‘’Evaluation of Flora Bacteria Grown in Blood Cultures: Are They Etiologic Agent of Infection or Only Contaminants?’’

Objective: In this study, it was aimed to determine whether the flora bacteria growing in blood cultures were infectious agents or only contaminants, for this purpose the hemogram parameters and other demographic characteristics of the patients were evaluated. Materials and Methods: We evaluated 11.579 blood culture results using the BacT/ALERT® microbial detection system. The skin flora bacteria was detected in the blood cultures during one year and the rates of infectious agents among these bacteria were investigated retrospectively. The blood culture results, which were accepted as true bacteremia and contamination were compared in terms of positive blood culture flask count and inflammation markers (white blood cell count, neutrophil ratio, lymphocyte ratio and C-reactive protein levels). Results: The total number of blood culture test was 11.579. Out of this number, 8205 (70.87%) was free of microbial growth and there was 3374 (29.13%) with microbial growth. 2609 (77.3%) of the positive cultures represented skin flora bacteria, 2510 (96.2%) of them were coagulase negative staphylococci. Only 50 (1.9%) of the flora bacteria were considered as infectious agents in terms of clinical and laboratory findings in addition to culture. A statistically significant correlation was found between true bacteremia and white blood cell (WBC) count and C-reactive protein (C-RP) levels (p <0.05). Conclusion: Peripheral blood collection instead of catheter and using special phlebotomy teams should be taken into consideration in order to reduce contamination rates precautions such as adequate skin preparation, preparation of blood culture bottles and using single needle instead of double needle. Bangladesh Journal of Medical Science Vol.20(2) 2021 p.288-292

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Diagnostic Significance of White Blood Cell Count and C-Reactive Protein in Neonatal Sepsis; Asella Referral Hospital, South East Ethiopia

The Open Microbiology Journal ◽

10.2174/1874285801812010209 ◽

2018 ◽

Vol 12 (1) ◽

pp. 209-217

Author(s):

Abebe Sorsa

Keyword(s):

Blood Culture ◽

Blood Cell ◽

White Blood Cell ◽

Neonatal Sepsis ◽

C Reactive Protein ◽

Diagnostic Significance ◽

Gram Negative ◽

Reactive Protein ◽

Wbc Count ◽

Sensitivity Specificity

Introduction:Nowadays various biochemical markers, such as C-Reactive Protein (CRP), Procalcitonin and tumor necrosis factor alpha, have been proposed as a potential marker for screening neonatal sepsis. In the current study, we tried to see the diagnostic significance of White Blood Cell (WBC) count and CRP in diagnostic screening of neonatal sepsis.Methods:A prospective cross-sectional study was conducted from May 2016 to April 2017 in Asella Teaching and Referral Hospital. Data were entered into EPI-INFO version 3.5.1 for cleanup and then exported to SPSS version 17 for further analysis. Sensitivity, specificity, positive predictive value (PPV) and negative predictive values (NPV) were used to assess the accuracy of CRP and WBC count taking blood culture as gold standard.Results:Data of 303 neonates with clinical sepsis were analyzed. Positive CRP and abnormal WBC were reported in 136(45%) and 99(32.7%) of study subjects respectively. Blood culture turned to be positive in 88(29.4%) of study subjects. The Sensitivity, Specificity, PPV and NPV of WBC count were 59.5 %, 79.6%, 52%, 64.5% respectively while the sensitivity, specificity, PPV and NPV of CRP were 65.6%, 78%, 42% and 91% respectively. By combining both WBC and CRP, the sensitivity, specificity, PPV and NPV improve to 78.5%, 83%, 60% and 93% respectively. CRP positivity rate was comparable across gram positive and gram negative bacteria while high WBC count were more reported among gram positive sepsis than gram negative ( OR 4.8, (95% CI 1.45-15.87, P 0.01)Conclusion:Based on this study’s finding, it can be concluded that CRP alone or in combination with WBC count showed better diagnostic accuracy in neonatal sepsis.

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P2212 A comparative study of white blood cell count, neopterin and C-reactive protein for prediction of stenosis complexity in patients with non-ST-segement elevation acute coronary syndromes

European Heart Journal ◽

10.1016/s0195-668x(03)95206-7 ◽

2003 ◽

Vol 24 (5) ◽

pp. 420

Author(s):

P AVANZAS

Keyword(s):

Blood Cell ◽

Comparative Study ◽

Cell Count ◽

White Blood Cell Count ◽

White Blood Cell ◽

Acute Coronary Syndromes ◽

C Reactive Protein ◽

Blood Cell Count ◽

Reactive Protein ◽

Coronary Syndromes

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C-Reactive Protein and White Blood Cell Count in Non-Infective Acute Ischemic Stroke Patients Treated with Intravenous Thrombolysis

