We aimed to investigate the diagnostic value of leukocyte cell population data (CPD) parameters obtained from an automated hematology analyzer to be able to use it in the diagnosis of neonatal sepsis. Our study was a retrospective and cross-sectional analysis. The neonates were classified into 3 groups: culture-positive sepsis (n = 20), clinical sepsis (n = 87), and control (n = 269). CPD parameters were determined during complete blood count (CBC) by volume-conductivity-scatter (VCS) technology with DxH 900 Coulter Cell Analyzer. Mean neutrophil volume (MNVNE), standard deviations of volumes of neutrophils (SDVNE), standard deviations of volumes of monocytes (SDVMO), and monocyte distribution width (MDW) were significantly increased in the culture-positive sepsis group compared with the clinical sepsis and control groups (P < .05). We have demonstrated the diagnostic utility of leukocyte CPD parameters, especially MNVNE, MDW, and their combination, for neonatal sepsis. These parameters are advantageous because they are obtained during routine CBC analysis without the need for additional blood collection and extra costs.
Zea-VeraAOchoaTJ.Challenges in the diagnosis and management of neonatal sepsis. J Trop Pediatr. 2015;61(1):1-13.
4.
Fleischmann-StruzekCGoldfarbDMSchlattmannPSchlapbachLJReinhartKKissoonN.The global burden of paediatric and neonatal sepsis: a systematic review. Lancet Respir Med. 2018;6(3):223-230.
5.
LiuLJohnsonHLCousensS, et al. Global, regional, and national causes of child mortality: an updated systematic analysis for 2010 with time trends since 2000. Lancet. 2012;379:2151-2161.
6.
GerdesJS.Diagnosis and management of bacterial infections in the neonate. Pediatr Clin North Am. 2004;51(4):939-959, viii.
7.
NewmanTBPuopoloKMWiSDraperDEscobarGJ.Interpreting complete blood counts soon after birth in newborns at risk for sepsis. Pediatrics. 2010;126(5):903-909.
8.
HedegaardSSWisborgKHvasAM.Diagnostic utility of biomarkers for neonatal sepsis-a systematic review. Infect Dis (Lond). 2015;47(3):117-124.
9.
YangAPLiuJYueLHWangHQYangWJYangGH.Neutrophil CD64 combined with PCT, CRP and WBC improves the sensitivity for the early diagnosis of neonatal sepsis. Clin Chem Lab Med. 2015;54:345-351.
ÇelikHTPortakalOYiğitŞHasçelikGKorkmazAYurdakökM.Efficacy of new leukocyte parameters versus serum C-reactive protein, procalcitonin, and interleukin-6 in the diagnosis of neonatal sepsis. Pediatr Int. 2016;58(2):119-125.
12.
KelkarUDoshiPTyagiTNisalAManiNS.Utility of volume, conductivity and scatter parameters for early diagnosis of neonatal sepsis. J Appl Hematol. 2017;8(3):105-109.
13.
AbiramalathaTSanthanamSMammenJJ, et al. Utility of neutrophil volume conductivity scatter (VCS) parameter changes as sepsis screen in neonates. J Perinatol. 2016;36(9):733-738.
14.
NesargiPNiranjanHSBandiyaPBenakappaN.Neutrophil volume, conductivity and scatter (VCS) as a screening tool in neonatal sepsis. Sci Rep. 2020;10(1):4457.
15.
CelikIHDemirelGAksoyHT, et al. Automated determination of neutrophil VCS parameters in diagnosis and treatment efficacy of neonatal sepsis. Pediatr Res. 2012;71(1):121-125.
16.
BhargavaMSalujaSSindhuriUSarafASharmaP.Elevated mean neutrophil volume + CRP is a highly sensitive and specific predictor of neonatal sepsis. Int J Lab Hematol. 2014;36(1):e11-e14.
17.
BahargavaMSindhuriUSalujaSSarafADayanandSSimon-LopezR.Volume, conductivity and scatter properties of leukocytes (VCS Technology) is a highly sensitive and specific predictor of blood culture proven neonatal sepsis. Blood. 2010;116(21):4729.
18.
CelikIHDemirelGSukhachevDErdeveODilmenU.Neutrophil volume, conductivity and scatter parameters with effective modeling of molecular activity statistical program gives better results in neonatal sepsis. Int J Lab Hematol. 2013;35(1):82-87.
19.
LeeAJKimSG.Mean cell volumes of neutrophils and monocytes are promising markers of sepsis in elderly patients. Blood Res. 2013;48(3):193-197.
20.
MardiDFwityBLobmannRAmbroschA.Mean cell volume of neutrophils and monocytes compared with C-reactive protein, interleukin-6 and white blood cell count for prediction of sepsis and nonsystemic bacterial infections. Int J Lab Hematol. 2010;32:410-418.
21.
CrouserEDParrilloJESeymourC, et al. Improved early detection of sepsis in the ED with a novel monocyte distribution width biomarker. Chest. 2017;152(3):518-526.
22.
SchmatzMSrinivasanLGrundmeierRW, et al. Surviving sepsis in a referral neonatal intensive care unit: association between time to antibiotic administration and in-hospital outcomes. J Pediatr. 2020;217:59-65.
23.
DeleonCShattuckKJainSK.Biomarkers of neonatal sepsis. Neoreviews. 2015;16(5):e297-e308.
24.
TziallaCManzoniPAchilleCBollaniLStronatiMBorghesiA.New diagnostic possibilities for neonatal sepsis. Am J Perinatol. 2018;35(6):575-577.
25.
BenitzWE.Adjunct laboratory tests in the diagnosis of early-onset neonatal sepsis. Clin Perinatol. 2010;37(2):421-438.
26.
ArnonSLitmanovitzIRegevRHBauerSShainkin-KestenbaumRDolfinT.Serum amyloid A: an early and accurate marker of neonatal early-onset sepsis. J Perinatol. 2007;27(5):297-302.
27.
StockerMFontanaMEl HelouSWegscheiderKBergerTM.Use of procalcitonin-guided decision-making to shorten antibiotic therapy in suspected neonatal early-onset sepsis: prospective randomized intervention trial. Neonatology. 2010;97(2):165-174.
28.
ChavesFTiernoBXuD.Quantitative determination of neutrophil VCS parameters by the Coulter automated hematology analyzer: new and reliable indicators for acute bacterial infection. Am J Clin Pathol. 2005;124(3):440-444.
29.
ChavesFTiernoBXuD.Neutrophil volume distribution width: a new automated hematologic parameter for acute infection. Arch Pathol Lab Med. 2006;130(3):378-380.
30.
JacobSJSumanFRDShaliniSCNNinanBVaradarajanSMagdaleneJ.Evaluation of various diagnostic markers for early detection of neonatal sepsis. J Med Surg Pathol. 2018;3:3.
HouSKLinHATsaiHWLinCFLinSF.Monocyte distribution width in children with systemic inflammatory response: retrospective cohort examining association with early sepsis. Pediatr Crit Care Med. 2022;23(9):698-707.
33.
RaimondiFFerraraTCapassoL, et al. Automated determination of neutrophil volume as screening test for late-onset sepsis in very low birth infants. Pediatr Infect Dis J. 2010;29(3):288.
34.
TuzunFOzkanHCetinkayaM, et al. Is European Medicines Agency (EMA) sepsis criteria accurate for neonatal sepsis diagnosis or do we need new criteria?PLoS ONE. 2019;14(6):e0218002.
