Evaluation of complete blood count, c-reactive protein, and lactate dehydrogenase in culturable and unculturable bacteremia for early diagnosis of sepsis
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Abstract
Bacteremia is a bacterial infection that enters the bloodstream. This study was designed to investigate if culture methods could detect the bacterial infection of the bloodstream and to assess certain criteria for bacterial sepsis in culturable and non-culturable blood samples from hospitalized patients, like C-reactive protein (CRP), lactate dehydrogenase (LDH), and complete blood count (CBC). A total of 100 blood samples from patients with symptoms of sepsis who resided in the Hilla City hospital were collected as well as 25 samples as a healthy control group without disease or inflammation. Each sample was divided into three containers; 2ml in an EDTA tube for the CBC test, 3ml in a centrifuged tube for the CRP and LDH test, and 3-7ml in brain heart infusion broth for blood culture. The study result showed that 65 (65%) of 100 samples had abnormal tests, whereas only 25 (25%) of 100 were culture positive. There was a statistically significant difference between patients and control regarding all parameters CRP, LDH, white blood cell (WBC), lymphocyte (LYM) and granulocyte (GRA) (P= 0.000). No significant association in studied parameters was observed between culture-positive and culture-negative patients. Significant strong positive correlation was observed between WBC and LDH (r= 0.332) (p= 0.007), LYM and GR) (r= -0.983) (p= 0.000), LYM and CRP (r= 0.257) (p= 0.03), and between GRA and LDH (r= 0.254) (p= 0.04). Therefore, the estimation of WBC, granulocytes, lymphocytes count, CRP and LDH values and blood culture results may help in the early identification of the causative agent of sepsis.
Article Details
Article Details
Bacteremia, Blood culture, C-reactive protein, Lactate dehydrogenase, Sepsis
Corey, G. R. (2009). Staphylococcus aureus bloodstream infections: definitions and treatment. Clinical Infectious Diseases, 48(Supplement_4). https://doi.org/10.1086/598186.
Dunn, R., Bares, S. & David, M. Z. (2011). Central venous catheter-related bacteremia caused by Kocuria kristinae: case report and review of the literature. Annals of Clinical Microbiology and Antimicrobials, 10(1), 1-5. https://doi.org/10.1186/1476-0711-10-31.
Egi, M., Ogura, H., Yatabe, T., Atagi, K., Inoue, S., Iba, T. ... & Kimura, S. (2021). The Japanese clinical practice guidelines for management of sepsis and septic shock 2020 (J-SSCG 2020). Journal of Intensive Care, 9(1), 1-144. https://doi.org/10.1186/s40560-021-00555-7.
Giacobbe, D. R., Battaglini, D., Ball, L., Brunetti, I., Bruzzone, B., Codda, G. ... & Bassetti, M. (2020). Bloodstream infections in critically ill patients with COVID‐19. European Journal of Clinical Investigation, 50(10), e13319. https://doi.org/10.1111/eci.13319.
Halabi, Z., Mocadie, M., El Zein, S., & Kanj, S. S. (2019). Pseudomonas stutzeri prosthetic valve endocarditis: a case report and review of the literature. Journal of infection and public health, 12(3), 434-437. https://doi.org/10.1016/j.jiph.2018.07.004.
Kang, H. E. & Park, D. W. (2016). Lactate as a biomarker for sepsis prognosis? Infection & Chemotherapy, 48(3), 252-253. DOI: https://doi.org/10.3947/ic.2016.48.3.252.
Khatri, A., Malhotra, P., Izard, S., Kim, A., Oppenheim, M., Gautam-Goyal, P., ... & Farber, B. (2021). Hospital-acquired bloodstream infections in patients hospitalized with severe acute respiratory syndrome coronavirus 2 infection (coronavirus disease 2019): association with immunosuppressive therapies. In: Open forum infectious diseases ( 8 (7), p. of ab339). US: Oxford University Press. https://doi.org/10.1093/ofid/ofab339.
