Limitation of the delta neutrophil index for assessing bacteraemia in immunocompromised children

Background: Delta neutrophil index (DNI) has been reported to be useful in assessing the prognosis of suspected bacteraemia in adults. However, data in children are limited. The purpose of this study was to investigate the correlation between the DNI and bacteraemia in children and to compare DNI values between immunocompetent and immunocompromised hosts. Methods: We retrospectively collected data on 8593 children who underwent simultaneous blood culture and DNI testing. DNI was determined with a blood cell analyser (AD VIA 120, Siemens, Inc.). The children were divided into immunocompromised (n = 664) and immunocompetent groups (n = 7929). Results: DNI was higher in the bacteraemia group than in the non-bacteraemia group (P < 0.001). According to the group, DNI was higher in immunocompromised than immunocompetent patients (P< 0.001). Within the immunocompromised group, there was no significant difference between the bacteraemia and non-bacteraemia subgroups due to a higher DNI as compared to the immunocompetent group. Conclusions: DNI could be an additional method for the early diagnosis of bacteraemia in children. However, the use of DNI for the prediction of bacteraemia in immunocompromised cases has limitations. Further studies on the usefulness of DNI according to specific diseases are needed. (C) 2014 Elsevier B.V. All rights reserved.