A novel diagnostic algorithm equipped on an automated hematology analyzer to differentiate between common causes of febrile illness in Southeast Asia

摘要

Author summary Distinguishing arboviral infections, such as dengue, from bacterial causes of febrile illness is of great importance for clinical management and antimicrobial stewardship. In resource-limited countries, costly and expertise-reliant diagnostic assays cannot be performed routinely. The Infection Manager Software (IMS) is a novel diagnostic algorithm equipped on an automated Sysmex hematology analyzer, making use of the principle that different infections evoke different changes in blood cell number and cell phenotype. In a cohort of adult Indonesian patients presenting to hospital with an arboviral and/or bacterial infection, we first trained and subsequently evaluated the diagnostic performance of the IMS to distinguish common causes of acute febrile illness. The authors show that the IMS has a reasonable sensitivity for detection of arboviral and bacterial infections and a high specificity. In comparison with the commonly used biomarkers C-reactive protein (CRP) and procalcitonin (PCT), the performance of the IMS was comparable to CRP and better than PCT. The authors conclude that the IMS is a novel, automated, easy to use diagnostic tool that allows rapid differentiation between common causes of febrile illness in Southeast Asia.