Kleinschmidt, S., Huygens, F., Faoagali, J., Rathnayake, I. U. & Hafner, L. M. (2015). Staphylococcus epidermidis as a cause of bacteremia. Future Microbiology, 10(11), 1859-1879. https://doi.org/10.2217/fmb.15.98.
M Novak-Weekley, S., & Dunne Jr, W. M. (2016). Blood culture a key investigation for diagnosis of bloodstream infections. http://hdl.handle.net/123456789/1030.
Mammen, J., Choudhuri, J., Paul, J., Sudarsan, T. I., Josephine, T., Mahasampath, G., ... & Peter, J. V. (2018). Cytomorphometric neutrophil and monocyte markers may strengthen the diagnosis of sepsis. Journal of Intensive Care Medicine, 33(12), 656-662. https://doi.org/10.1177/0885066616682940.
Nannan Panday, R. S., Wang, S., Van De Ven, P. M., Hekker, T. A. M., Alam, N. & Nanayakkara, P. W. B. (2019). Evaluation of blood culture epidemiology and efficiency in a large European teaching hospital. PLoS One, 14(3), e0214052. https://doi.org/10.1371/journal.pon e.0214052.
Nielsen, L. E., Nguyen, K., Wahl, C. K., Huss, J. L., Chang, D., Ager, E. P. & Hamilton, L. (2022). Initial Specimen Diversion Device® reduces blood culture contamination and vancomycin use in academic medical centre. Journal of Hospital Infection, 120, 127-133. https://doi.org/10.1016/j.jhin.2021.10.017.
Peker, N., Couto, N., Sinha, B. & Rossen, J. W. (2018). Diagnosis of bloodstream infections from positive blood cultures and directly from blood samples: recent developments in molecular approaches. Clinical Microbiology and Infection, 24(9), 944-955. https://doi.org/10.1016/j.cmi.2018.05.007.
Schwarzenbacher, J., Kuhn, S. O., Vollmer, M., Scheer, C., Fuchs, C., Rehberg, S., ... & Gründling, M. (2019). On-site blood culture incubation shortens the time to knowledge of positivity and microbiological results in septic patients. Plos one, 14(12), e0225999. https://doi.org/10.1371/journal.pone.0225999.
Singer, M., Deutschman, C. S., Seymour, C. W., Shankar-Hari, M., Annane, D., Bauer, M., ... & Angus, D. C. (2016). The third international consensus definitions for sepsis and septic shock (Sepsis-3). Jama, 315(8), 801-810. doi:10.1001/jama.2016.0287.
Sproston, N. R. & Ashworth, J. J. (2018). Role of C-reactive protein at sites of inflammation and infection. Frontiers in Immunology, 9, 754. https://doi.org/10.3389/fimmu.2018.00754.
Towns, M. L., Jarvis, W. R. & Hsueh, P. R. (2010). Guidelines on blood cultures. Journal of Microbiology, Immunology, and Infection, 43(4), 347-349. https://doi.org/10.1016/S1684-1182(10)60054-0.
Weinstein, M. P. & Doern, G. V. (2011). A critical appraisal of the role of the clinical microbiology laboratory in the diagnosis of bloodstream infections. Journal of Clinical Microbiology, 49(9_Supplement), S26-S29. https://doi.org/10.1128/JCM.00765-11.
Wilson, M. L., Mirrett, S., Reller, L. B., Weinstein, M. P. & Reimer, L. G. (1993). Recovery of clinically important microorganisms from the BacT/Alert blood culture system does not require testing for seven days. Diagnostic Microbiology and Infectious Disease, 16(1), 31-34. https://doi.org/10.1016/0732-8893(93)90127-S.
Zhang, J., Yang, F., Sun, Z., Fang, Y., Zhu, H., Zhang, D., ... & Zhao, H. (2022). Rapid and precise identification of bloodstream infections using a pre-treatment protocol combined with high throughput multiplex genetic detection system. Future Microbiology, 12(10), 368-374. https://doi.org/10.21203/rs.3.rs-1784956/v1
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