Speaker   

Nathan Jones

Specialist BMS

Countess of Chester Hospital

United Kingdom

Moderator

Tan Swee Jin, PhD, PMP

Senior Manager, Scientific Affairs
at Sysmex Asia Pacific

Webinar Objective

Platelets are essentially established as a marker of thrombosis, haemostasis, and wound healing. However, as the second most common circulating blood cells, emerging evidence points to its active role as an immune-modulating effectors cells during an infectious process. In this webinar, the speaker will present the potential utility of immature platelet indices (IPF and AIPC) in recognising systemic bacterial infection among sepsis patients admitted to the ICU

Abstract of Lecture

Haematological markers that can be rapidly analysed and regularly monitored during a patient’s stay on ICU, and that can identify bacterial causes of sepsis are being extensively sought. The significance of platelets in early immunological responses provides justification for assessing their usefulness in the identification of bacteremia amongst sepsis patients.

Sepsis is a complex disease with highly varied presentation. The presence of bacteremia in these patients is currently confirmed using blood culture techniques which can take anywhere between 8 and 72 hours to provide a result. In cases of sepsis where early intervention is a key factor in prognosis, identifying a haematological marker that is both sensitive and specific for bacteremia whilst having a rapid turnaround time presents a great advantage.

The PLT-F application on the Sysmex XN series produces a platelet count by fluorescence and also provides a number of immature platelet indices including an absolute immature platelet count (AIPC), and an immature platelet fraction (IPF%). Given the importance of platelets in the systemic immune response to infection, these platelet indices were analysed in ICU patients, alongside other well established laboratory tests to monitor infection over a five day period. Patients were split into two cohorts depending on whether their blood cultures were positive or negative, thus confirming or excluding bacteremia.

Procalcitonin (PCT) provided the earliest indicator of bacteremia with significant differences between the two cohorts on day 1. The change in IPF% and AIPC from day 1 to day 2 ( Δ IPF% and Δ  AIPC) provided the most accurate indication; A combination of Δ IPF% and day 2 PCT, provided a positive predictive value and negative predictive value of 100% and 96.1%, respectively.

Further research is certainly warranted in finding a haematological marker that is both sensitive and specific for bacteremia whilst having a rapid turnaround time. This promising early study demonstrates the potential of immature platelet indices to aid in the identification of bacteremia in sepsis patients.

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