Suhendro Suwarto1, Zahra Farhanni Suhardi2, Amin Soebandrio3,4
1Division of Tropical and Infectious Diseases, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia, Dr. Cipto Mangunkusumo National General Hospital, Jakarta, Indonesia.
2 Faculty of Medicine Universitas Indonesia.
3Eijkman Institute for Molecular Biology, Jakarta, Indonesia.
4Department of Microbiology, Faculty of Medicine Universitas Indonesia.

Abstract

Background: The laboratory marker of leucocytes, neutrophils and procalcitonin (PCT) are elevated in Gram-negative-infected patients. Salmonella species, a cause of typhoid fever, are also a type of Gram-negative bacteria. We investigated the laboratory marker of bacterial infection levels in Salmonella and Gram-negative bacteremias.
Methods: This retrospective study was conducted in Jakarta, Indonesia. Sixty-one patients with positive blood cultures of Salmonellaor Gram-negative bacteria who were admitted to the hospital from April 2014 through May 2017 were included. Twenty-seven patients (44,3%) had Salmonella, and 34 patients (55,7%) had Gram-negative bacteremias. The following laboratory parameters were recorded: leucocyte count, neutrophil count, and PCT levels. Bivariate analysis was used to analyze the differences in the laboratory marker between Salmonella and Gram-negative bacteremias.
Results: Gram-negative bacteremia was significantly associated with an elevated leucocyte count (p<0.001), neutrophil count (p<0,001) and PCT levels (p<0,001). The leucocyte count cut-off of ≥10.5x103/μL, a neutrophil countcut-off of ≥80,9% and a PCT level cut-off of ≥1,18 ng/ml were significantly higher in the Gram-negative bacteremia group compared with the Salmonella group (p<0,001 for each variable).
Conclusion: Leucocyte, neutrophil counts, and PCT levels in Gram-negative bacteremia were higher than inSalmonella bacteremia.
Keywords: Gram negative bacteremia,leucocyte, neutrophils cells counts, procalcitonin, Salmonella bacteremia.