Infection Manager System

Background New hemocytometric parameters can be used to differentiate causes of acute febrile illness (AFI). We evaluated a software algorithm-Infection Manager System (IMS)-which uses hemocytometric data generated by Sysmex hematology analyzers, for its accuracy to detect bacteremia in AFI patients...

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Bibliographic Details
Published in:PLoS neglected tropical diseases 2021-03, Vol.15 (3)
Main Authors: Diallo, Salou, Tinto, Halidou, Bognini, Joel, Post, Annelies, Langereis, Jeroen D, van der Ven, Andre J, van der Gaast-de Jongh, Christa E, Kaboré, Berenger, Rahamat-Langendoen, Janette, de Jonge, Marien I, van Opzeeland, Fred, Lompo, Palpouguini, Herssens, Natacha, de Mast, Quirijn, Wertheim, Heiman, Sauerwein, Robert W, Kam, Basile, Bousema, Teun, Jacobs, Jan
Format: Article
Language:English
Subjects:
Algorithms
Bacteremia
Blood
Cytodiagnosis
Diagnosis
Medical examination
Methods
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Summary:Background New hemocytometric parameters can be used to differentiate causes of acute febrile illness (AFI). We evaluated a software algorithm-Infection Manager System (IMS)-which uses hemocytometric data generated by Sysmex hematology analyzers, for its accuracy to detect bacteremia in AFI patients with and without malaria in Burkina Faso. Secondary aims included comparing the accuracy of IMS with C-reactive protein (CRP) and procalcitonin (PCT). Methods In a prospective observational study, patients of [greater than or equal to] three-month-old (range 3 months- 90 years) presenting with AFI were enrolled. IMS, blood culture and malaria diagnostics were done upon inclusion and additional diagnostics on clinical indication. CRP, PCT, viral multiplex PCR on nasopharyngeal swabs and bacterial- and malaria PCR were batch-tested retrospectively. Diagnostic classification was done retrospectively using all available data except IMS, CRP and PCT results. Findings A diagnosis was affirmed in 549/914 (60.1%) patients and included malaria (n = 191) bacteremia (n = 69), viral infections (n = 145), and malaria-bacteremia co-infections (n = 47). The overall sensitivity, specificity, and negative predictive value (NPV) of IMS for detection of bacteremia in patients of [greater than or equal to] 5 years were 97.0% (95% CI: 89.8-99.6), 68.2% (95% CI: 55.6-79.1) and 95.7% (95% CI: 85.5-99.5) respectively, compared to 93.9% (95% CI: 85.2-98.3), 39.4% (95% CI: 27.6-52.2), and 86.7% (95% CI: 69.3-96.2) for CRP at [greater than or equal to]20mg/L. The sensitivity, specificity and NPV of PCT at 0.5 ng/ml were lower at respectively 72.7% (95% CI: 60.4-83.0), 50.0% (95% CI: 37.4-62.6) and 64.7% (95% CI: 50.1-77.6) The diagnostic accuracy of IMS was lower among malaria cases and patients
ISSN:1935-2727