Eosinopenia: Is it a good marker of sepsis in comparison to procalcitonin and C-reactive protein levels for patients admitted to a critical care unit in an urban hospital?
BACKGROUND
The role of eosinopenia as a marker of sepsis has recently been evaluated. The aim of our study was to test the value of eosinopenia as a diagnostic marker of sepsis in comparison to procalcitonin and C-reactive protein levels.


METHODS
A prospective study of critically ill adult patients admitted to the medical intensive care unit at an urban hospital. Procalcitonin, C-reactive protein (CRP) levels and eosinophil counts were measured on admission. Patients were classified as non-infected or infected by the medical residents, fellows, and attendings.


RESULTS
A total of 68 patients were enrolled into the study. At a cut-off value of 70 mg/L, the CRP level yielded a sensitivity of 94%, a specificity of 84%, a positive predicted value (PPV) of 83% and a negative predicted value (NPV) of 94%. At a cutoff value of 1.5 μg/L, the sensitivity of the procalcitonin test was 84%, specificity of 92%, PPV 90%, and NPV of 87%. The eosinophil cell count (cutoff of 50 cells/mm(3)) produced a sensitivity of 81%, specificity of 65%, a PPV of 66%, and a NPV of 80%. The comparison of the eosinophil cell count (<50 cells/mm(3)) and procalcitonin levels among the non-infected and infected groups showed a significant statistical difference (Fisher exact test, P = .0239). There was no statistical difference observed when comparisons were made between CRP levels and eosinophil count (Fisher exact test, P = .12). There was also a lack of significant statistical difference when CRP levels were compared to procalcitonin levels (Fisher exact test, P = .49).


CONCLUSIONS
Eosinopenia is a very sensitive yet not specific serological marker of sepsis in the intensive care unit and can be utilized to guide physicians in the diagnosis of sepsis.
Shaaban
Hamid
H
Infectious Diseases Division, St Michael's Medical Center, Newark, NJ 07102, USA. hamidshaaban@gmail.com
Daniel
Sunil
S
Sison
Raymond
R
Slim
Jihad
J
Perez
George
G
D000368:Aged; D000380:Agranulocytosis / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis*; D002116:Calcitonin / Q000097:blood*; D015740:Calcitonin Gene-Related Peptide; D004804:Eosinophils; D005260:Female; D006786:Hospitals, Urban; D006801:Humans; D007362:Intensive Care Units; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011498:Protein Precursors / Q000097:blood*; D012680:Sensitivity and Specificity; D018805:Sepsis / Q000097:blood / Q000175:diagnosis*
D015415:Biomarkers; C000606589:CALCA protein, human; D011498:Protein Precursors; D002116:Calcitonin; D002097:C-Reactive Protein; D015740:Calcitonin Gene-Related Peptide