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Research article
Taro Shimizu
Dokkyo Medical University
Corresponding Author
ORCiD: https://orcid.org/0000-0002-3788-487X
License:
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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 study was a retrospective cohort study. 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 January 1–December 31, 2018, after excluding those with the use of antibiotic therapy within 2 weeks prior to blood culture, steroid therapy, a history of haematological cancer, or eosinophilia. 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 (<10 cells/mm3) alone yielded little overall predictive ability (AUROC: 0.606, 95% confidence interval (CI): 0.502–0.710, P=0.035), and only moderate sensitivity (50%, 95%CI: 29–70%) and specificity (71%, 95%CI: 63–78%). The model comprising baseline variables (age, sex) and the C-reactive protein level yielded an AUROC of 0.7384, and the further addition of eosinopenia yielded a slight improvement, with an AUROC of 0.7547 (P=0.4297) and a statistically significant net reclassification improvement (NRI) (P=0.03). However, the integrated discrimination index (IDI) (P=0.282) remained non-significant.
Conclusions Severe eosinopenia can be considered an inexpensive marker of bloodstream infection in a general internal medicine setting.
Keywords
eosinopenia, bloodstream infection, blood culture
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CURRENT STATUS: Published
View the published article at BMC Infectious Diseases.
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Posted 23 Jan, 2020
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On 21 Jan, 2020
Editorial decision: Accept
On 21 Jan, 2020
Editor assigned
On 20 Jan, 2020
Editor invited
On 19 Jan, 2020
No comments provided
Editorial decision: Minor revision
On 16 Jan, 2020
Editor assigned
On 15 Jan, 2020
Submission checks complete
On 14 Jan, 2020
Editor invited
On 14 Jan, 2020
No comments provided
Editorial decision: Minor revision
On 08 Jan, 2020
Editor assigned
On 09 Dec, 2019
Submission checks complete
On 08 Dec, 2019
Editor invited
On 08 Dec, 2019
No comments provided
Reviewer #2 agreed
On 06 Nov, 2019
Review #2 received
Received 06 Nov, 2019
Editorial decision: Major revision
On 06 Nov, 2019
Review #1 received
Received 05 Oct, 2019
Reviewer #1 agreed
On 21 Sep, 2019
Reviewers invited
Invitations sent on 14 Aug, 2019
Submission checks complete
On 06 Aug, 2019
Editor assigned
On 06 Aug, 2019
Editor invited
On 05 Aug, 2019
First submitted
On 29 Jul, 2019
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Subject Areas
Infectious Diseases
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A new preprint design is coming!
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See the published version of this preprint at BMC Infectious Diseases.
This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Taro Shimizu
Dokkyo Medical University
Corresponding Author
ORCiD: https://orcid.org/0000-0002-3788-487X
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
View the published article at BMC Infectious Diseases.
Version 4
Posted 23 Jan, 2020
No community comments so far
Submission checks complete
On 21 Jan, 2020
Editorial decision: Accept
On 21 Jan, 2020
Editor assigned
On 20 Jan, 2020
Editor invited
On 19 Jan, 2020
No comments provided
Editorial decision: Minor revision
On 16 Jan, 2020
Editor assigned
On 15 Jan, 2020
Submission checks complete
On 14 Jan, 2020
Editor invited
On 14 Jan, 2020
No comments provided
Editorial decision: Minor revision
On 08 Jan, 2020
Editor assigned
On 09 Dec, 2019
Submission checks complete
On 08 Dec, 2019
Editor invited
On 08 Dec, 2019
No comments provided
Reviewer #2 agreed
On 06 Nov, 2019
Review #2 received
Received 06 Nov, 2019
Editorial decision: Major revision
On 06 Nov, 2019
Review #1 received
Received 05 Oct, 2019
Reviewer #1 agreed
On 21 Sep, 2019
Reviewers invited
Invitations sent on 14 Aug, 2019
Submission checks complete
On 06 Aug, 2019
Editor assigned
On 06 Aug, 2019
Editor invited
On 05 Aug, 2019
First submitted
On 29 Jul, 2019
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Infectious Diseases
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published article at BMC Infectious Diseases.
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 study was a retrospective cohort study. 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 January 1–December 31, 2018, after excluding those with the use of antibiotic therapy within 2 weeks prior to blood culture, steroid therapy, a history of haematological cancer, or eosinophilia. 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 (<10 cells/mm3) alone yielded little overall predictive ability (AUROC: 0.606, 95% confidence interval (CI): 0.502–0.710, P=0.035), and only moderate sensitivity (50%, 95%CI: 29–70%) and specificity (71%, 95%CI: 63–78%). The model comprising baseline variables (age, sex) and the C-reactive protein level yielded an AUROC of 0.7384, and the further addition of eosinopenia yielded a slight improvement, with an AUROC of 0.7547 (P=0.4297) and a statistically significant net reclassification improvement (NRI) (P=0.03). However, the integrated discrimination index (IDI) (P=0.282) remained non-significant.
Conclusions Severe eosinopenia can be considered an inexpensive marker of bloodstream infection in a general internal medicine setting.
Figure 1
Figure 2
This is a list of supplementary files associated with this preprint. Click to download.
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