Volume 24, Issue 4 (Avicenna Journal of Clinical Medicine- Winter 2018)                   Avicenna J Clin Med 2018, 24(4): 270-276 | Back to browse issues page

XML Persian Abstract Print

Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
Hashemi S H, Ghasemi Basir H R, Seifrabiei M A, Saify A. Comparison of the Predictive Values of Absolute Neutrophil Count, Absolute Band Count, and Toxic Granulation of Neutrophils with Serum Levels of C-reactive Protein for the Diagnosis of Bacterial Infections. Avicenna J Clin Med 2018; 24 (4) :270-276
URL: http://sjh.umsha.ac.ir/article-1-1615-en.html
Comparison of the Predictive Values of Absolute Neutrophil Count, Absolute Band Count, and Toxic Granulation of Neutrophils with Serum Levels of C-reactive Protein for the Diagnosis of Bacterial Infections
Seyed Hamid Hashemi1 , Hamid Reza Ghasemi Basir 2, Mohammad Ali Seifrabiei1 , Anahita Saify1
1- Hamadan University of Medical Sciences, Hamadan, Iran
2- Department of Pathology, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran , hrgb2004@yahoo.com
Abstract:   (7650 Views)
Background and Objective: Correct and early diagnosis of infections contributes to proper treatment and helps prevent unnecessary antibiotic treatment. Thus, we aimed to compare the predictive values of the absolute neutrophil count, band count, and toxic granulation of neutrophils with the serum levels of C-reactive protein (CRP) in bacterial infections.
Materials and Methods: In this descriptive cross-sectional study, we enrolled 200 patients who were admitted to the infectious disease ward of Sina Hospital, Hamadan, Iran, for bacterial infections in the first 6 months of 2016. The participants were chosen using the census sampling method. Before initiating the treatment, to carry out complete blood count (CBC) and quantitative CRP, 5 cc blood was obtained from the patients after obtaining their permission, and the percentages of neutrophils, band cells, and toxic granulation were evaluated in peripheral blood smear. This information and demographic data were collected by a checklist and analyzed by using SPSS, version 16.
Results: The mean age of the patients was 56.26 years (range: 12 to 103 years), and 60.5% of the participants were male. The most frequent causes of hospitalization were pneumonia, soft tissue infections, sepsis, urinary tract infection, septic arthritis, and dysentery. The means of serum CRP, absolute neutrophil count, and band-cell count were 61.18 mg/L, 815.86 per mm3, and 318.86 per mm3, respectively. The correlation coefficients between quantitative CRP and absolute neutrophil count, band count, and toxic granulation severity were 0.43, 0.47, and 0.47, respectively.
Conclusion: The results of the present study shows a linear correlation between CRP and the absolute neutrophil count, band count, and toxic granulation, indicating that these variables can replace CRP in the diagnosis of infections. Also, the predictive values of toxic granulation and band count for replacing CRP are equal and higher than that of absolute neutrophil count.
 