Journal of Clinical Medicine ◽

10.3390/jcm10081610 ◽

2021 ◽

Vol 10 (8) ◽

pp. 1610

Author(s):

Marcin Wnuk ◽

Justyna Derbisz ◽

Leszek Drabik ◽

Agnieszka Slowik

Keyword(s):

Ischemic Stroke ◽

Blood Cell ◽

Acute Ischemic Stroke ◽

Cell Count ◽

White Blood Cell Count ◽

White Blood Cell ◽

Intravenous Thrombolysis ◽

C Reactive Protein ◽

Blood Cell Count ◽

Reactive Protein

Background: Previous studies on inflammatory biomarkers in acute ischemic stroke (AIS) produced divergent results. We evaluated whether C-reactive protein (CRP) and white blood cell count (WBC) measured fasting 12–24 h after intravenous thrombolysis (IVT) were associated with outcome in AIS patients without concomitant infection. Methods: The study included 352 AIS patients treated with IVT. Excluded were patients with community-acquired or nosocomial infection. Outcome was measured on discharge and 90 days after stroke onset with the modified Rankin scale (mRS) and defined as poor outcome (mRS 3–6) or death (mRS = 6). Results: Final analysis included 158 patients (median age 72 years (interquartile range 63-82), 53.2% (n = 84) women). Poor outcome on discharge and at day 90 was 3.8-fold and 5.8-fold higher for patients with CRP ≥ 8.65 mg/L (fifth quintile of CRP), respectively, compared with first quintile (<1.71 mg/L). These results remained significant after adjustment for potential confounders (odds ratio (OR) on discharge = 10.68, 95% CI: 2.54–44.83, OR at day 90 after stroke = 7.21, 95% CI: 1.44–36.00). In-hospital death was 6.3-fold higher for patients with fifth quintile of CRP as compared with first quintile and remained independent from other variables (OR = 4.79, 95% CI: 1.29–17.88). Independent predictors of 90-day mortality were WBC < 6.4 × 109 /L (OR = 5.00, 95% CI: 1.49–16.78), baseline National Institute of Health Stroke Scale (NIHSS) score (OR = 1.13 per point, 95% CI: 1.01–1.25) and bleeding brain complications (OR = 5.53, 95% CI: 1.59–19.25) but not CRP ≥ 8.65 mg/L. Conclusions: Non-infective CRP levels are an independent risk factor for poor short- and long-term outcomes and in-hospital mortality in AIS patients treated with IVT. Decreased WBC but not CRP is a predictor for 90-day mortality.

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Predictive values of Alvarado score, serum C-reactive protein, and white blood cell count in the diagnosis of acute appendicitis: a prospective study

Annals of Pediatric Surgery ◽

10.1186/s43159-021-00074-y ◽

2021 ◽

Vol 17 (1) ◽

Author(s):

Ademola Olusegun Talabi ◽

Tewogbade Adeoye Adedeji ◽

Oludayo Adedapo Sowande ◽

Olusanya Adejuyigbe

Keyword(s):

Acute Appendicitis ◽

Blood Cell ◽

Cell Count ◽

White Blood Cell Count ◽

White Blood Cell ◽

C Reactive Protein ◽

Blood Cell Count ◽

Alvarado Score ◽

Reactive Protein ◽

Wbc Count

Abstract Background The diagnosis of acute appendicitis in children is quite challenging as the rate of negative appendectomy varies between 15 and 57%. Increased utilization of imaging diagnostic facilities in advanced countries seems to have reduced the incidence of operating on normal appendix to a single digit. In low- and middle-income countries, the incidence remains unacceptably high (double digits). Inflammatory markers and scoring systems may be a suitable adjunct to increase diagnostic yield in most third world countries. Thus, the aim of this study was to evaluate the diagnostic value of Alvarado score, white blood cell count, and serum C-reactive protein in children with acute appendicitis. Results The ages of patients ranged between 4 and 15 years with a mean of 11.2 ± 2.8 years. The male to female ratio was 1.4 to 1.0. Nineteen percent of patients had negative appendiceal findings on histological examination. The sensitivity and specificity of Alvarado score, C-reactive protein estimation, total white blood cell count in diagnosing acute appendicitis were 86.4% and 63.2%, 98.8% and 36.8%, and 51.9% and 89.5% respectively. Alvarado score has the highest area under ROC curve analysis 0.824, 95% CI of 0.724 to 0.924 compared with CRP, 0.769. 95% CI of = 0.647 to 0.891 and WBC count, 0.765, 95% CI of 0.643 to 0.887. Both CRP and WBC count showed higher discriminatory values between complicated and uncomplicated appendicitis, p < 0.001. Conclusion Alvarado score outperformed other tests in setting the diagnosis of acute appendicitis. However, none of the tests can be relied on wholly for operative decision. Clinical judgement remains the bedrock for diagnosis and operative management.

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