Mean cell volume of neutrophils and monocytes compared with C‐reactive protein, interleukin‐6 and white blood cell count for prediction of sepsis and nonsystemic bacterial infections

Abstract

Clinicians are in need of better diagnostic markers for rapid diagnosis of severe infections. Therefore, we studied the diagnostic significance of mean cell volume of neutrophils (MNV) and monocytes (MMV) compared with Interleukin-6 (IL-6), C-reactive protein (CRP) and white blood cell count for predicting systemic clinical infection (sepsis). MNV and MMV were obtained by volume conductivity scatter (VCS) technique of the Coulter LH 750 hematology analyzer during automated differential counts, and blood samples from patients with sepsis (n = 37), nonsystemic bacterial infections (n = 39) and controls (n = 48) were studied. We observed a significant increase in MNV and MMV in the sepsis group compared with limited infections and controls. However, at a designated cut-off point of 250 pg/ml, IL-6 seemed to be the best predictor for sepsis with a sensitivity of 93% and a specificity of 76%. Compared with CRP (cut-off point 60 mg/dl), MNV at a cut-off of 150 had a comparable sensitivity and specificity and was the most predictive VCS parameter. Taken together, MNV and MMV seemed to be potential parameters to discriminate between sepsis and nonsystemic infections.

Automated determination of neutrophil VCS parameters in diagnosis and treatment efficacy of neonatal sepsis

“…Koening (2010) studied neutrophil and monocyte VCS parameters in adults including 37 sepsis and 39 nonsystemic-infection patients (12). They found higher MNV in the sepsis group than in the nonsystemic-infection and control groups, and lower MNS in the sepsis and nonsystemic-infection groups than in the control group.…”

“…These parameters can be measured by the VCS technology of the Coulter LH 780 hematology analyzer (9)(10)(11)(12)(13). This so-called VCS technology is analogous to microscopic evaluation of a peripheral blood smear but evaluates more than a microscope.…”

“…This study also gives additional information about effects of sepsis onset time and birth weight on VCS parameters. Previous studies mostly included adult patients and there was only one study including newborns to diagnose late-onset neonatal sepsis (11)(12)(13)(14). Raimondi et al (2010) reported the cutoff levels of MNV and VDW as 148 au and 27.5 au in late-onset sepsis of very-lowbirth-weight infants, including 20 with proven and 20 with clinical sepsis.…”

“…It has been previously reported that VCS parameters can detect morphologic changes in immature and reactive neutrophils. This so-called VCS technology is analogous to microscopic evaluation of a peripheral blood smear but evaluates more than a microscope (9)(10)(11)(12)(13).…”

A Novel Approach for the Screening of Megaloblastic Anaemia

“…Recently these same parameters have been found to predict sepsis and non-systemic bacterial infection [13] which might lead to the supposition that in the presence of infection NeMV or MoMV would loose specificity for the detection of B12 and/or folate deficiency by showing false positive results in these circumstances. In this small group of patients this did not seem to be the case.…”