Original article / research
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The Potential of Using VCS Parameters of Neutrophils and Monocytes as an Early Diagnostic Tool in Acute Bacterial Infections |
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| Correspondence
Address : Dr. Aarthi Kannan, E1, Park Side Villas,148, Ist Cross Street, Annai Indira Nagar, Thoraipakkam, Chennai-600097, Tamil Nadu, India. E-mail: aarthi.kanna@gmail.com |
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Introduction: Infection and sepsis are known to produce numerical and morphological changes in the leucocytes. Morphological assessment of leucocytes by peripheral blood smear examination is time consuming and more subjective. The V (Volume), C (Conductivity), and S (Scatter) parameters of neutrophils are emerging as a sensitive predictor of acute bacterial infection and sepsis even in the absence of leucocytosis and neutrophilia. Volume, Conductivity and Scatter parameters (VCS) of leucocytes are obtained after analysis of about 8,000 leucocytes in a few seconds, using impedance to measure cell volume (V), radio frequency opacity to characterize conductivity (C) for internal composition of each cell and laser beam to measure light scatter (S) for cytoplasmic granulations and nuclear structure. The change in the morphology and in the number of these cells which are reflected in the VCS parameters of leucocytes proves to be a very accurate and sensitive method than the manual method. Aim: To study the difference between the CBC and VCS parameters between bacterial culture positive and control cases and to assign a cut off value for these parameters that would aid in the diagnosis of acute bacterial infection. Materials and Methods: CBC report of cases (positive bacterial culture with acute bacterial infections) generated from LH 780 automated analyser and CBC report of controls who doesn’t have the disease is taken. CBC and VCS parameters of them were analysed with SPSS v.19 Results: Total 110 cases of acute bacterial infection with positive bacterial culture and 110 controls were taken into study. Mean age in the case group was 49.42±19.62 years and in the control group, the mean age was 39.77±12.14 years. There was significant difference in the WBC count (14.1 vs. 7.3; p<0.01), neutrophil percentage (74.2 vs. 59.0; p<0.01), MNV (139.4 vs. 131.9; p<0.01), MNS (141.4 vs. 136.8; p<0.01), MMV (157.4 vs. 154.3; p=0.04) and MMS (84.5 vs. 82.5; p<0.01) but there was no significance in the difference of MNC (157.7 vs 158.6; p=0.276) and MMC (131.3 vs. 130.6; p=0.25) between the case and control group. This significant difference in MNV was noted even when neutrophils count of the cases was <85% or WBC count <11,000/cumm. ROC curve was analysed for MNV values and it gave a criterion value of >129.3 with sensitivity of 92.7%. For MMV, the criterion value was >157.4 with a sensitivity of 47.27%. Conclusion: Since, there is a significant difference in the VCS parameters of neutrophils and monocytes in acute bacterial infection, they can be used as sensitive indicators for diagnosing acute bacterial infections. |
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