Keywords: C-reactive Protein, Infection, Neutrophil, Toxic Granulation
Full-Text [PDF 583 kb]   (1622 Downloads)    
Type of Study: Original |
References
1. 1. Khabbaz R, Bell BP, Schuchat A, Ostroff SM, Moseley R, Levitt A, et al. Emerging and reemerging infectious disease threats. In: Bennett J, Dolin R, Blaser MJ, editors. Principles and practice of infectious diseases. Philadelphia: Elsevier Saunders; 2015. P. 158-78.
2. 2. Martin G, Mannino D, Eaton S, Moss M. The epidemiology of sepsis in the United States from 1979 through 2000. N Engl J Med. 2003;348(16):1546-54. [DOI] [PubMed]
3. 3. Balk RA. Systemic inflammatory response syndrome (SIRS): where did it come from and is it still relevant today? Virulence. 2014;5(1):20-6. [DOI] [PubMed]
4. 4. World Health Organization. Overcoming antimicrobial resistance. Geneva: World Health Organization; 2000.
5. 5. Lorrot M, Moulin F, Coste J, Ravilly S, Guerin S, Lebon P, et al. Procalcitonin in pediatric emergencies: comparison with C-reactive protein, interleukin 6 and interferon alpha in the differentation between bacterial and viral infections. Presse Med. 2000;29(3):128-34. [PubMed]
6. 6. Cals JW, Butler CC, Hopstaken RM, Hood K, Dinant GJ. Effect of point of care testing for C reactive protein and training in communication skills on antibiotic use in lower respiratory tract infections: cluster randomised trial. BMJ. 2009;338:b1374. [PubMed]
7. 7. Cursons RT, Jeyerajah E, Sleigh JW. The use of polymerase chain reaction to detect septicemia in critically ill patients. Crit Care Med. 1999;27(5):937-40. [PubMed]
8. 8. Sands KE, Bates DW, Lanken PN, Graman PS, Hibberd PL, Kahn KL, et al. Epidemiology of sepsis syndrome in 8 academic medical centers. JAMA. 1997;278(3):234-40. [PubMed]
9. 9. Harris KA, Hartley JC. Development of broad-range 16S rDNA PCR for use in the routine diagnostic clinical microbiology service. J Med Microbiol. 2003;52(Pt 8):685-91. [DOI] [PubMed]
10. 10. Rothman RE, Majmudar MD, Kelen GD, Madico G, Gaydos CA, Walker T, et al. Detection of bacteremia in emergency department patients at risk for infective endocarditis using universal 16S rRNA primers in a decontaminated polymerase chain reaction assay. J Infect Dis. 2002;186(11):1677-81. [DOI] [PubMed]
11. 11. Al-Gwaiz LA, Babay HH. The diagnostic value of absolute neutrophil count, band count and morphologic changes of neutrophils in predicting bacterial infections. Med Princ Pract. 2007;16(5):344-7. [DOI] [PubMed]
12. 12. Cornbleet PJ. Clinical utility of the band count. Clin Lab Med. 2002;22(1):101-36. [PubMed]
13. 13. Newman TB, Draper D, Puopolo KM, Wi S, Escobar GJ. Combining immature and total neutrophil counts to predict early onset sepsis in term and late preterm newborns: use of the I/T2. Pediatr Infect Dis J. 2014;33(8):798-802. [DOI] [PubMed]
14. 14. Zarkesh M, Sedaghat F, Heidarzadeh A, Tabrizi M, Bolooki-Moghadam K, Ghesmati S. Diagnostic value of IL-6, CRP, WBC, and absolute neutrophil count to predict serious bacterial infection in febrile infants. Acta Med Iran. 2015;53(7):408-11. [PubMed]
15. 15. Novac R. The beleaguered band coun. Clin Lab Med. 1993;13(4):895-903. [PubMed]
16. 16. Rimarenko S, Castella A, Salzberg MR, Strand CL. Evaluation of the automated leukocyte differential count in emergency department patients. Am J Emerg Med. 1987;5(3):187-9. [PubMed]
17. 17. Shapiro MF, Greenfield S. The complete blood count and leukocyte differential count: an approach to their rational application. Ann Intern Med. 1987;106(1):65-74. [PubMed]
18. 18. Krause JR. Automated differentials in the hematology laboratory. Am J Clin Pathol. 1990;93(Suppl 1):11-6. [PubMed]
19. 19. Wenz B, Gennis P, Canova C, Burns ER. The clinical utility of the leukocyte differential in emergency medicine. Am J Clin Pathol. 1986;86(3):298-303. [PubMed]
20. 20. Mare TA, Treacher DF, Shankar-Hari M, Beale R, Lewis SM, Chambers DJ, et al. The diagnostic and prognostic significance of monitoring blood levels of immature neutrophils in patients with systemic inflammation. Crit Care. 2015;19:57. [DOI] [PubMed]
21. 21. Benez EI. Hematologic response to acute inflammation: the band neutrophil revisited. Tex Med. 1990;86(4):26-8. [PubMed]
22. 22. Seebach JD, Morant R, Ruegg R, Seifer L, Fehr J. The diagnostic value of the neutrophil left shift in predicting inflammatory and infectious diseases. Am J Clin Pathol. 1997;107(5):582-91. [PubMed]
23. 23. van de Vyver A, Delport EF, Esterhuizen M, Pool R. The correlation between C-reactive protein and toxic granulation of neutrophils in the peripheral blood. S Afr Med J. 2010;100(7):442-4. [PubMed]
24. 24. Kawakami M, Tsutsumi H, Kumakawa T, Abe H, Hirai M, Kurosawa S, et al. Levels of serum granulocyte colony-stimulating factor in patients with infections. Blood. 1990;76(10):1962-4. [PubMed]
25. 25. Struzyna J, Pojda Z, Braun B, Chomicka T, Sobiczewska E, Wremel J. Serum cytokine levels (IL-4, IL-6, IL-8, G-CSF) in burned patients. Burns. 2000;21(6):437-40. [PubMed]
26. 26. Harrington JM, Chou HT, Gutsmann T, Gelhaus C, Stahlberg H, Leippe M, et al. Membrane activity of a C-reactive protein. FEBS Lett. 2009;583(6):1001-5. [DOI] [PubMed]
27. 27. Marnell L, Mold C, Du Clos TW. C-reactive protein: ligands, receptors and role in inflammation. Clin Immunol. 2005;117(2):104-11. [DOI] [PubMed]
28. 28. Kabutomori O, Kanakura Y, Watani Y. Toxic granulation neutrophils and C-reactive protein. Arch Intern Med. 2001;160(21):3326-7. [PubMed]
29. 29. Fauci AS. Harrison 's principles of internal medicine. 18th ed. New York: MCGraw-Hill; 2012. P. 749-1825.
30. 30. Tejeswini V, Kande S, Premalatha P. Correlation of granularity index with toxic granulation of neutrophils by manual microscopy and C-reactive protein. J Dental Med Sci. 2012;3(2):35-9.
31. 31. Dhananjay BS, Nandaa SK. Comparison of biochemical and pathological markers in neonates with sepsis and neonates without sepsis. Int J Biol Med Res. 2011;2(4):1131-4.
Add your comments about this article : Your username or Email:
CAPTCHA
Send email to the article author

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

© 2024 CC BY-NC 4.0 | Avicenna Journal of Clinical Medicine

Designed & Developed by : Yektaweb