Eosinopenia as a diagnostic marker of bloodstream infection in a general internal medicine setting: a cohort study
Abstract Background Little is known about the potential use of the eosinophil count as a predictive marker of bloodstream infection. In this study, we aimed to assess the reliability of eosinopenia as a predictive marker of bloodstream infection. Methods This retrospective cohort study was performed...
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doaj-942d2590454f4eedb32b73e4a96328142021-01-31T12:15:00ZengBMCBMC Infectious Diseases1471-23342020-01-012011710.1186/s12879-020-4814-5Eosinopenia as a diagnostic marker of bloodstream infection in a general internal medicine setting: a cohort studyTakanobu Hirosawa0Yukinori Harada1Kohei Morinaga2Hiroshi Takase3Michihiro Nin4Taro Shimizu5Department of Diagnostic and Generalist Medicine, Dokkyo Medical University HospitalDepartment of Diagnostic and Generalist Medicine, Dokkyo Medical University HospitalDepartment of Diagnostic and Generalist Medicine, Dokkyo Medical University HospitalDepartment of Diagnostic and Generalist Medicine, Dokkyo Medical University HospitalDepartment of Diagnostic and Generalist Medicine, Dokkyo Medical University HospitalDepartment of Diagnostic and Generalist Medicine, Dokkyo Medical University HospitalAbstract Background Little is known about the potential use of the eosinophil count as a predictive marker of bloodstream infection. In this study, we aimed to assess the reliability of eosinopenia as a predictive marker of bloodstream infection. Methods This retrospective cohort study was performed in the outpatient department and general internal medicine department of a tertiary university hospital in Japan. A total of 189 adult patients with at least 2 sets of blood cultures obtained during the period January 1–December 31, 2018, were included; those with the use of antibiotic therapy within 2 weeks prior to blood culture, steroid therapy, or a history of haematological cancer were excluded. The diagnostic accuracies of each univariate variable and the multivariable logistic regression models were assessed by calculating the areas under the receiver operating characteristic curves (AUROCs). The primary outcome was a positive blood culture indicating bloodstream infection. Results Severe eosinopenia (< 24.4 cells/mm3) alone yielded small but statistically significant overall predictive ability (AUROC: 0.648, 95% confidence interval (CI): 0.547–0.748, P < 0.05), and only moderate sensitivity (68, 95% CI: 46–85%) and specificity (62, 95% CI: 54–69%). The model comprising baseline variables (age, sex), the C-reactive protein level, and neutrophil count yielded an AUROC of 0.729, and further addition of eosinopenia yielded a slight improvement, with an AUROC of 0.758 (P < 0.05) and a statistically significant net reclassification improvement (NRI) (P = 0.003). However, the integrated discrimination index (IDI) (P = 0.284) remained non-significant. Conclusions Severe eosinopenia can be considered an inexpensive marker of bloodstream infection, although of limited diagnostic accuracy, in a general internal medicine setting.https://doi.org/10.1186/s12879-020-4814-5EosinopeniaBloodstream infectionBlood culture |
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DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Takanobu Hirosawa Yukinori Harada Kohei Morinaga Hiroshi Takase Michihiro Nin Taro Shimizu |
spellingShingle |
Takanobu Hirosawa Yukinori Harada Kohei Morinaga Hiroshi Takase Michihiro Nin Taro Shimizu Eosinopenia as a diagnostic marker of bloodstream infection in a general internal medicine setting: a cohort study BMC Infectious Diseases Eosinopenia Bloodstream infection Blood culture |
author_facet |
Takanobu Hirosawa Yukinori Harada Kohei Morinaga Hiroshi Takase Michihiro Nin Taro Shimizu |
author_sort |
Takanobu Hirosawa |
title |
Eosinopenia as a diagnostic marker of bloodstream infection in a general internal medicine setting: a cohort study |
title_short |
Eosinopenia as a diagnostic marker of bloodstream infection in a general internal medicine setting: a cohort study |
title_full |
Eosinopenia as a diagnostic marker of bloodstream infection in a general internal medicine setting: a cohort study |
title_fullStr |
Eosinopenia as a diagnostic marker of bloodstream infection in a general internal medicine setting: a cohort study |
title_full_unstemmed |
Eosinopenia as a diagnostic marker of bloodstream infection in a general internal medicine setting: a cohort study |
title_sort |
eosinopenia as a diagnostic marker of bloodstream infection in a general internal medicine setting: a cohort study |
publisher |
BMC |
series |
BMC Infectious Diseases |
issn |
1471-2334 |
publishDate |
2020-01-01 |
description |
Abstract Background Little is known about the potential use of the eosinophil count as a predictive marker of bloodstream infection. In this study, we aimed to assess the reliability of eosinopenia as a predictive marker of bloodstream infection. Methods This retrospective cohort study was performed in the outpatient department and general internal medicine department of a tertiary university hospital in Japan. A total of 189 adult patients with at least 2 sets of blood cultures obtained during the period January 1–December 31, 2018, were included; those with the use of antibiotic therapy within 2 weeks prior to blood culture, steroid therapy, or a history of haematological cancer were excluded. The diagnostic accuracies of each univariate variable and the multivariable logistic regression models were assessed by calculating the areas under the receiver operating characteristic curves (AUROCs). The primary outcome was a positive blood culture indicating bloodstream infection. Results Severe eosinopenia (< 24.4 cells/mm3) alone yielded small but statistically significant overall predictive ability (AUROC: 0.648, 95% confidence interval (CI): 0.547–0.748, P < 0.05), and only moderate sensitivity (68, 95% CI: 46–85%) and specificity (62, 95% CI: 54–69%). The model comprising baseline variables (age, sex), the C-reactive protein level, and neutrophil count yielded an AUROC of 0.729, and further addition of eosinopenia yielded a slight improvement, with an AUROC of 0.758 (P < 0.05) and a statistically significant net reclassification improvement (NRI) (P = 0.003). However, the integrated discrimination index (IDI) (P = 0.284) remained non-significant. Conclusions Severe eosinopenia can be considered an inexpensive marker of bloodstream infection, although of limited diagnostic accuracy, in a general internal medicine setting. |
topic |
Eosinopenia Bloodstream infection Blood culture |
url |
https://doi.org/10.1186/s12879-020-4814-5 |
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