Department of Laboratory Medicine, Konkuk University School of Medicine, Chungju, South Korea.
Clin Chim Acta. 2014 Jan 1;427:11-4. doi: 10.1016/j.cca.2013.09.016. Epub 2013 Sep 28.
Delta neutrophil index (DNI) has been reported to be useful in the diagnosis of sepsis. We evaluated the role of DNI for differentiating true bacteremia from blood contamination and compared the DNI value with previously validated markers such as procalcitonin (PCT) and C-reactive protein (CRP).
The blood culture positive group was subdivided into true bacteremia (n=199) and contamination (n=158). The blood cultures were incubated in the BacT/Alert 3D (bioMérieux, Marcyl'Etoile, France) and BACTEC FX (Becton Dickinson, Sparks, MD, USA) systems for 5days. Data of complete blood cell count were collected from an automatic cell analyzer (ADVIA2120 Hematology System, Siemens Healthcare Diagnostics) to calculate DNI.
Concentrations for DNI, PCT, and CRP were significantly higher in the true bacteremia group. When the gram-positive and gram-negative infections were compared among true bacteremia, only PCT was increased significantly in GNB bacteremia. DNI levels were well correlated with PCT (r=0.564, P<0.0001) and CRP (r=0.344, P<0.001) using the Spearman test among the culture positive bacteremia. The area under the ROC curve was 0.75 for PCT, 0.69 for CRP, and 0.69 for DNI.
We demonstrated the usefulness of DNI in differentiating true bacteremia from contamination in patients with a positive blood culture.
已有研究报道，中性粒细胞 delta 指数（DNI）有助于脓毒症的诊断。我们评估了 DNI 用于鉴别真性菌血症与血污染的作用，并将 DNI 值与降钙素原（PCT）和 C 反应蛋白（CRP）等先前已验证的标志物进行了比较。
将血培养阳性组细分为真性菌血症（n=199）和血污染（n=158）。将血培养物分别置于 BacT/Alert 3D（bioMérieux，Marcyl'Etoile，法国）和 BACTEC FX（Becton Dickinson，Sparks，MD，美国）系统中孵育 5 天。从自动细胞分析仪（ADVIA2120 血液学系统，西门子医疗诊断）收集全血细胞计数数据，以计算 DNI。
真性菌血症组 DNI、PCT 和 CRP 浓度显著升高。在真性菌血症中比较革兰阳性菌和革兰阴性菌感染时，仅革兰阴性菌感染时 PCT 显著升高。Spearman 检验显示，在培养阳性菌血症中，DNI 水平与 PCT（r=0.564，P<0.0001）和 CRP（r=0.344，P<0.001）均呈良好相关性。ROC 曲线下面积为 0.75 的是 PCT，0.69 的是 CRP，0.69 的是 DNI。
我们证明了 DNI 有助于鉴别血培养阳性患者的真性菌血症与血污染。
