Department of Clinical Laboratory, Second Hospital of Anhui Medical University, Hefei, Anhui, China.
Department of Gynecology and Obstetrics, First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China.
J Infect Dev Ctries. 2020 Nov 30;14(11):1264-1273. doi: 10.3855/jidc.12811.
To date, the relationship between the causative pathogens and the changes of hematological parameters was rarely referred and deserves further investigation.
A total of 825 adult patients, including 134 negative blood cultures patients and 691 bloodstream infection (BSI) patients, were screened for eligibility in this study. Receiver operating characteristic curves and binary logistic regression models were used to assess the power of hematological parameters to distinguish patients with BSI caused by different pathogens.
Except for platelet-to-lymphocyte ratio (PLR) and platelet larger cell count (P-LCC), the other hematological parameters investigated in the study were significantly different in patients with BSI caused by different pathogens, including Candida. The specific combinations of lymphocyte count (LYM), platelet count (PLT), neutrophil-to-lymphocyte ratio (NLR), mean platelet volume (MPV), MPV-to-PLT ratio (MPV/PLT), platelet larger cell ratio (P-LCR), and C-reactive protein (CRP) can improve the ability to distinguish various BSI from negative blood cultures. The highest area under the curve of was 0.753 (95% CI 0.709-0.797) for positive blood cultures, 0.715 (95% CI 0.658-0.771) for Gram-positive pathogens BSI, 0.777 (95% CI 0.730-0.824) for Gram-negative pathogens BSI, 0.797 (95% CI 0.747-0.846) for Escherichia coli BSI, 0.943 (95% CI 0.899-0.987) for Enterobacter aerogenes BSI, 0.830 (95% CI 0.740-0.921) for Pseudomonas aeruginosa BSI, and 0.767 (95% CI 0.695-0.839) for Staphylococcus aureus BSI.
The specific combinations of hematological parameters can improve the power to distinguish patients with BSI caused by different pathogens. Attention to these parameters can be easily integrated into daily medical activities, without extra costs.
迄今为止，有关病原体与血液学参数变化之间的关系鲜少被提及，值得进一步研究。
本研究共筛选了 825 名成年患者，包括 134 名血培养阴性患者和 691 名血流感染（BSI）患者。使用受试者工作特征曲线和二元逻辑回归模型来评估血液学参数区分不同病原体引起的 BSI 患者的能力。
除血小板淋巴细胞比（PLR）和血小板大细胞计数（P-LCC）外，本研究中调查的其他血液学参数在不同病原体引起的 BSI 患者中差异显著，包括念珠菌。淋巴细胞计数（LYM）、血小板计数（PLT）、中性粒细胞淋巴细胞比（NLR）、平均血小板体积（MPV）、MPV 与 PLT 比（MPV/PLT）、血小板大细胞比（P-LCR）和 C 反应蛋白（CRP）的特定组合可以提高区分各种 BSI 与血培养阴性的能力。阳性血培养的曲线下面积最高为 0.753（95%CI 0.709-0.797），革兰阳性病原体 BSI 为 0.715（95%CI 0.658-0.771），革兰阴性病原体 BSI 为 0.777（95%CI 0.730-0.824），大肠埃希菌 BSI 为 0.797（95%CI 0.747-0.846），产气肠杆菌 BSI 为 0.943（95%CI 0.899-0.987），铜绿假单胞菌 BSI 为 0.830（95%CI 0.740-0.921），金黄色葡萄球菌 BSI 为 0.767（95%CI 0.695-0.839）。
血液学参数的特定组合可以提高区分不同病原体引起的 BSI 患者的能力。关注这些参数可以很容易地整合到日常医疗活动中，无需额外费用。
