.91

    0.044

    1.05

    23.05

    Infection acquired in hospital

    1.99

    0.349

    0.47

    8.44

    Conclusion: DNI has implications for the prognosis of bacteremia, and DNI at 72 hours after bacteremia may be valuable to assess the prognosis of patients with bacteremia.


    Subject Category: D. Diagnostic microbiology

    Hye won Kim, MD, Nam Su Ku, MD, Su Jin Jeong, MD, Heekyoung Choi, MD, Sang Hoon Han, MD, Jun Yong Choi, MD and June Myung Kim, MD, Department of Internal Medicine and AIDS Research Institute, Yonsei University College of Medicine, Seoul, South Korea

    Disclosures:

    H. W. Kim, None

    N. S. Ku, None

    S. J. Jeong, None

    H. Choi, None

    S. H. Han, None

    J. Y. Choi, None

    J. M. Kim, None

    Findings in the abstracts are embargoed until 12:01 a.m. EST Thursday, Oct. 20 with the exception of research findings presented at IDSA press conferences.