The absolute neutrophil count: Is it the best indicator for occult bacteremia in infants?

Michal M. Gombos, Robert S. Bienkowski, Robert F. Gochman, Henny H. Billett

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

Occult bacteremia affects approximately 5% of febrile children ages 2 to 36 months. Many physicians empirically treat children who have a temperature higher than 39°C, a white blood cell (WBC) count of more than 15.0 x 109/L, and no focus of infection with antibiotics. We undertook this investigation to better define predictive indicators for bacteremia. Specifically we were concerned with determining whether the absolute neutrophil count (ANC) is a better diagnostic indicator than the total WBC count and whether the manual differential (which includes a band cell count) is necessary or helpful. Three separate groups of patients aged 2 to 36 months were assessed retrospectively. Group A consisted of febrile children (temperature, > 39°C) who had positive blood cultures (50 patients). Group B included febrile children (temperature, > 39°C) who had negative blood cultures (59 patients). Group C, nonfebrile children admitted to the hospital was the control group (61 patients). The ANC and the total WBC count were significantly higher in group A than in group B. Although they were equally sensitive, the ANC was more specific than the total WBC count. Band cell counts of greater than 10% and the percentage of total neutrophils also were greater in group A than in group B. The values for group C were not significantly different from those for group B. Although a total WBC count of 15.0 x 109/L is currently used to identify children at risk for occult bacteremia, the ANC seems to be as sensitive an indicator and may be more specific. Our study demonstrated that (1) the WBC count is a good indicator of occult bacteremia, (2) the ANC is as sensitive as the WBC count and may be more specific, (3) automated ANCs are comparable to manual ANCs, and (4) the band cell count is insensitive as an indicator and does not add any predictive value.

Original languageEnglish (US)
Pages (from-to)221-225
Number of pages5
JournalAmerican Journal of Clinical Pathology
Volume109
Issue number2
StatePublished - Feb 1998

Fingerprint

Bacteremia
Leukocyte Count
Neutrophils
Fever
Cell Count
Temperature
Anti-Bacterial Agents
Physicians
Control Groups
Infection

Keywords

  • Absolute neutrophil count
  • Occult bacteremia
  • White blood cell count

ASJC Scopus subject areas

  • Pathology and Forensic Medicine

Cite this

The absolute neutrophil count : Is it the best indicator for occult bacteremia in infants? / Gombos, Michal M.; Bienkowski, Robert S.; Gochman, Robert F.; Billett, Henny H.

In: American Journal of Clinical Pathology, Vol. 109, No. 2, 02.1998, p. 221-225.

Research output: Contribution to journalArticle

@article{e65deaca70a945e6946c40971ab17451,
title = "The absolute neutrophil count: Is it the best indicator for occult bacteremia in infants?",
abstract = "Occult bacteremia affects approximately 5{\%} of febrile children ages 2 to 36 months. Many physicians empirically treat children who have a temperature higher than 39°C, a white blood cell (WBC) count of more than 15.0 x 109/L, and no focus of infection with antibiotics. We undertook this investigation to better define predictive indicators for bacteremia. Specifically we were concerned with determining whether the absolute neutrophil count (ANC) is a better diagnostic indicator than the total WBC count and whether the manual differential (which includes a band cell count) is necessary or helpful. Three separate groups of patients aged 2 to 36 months were assessed retrospectively. Group A consisted of febrile children (temperature, > 39°C) who had positive blood cultures (50 patients). Group B included febrile children (temperature, > 39°C) who had negative blood cultures (59 patients). Group C, nonfebrile children admitted to the hospital was the control group (61 patients). The ANC and the total WBC count were significantly higher in group A than in group B. Although they were equally sensitive, the ANC was more specific than the total WBC count. Band cell counts of greater than 10{\%} and the percentage of total neutrophils also were greater in group A than in group B. The values for group C were not significantly different from those for group B. Although a total WBC count of 15.0 x 109/L is currently used to identify children at risk for occult bacteremia, the ANC seems to be as sensitive an indicator and may be more specific. Our study demonstrated that (1) the WBC count is a good indicator of occult bacteremia, (2) the ANC is as sensitive as the WBC count and may be more specific, (3) automated ANCs are comparable to manual ANCs, and (4) the band cell count is insensitive as an indicator and does not add any predictive value.",
keywords = "Absolute neutrophil count, Occult bacteremia, White blood cell count",
author = "Gombos, {Michal M.} and Bienkowski, {Robert S.} and Gochman, {Robert F.} and Billett, {Henny H.}",
year = "1998",
month = "2",
language = "English (US)",
volume = "109",
pages = "221--225",
journal = "American Journal of Clinical Pathology",
issn = "0002-9173",
publisher = "American Society of Clinical Pathologists",
number = "2",

}

TY - JOUR

T1 - The absolute neutrophil count

T2 - Is it the best indicator for occult bacteremia in infants?

