Abstract
IntroductionThere is scarce evidence on the use of eosinophil count as a marker of outcome in patients with infection. The aim of this study was to evaluate whether changes in eosinophil count, as well as the neutrophil-lymphocyte count ratio (NLCR), could be used as clinical markers of outcome in patients with bacteremia.MethodsWe performed a retrospective study of patients with a first episode of community-acquired or healthcare-related bacteremia during hospital admission between 2004 and 2009. A total of 2,311 patients were included. Cox regression was used to analyze the behaviour of eosinophil count and the NLCR in survivors and non-survivors.ResultsIn the adjusted analysis, the main independent risk factor for mortality was persistence of an eosinophil count below 0.0454·103/uL (HR = 4.20; 95% CI 2.66–6.62). An NLCR value >7 was also an independent risk factor but was of lesser importance. The mean eosinophil count in survivors showed a tendency to increase rapidly and to achieve normal values between the second and third day. In these patients, the NLCR was <7 between the second and third day.ConclusionBoth sustained eosinopenia and persistence of an NLCR >7 were independent markers of mortality in patients with bacteremia.
Highlights
There is scarce evidence on the use of eosinophil count as a marker of outcome in patients with infection
In 2003 Gil et al [6] showed that eosinophil count was a marker of infection, demonstrating that a leukocyte count of above 10,000/mm3 and an eosinophil count of below 40/mm3 were strongly related to the presence of bacterial infections
Aim To evaluate whether changes in eosinophil count, as well as the neutrophil-lymphocyte count ratio (NLCR), could be used as clinical markers of outcome in patients with bacteremia
Summary
There is scarce evidence on the use of eosinophil count as a marker of outcome in patients with infection. In 1922, Simon [3] coined the term ‘‘septic factor’’ to describe an association between neutrophilia and eosinopenia, and considered this factor a useful sign to guide diagnosis of pyogenic infection. This author suggested that an increase in eosinophils could indicate that recovery had begun. Several studies have used eosinophil counts, eosinopenia, as a marker of infection [4,5,6,7,8] and as an indicator of bacteremia [9,10,11], the results are controversial.
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