The Clinical Utility of Automated Immature Granulocyte Measurement in the Early Diagnosis of Bacteremia.

Abstract

Background Early diagnosis and prompt management are crucial for bacteremia and sepsis, as they have the potential to lead to septic shock and fatal outcomes. Bacteremia induces the recruitment of immature granulocytes (IGs) into the circulation, which indicates active bone marrow response. The goal of our present study is to determine the effectiveness of automated IG measurement as an alternate indicator for infection and also its clinical utility in predicting positive blood culture (BC) results. Methods We conducted a retrospective study including 100 BC-positive patients for whom complete blood count (CBC) and BC were done at the same time. Multiple hematological parameters including total white blood cell count (TWC), absolute neutrophil count (ANC), absolute lymphocyte count (ALC), IG count (IGC), and IG percentage (IG%) were obtained from the automated hematology analyzer, and IGC/TWC (IG ratio), IGC/ANC (immature-to-total neutrophil ratio), and ANC/ALC (neutrophil-to-lymphocyte ratio) were calculated using the primary data and compared with 100 uninfected normal individuals. Results The mean value of IG% and IGC between culture-positive and culture-negative groups were statistically significant (p-value < 0.05), suggesting that they are potential markers for bacteremia, and also the IG% was significantly higher in patients with positive BCs. Conclusion IG measurement is an easily accessible, cost-effective potential marker for screening bacteremia. Therefore, IGC and IG% could be incorporated as a part of the CBC report.