AU - Gombos, Michal M.

AU - Bienkowski, Robert S.

AU - Gochman, Robert F.

AU - Billett, Henny H.

PY - 1998/2

Y1 - 1998/2

N2 - Occult bacteremia affects approximately 5% of febrile children ages 2 to 36 months. Many physicians empirically treat children who have a temperature higher than 39°C, a white blood cell (WBC) count of more than 15.0 x 109/L, and no focus of infection with antibiotics. We undertook this investigation to better define predictive indicators for bacteremia. Specifically we were concerned with determining whether the absolute neutrophil count (ANC) is a better diagnostic indicator than the total WBC count and whether the manual differential (which includes a band cell count) is necessary or helpful. Three separate groups of patients aged 2 to 36 months were assessed retrospectively. Group A consisted of febrile children (temperature, > 39°C) who had positive blood cultures (50 patients). Group B included febrile children (temperature, > 39°C) who had negative blood cultures (59 patients). Group C, nonfebrile children admitted to the hospital was the control group (61 patients). The ANC and the total WBC count were significantly higher in group A than in group B. Although they were equally sensitive, the ANC was more specific than the total WBC count. Band cell counts of greater than 10% and the percentage of total neutrophils also were greater in group A than in group B. The values for group C were not significantly different from those for group B. Although a total WBC count of 15.0 x 109/L is currently used to identify children at risk for occult bacteremia, the ANC seems to be as sensitive an indicator and may be more specific. Our study demonstrated that (1) the WBC count is a good indicator of occult bacteremia, (2) the ANC is as sensitive as the WBC count and may be more specific, (3) automated ANCs are comparable to manual ANCs, and (4) the band cell count is insensitive as an indicator and does not add any predictive value.

AB - Occult bacteremia affects approximately 5% of febrile children ages 2 to 36 months. Many physicians empirically treat children who have a temperature higher than 39°C, a white blood cell (WBC) count of more than 15.0 x 109/L, and no focus of infection with antibiotics. We undertook this investigation to better define predictive indicators for bacteremia. Specifically we were concerned with determining whether the absolute neutrophil count (ANC) is a better diagnostic indicator than the total WBC count and whether the manual differential (which includes a band cell count) is necessary or helpful. Three separate groups of patients aged 2 to 36 months were assessed retrospectively. Group A consisted of febrile children (temperature, > 39°C) who had positive blood cultures (50 patients). Group B included febrile children (temperature, > 39°C) who had negative blood cultures (59 patients). Group C, nonfebrile children admitted to the hospital was the control group (61 patients). The ANC and the total WBC count were significantly higher in group A than in group B. Although they were equally sensitive, the ANC was more specific than the total WBC count. Band cell counts of greater than 10% and the percentage of total neutrophils also were greater in group A than in group B. The values for group C were not significantly different from those for group B. Although a total WBC count of 15.0 x 109/L is currently used to identify children at risk for occult bacteremia, the ANC seems to be as sensitive an indicator and may be more specific. Our study demonstrated that (1) the WBC count is a good indicator of occult bacteremia, (2) the ANC is as sensitive as the WBC count and may be more specific, (3) automated ANCs are comparable to manual ANCs, and (4) the band cell count is insensitive as an indicator and does not add any predictive value.

KW - Absolute neutrophil count

KW - Occult bacteremia

KW - White blood cell count

UR - http://www.scopus.com/inward/record.url?scp=0031882538&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0031882538&partnerID=8YFLogxK

M3 - Article

C2 - 9583895

AN - SCOPUS:0031882538

VL - 109

SP - 221

EP - 225

JO - American Journal of Clinical Pathology

JF - American Journal of Clinical Pathology

SN - 0002-9173

IS - 2

ER -