• Journal of the Korean Burn Society
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• v.22 no.2
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• pp.38-44
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• 2019

Purpose: The immature granulocyte count has been reported to be a marker of infection and sepsis. The difference in leukocyte subfractions (delta neutrophil index, DNI) in ADVIA 2120 reflects the fraction of circulating immature granulocytes in the blood. This study evaluated the clinical utility of DNI as a severity and prediction marker in critically ill patients with burn sepsis. Methods: One hundred and sixty nine patients admitted to the burn care unit were studied. DNI (the difference in leukocyte subfractions identified by myeloperoxidase and nuclear lobularity channels) was determined using a specific blood cell analyzer. Results: Seventy one patients (42 %) were diagnosed with burn sepsis. DNI was significantly higher in patients with burn sepsis than in patients without (P<0.01). Delta neutrophil index was a better indicator of burn sepsis than C-reactive protein, lactate, white blood cell count, HCO3, base excess, lactate, procalcitonin (odds ratio, 6.31; confidence interval 2.36~16.90; P<0.01). And the receiver operating characteristic curves showed that delta neutrophil index, AUC 0.795 (95% confidence interval, 0.721~0.869; P<0.05) was a better predictor of burn sepsis than lactate, procalcitonin, white blood cell, base excess and abbreviated burn severity index. Conclusion: Delta neutrophil index may be used as a early marker of patients with burn sepsis.

• Pediatric Infection and Vaccine
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• v.24 no.1
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• pp.1-6
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• 2017

Purpose: We investigated the effectiveness of the delta neutrophil index (DNI) for the prediction of neonatal bacteremia and compared it to other indices. Methods: A total of 146 pediatric patients, aged less than 31 days, admitted to the neonatal intensive care unit of Wonju Severance Christian Hospital with fever before or during hospitalization were enrolled in this study. We divided the patients into two groups based on the existence of neonatal bacteremia and performed blood culture tests on both groups. We examined white blood cell count, absolute neutrophil count, DNI, platelet count, and C-reactive protein (CRP) test. We used a receiver operating characteristic (ROC) curve to evaluate their diagnostic significance. Results: Seventy-seven patients were diagnosed with neonatal bacteremia. The mean gestational age was 38.74 weeks and the mean birth weight was 3.20 kg. The mean gestational age of the control group was 33.34 weeks and the mean birth weight was 2.20 kg. Causative organisms of bacteremia included Staphylococcus aureus (n=22), Staphylococcus epidermidis (n=18), and Streptococcus agalactiae (n=8). Both DNI and CRP were significantly associated with neonatal bacteremia after adjusting for gestational age and birth weight. The area under the ROC curve (AUC) for DNI (0.70) was higher than that for CRP (0.68). Conclusions: The DNI can be used to effectively predict neonatal bacteremia. The prediction will be more accurate if DNI is used in conjunction with other indices. In future, it will be useful to compare DNI with other indices and investigate its relationship with prognosis.

• Childhood Kidney Diseases
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• v.26 no.1
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• pp.46-51
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• 2022

Purpose: Delta neutrophil index (DNI) indicates immature granulocytes in peripheral blood and has been confirmed to be effective as a prognostic factor for neonatal sepsis. Also, it has been reported to have diagnostic value in acute pyelonephritis and in predicting vesicoureteral reflux (VUR) in the infant. We conducted the study to verify whether DNI is also helpful in the entire pediatric age group with febrile urinary tract infection (UTI). Methods: Medical records of children hospitalized for febrile UTIs were analyzed retrospectively. All subjects underwent kidney ultrasound and voiding cystourethrography. In the group with and without VUR, we compared sex and age, and the following laboratory values: the white blood cell count, neutrophil, polymorphonuclear leucocyte, eosinophil, hemoglobin, platelet count, C-reactive protein, DNI value, and the finding of ultrasound. Results: A total of 315 patients (163 males and 152 females; range, 0-127 months) were eligible, and 41 patients (13%) had VUR. As a result of univariate analysis, the white blood cell count, neutrophil, DNI, and ultrasonic abnormalities were high in the reflux group, and the hemoglobin and lymphocyte fraction values were low. The value of DNI and the abnormal ultrasound were significantly higher in the reflux group on the multivariate analysis. The area under the curve value of the receiver operating curve was higher in DNI (0.640; 95% confidence interval, 0.536-0.744; P=0.004), and the DNI cutoff value for VUR prediction was 1.85%. Conclusions: We identified that ultrasound findings and DNI values were helpful predictors of VUR in pediatric febrile UTIs.