Cytographic changes on BC-6800 Haematological Analyzer related to the presence ofCandida albicansin peripheral blood. A new tool to suspect candidemia?
BACKGROUND
We studied the quantitative and cytographic changes that the presence ofCandida albicans(C. albicans) in peripheral blood (PB) samples causes on the Mindray BC-6800 Haematological Analyzer.


METHODS
A simulated in vitro candidemia was obtained by adding a different amount ofC. albicansto discarded remnants of PB samples. Quantitative data and cytographic features were evaluated immediately as well as after 120 and 240 min of the yeast addition. A microscopic slides review was even performed at the same time.


RESULTS
After yeasts addition, an increase of total leucocytes, neutrophils and basophils have been observed, but these increases are not certainly descriptive ofC. albicanspresence.Instead, extracellular blastospores cause a false increase in nucleated red blood cells (nRBCs), which appear as a new population in the specific counting channel for erytroblasts (NRBC channel). Regardless of the numbers,C. albicansform a pseudo-erythroblastic cluster in the NRBC channel whose resulting shape is so different than the 'normal' nRBC that it demands a microscopic review. Even cytographic changes related with the neutrophilic phagocytic activity have been observed on leucocyte's differential count citogram (DIFF) of the BC-6800.


CONCLUSIONS
Our observations suggest that the results of the BC-6800, which are due toC. albicans' presence, might be useful to speculate earlier diagnosis of sepsis.
U.O. Patologia Clinica, Ospedale "F. Lotti", Pontedera, Italy.
Antonio
A
La Gioia
Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy.
Alessandra
A
Devito
U.O. Patologia Clinica, Ospedale "F. Lotti", Pontedera, Italy.
Fabiana
F
Fiorini
UOC Medicina di Laboratorio Livorno, Azienda USL Toscana Nord Ovest, Livorno, Italy.
Maria
M
Bombara
UOC Medicina di Laboratorio Livorno, Azienda USL Toscana Nord Ovest, Livorno, Italy.
Patrizia
P
Isola
Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy.
Barbara
B
Spinale
U.O. Patologia Clinica, Ospedale "F. Lotti", Pontedera, Italy.
Lucia
L
Francioni
U.O. Patologia Clinica, Ospedale "F. Lotti", Pontedera, Italy.
Domenico
D
Salamone
UOC Medicina di Laboratorio Livorno, Azienda USL Toscana Nord Ovest, Livorno, Italy.
Paola
P
Marelli
Clinical Chemistry Laboratory, Papa Giovanni XXIII Hospital, Bergamo, Italy.
Sabrina
S
Buoro
UOC Medicina di Laboratorio Livorno, Azienda USL Toscana Nord Ovest, Livorno, Italy.
Marcello
M
Fiorini
D002176:Candida albicans / Q000302:isolation & purification*; D058387:Candidemia / Q000175:diagnosis*; D042241:Early Diagnosis; D006801:Humans; D008853:Microscopy / Q000295:instrumentation / Q000379:methods; D009172:Mycology / Q000295:instrumentation* / Q000379:methods; D012372:ROC Curve
FUNGI; HOSPITAL INFECTIONS; INFECTIONS