We stumbled upon this coagulation question the other day on the Pathology Student website and thought the laboratory professionals, residents, and clinical laboratory science students reading this blog might find it helpful.
Saying the word “meningitis” is a sure-fire way to scare parents of young children or college students. Invasive infections caused by Neisseria meningitidis are rare but serious. Mortality rates can run around 15%; complications include amputations due to tissue necrosis and hearing loss. In short, N. meningitidis infections are nothing to mess around with.
In order to avoid death and extremity loss, the infection needs to be diagnosed early. Trouble is, the early symptoms can be similar to those of a run-of-the-mill viral infection. Some patients do not exhibit the elevated white blood cell count so common in bacterial infections. Without clear signposts to guide the way, how can clinicians catch this fast-moving infection early in its course? A handful of esoteric hematology parameters might hold the key.
Demissie et al recently published this paper in The Pediatric Infectious Disease Journal about using neutrophil counts to diagnose meningococcal infection in children. It’s behind a paywall, but here’s the gist:
-Your automated hematology analyzer needs to report immature white blood cells.
-Using total white blood cell (WBC) counts or total neutrophil counts alone is insufficient.
-The parameters to check are absolute neutrophil count (ANC), immature neutrophil count (INC), and immature-to-total neutrophil ratio (ITR).
-Patients with invasive meningococcal infection (or, the authors also say, a serious bacterial infection) display abnormalities in at least one of the three parameters.
What do you think about these guidelines? Do you think they’d be effective in diagnosing invasive meningococcal infections?
The common maxim when buying laboratory equipment is “Fast, accurate, or cheap; pick two.” The perfect analyzer would have all three qualities, but as the saying suggests, it’s hard to find those instruments. Enter Beckman Coulter. Their website suggests the UniCel DxH800 is designed to meet these demands by improving productivity, decreasing turnaround time and reducing overall cost.
Recently Lab Medicine published a paper evaluating the performance of Beckman Coulter’s Unicel DxH800. The authors of the paper found the instrument to be accurate and efficient. They also commented that for larger facilities, this analyzer could improve productivity and turnaround times when compared to the older model (LH 750). Notably, the authors don’t mention cost, quality control, or maintenance concerns.
Does your laboratory have the DxH800? Is the maintenance easy to perform? Has this analyzer improved turnaround times in your lab? Let us know in the comments.