ArticleEuropean journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology2026
Early diagnosis of bloodstream infections by Neutrophil-Reactive Intensity (NEUT-RI): a retrospective analysis.
Article in European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Bloodstream infections (BSIs) are serious conditions caused by the presence of microorganisms in the blood. Although blood culture remains the diagnostic gold standard, it is time-consuming. Neutrophil activation plays a central role in the early immune response to infection and can be quantified using the Neutrophil-Reactive Intensity (NEUT-RI) parameter, derived from hematological analyzer using the fluorescence flow cytometry technology. The purpose of this study is to evaluate NEUT-RI as an early marker of BSI and compare its diagnostic performance with standard infection biomarkers. We conducted a retrospective study involving 120 inpatients with documented BSI. Each inpatient underwent blood testing for PCT (Procalcitonin), serum CRP (C-Reactive Protein), WBCs (White Blood Cells), neutrophil absolute count within 12 h prior to blood culture sampling. NEUT-RI values were retrieved from the complete blood count. A control group of 52 inpatients with negative blood cultures was also analyzed. Median NEUT-RI was significantly higher in BSI patients than in controls (53.43 FI vs 48.65 FI; p < 0.001). ROC (Receiver Operating Characteristic) curve analysis showed an AUC (Area Under the Curve) of 0.785 for NEUT-RI, with 72.5% sensitivity and 76.9% specificity at a cut-off of 50.7 FI. Only Procalcitonin (AUC 0.882) outperformed NEUT-RI (p = 0.01). Our findings suggest that NEUT-RI increases in the early stages of bacteremia and may serve as a useful early indicator of bloodstream infection. NEUT-RI could be integrated into multi-parametric diagnostic algorithms to improve early detection of BSIs. Further studies are warranted to validate these preliminary results.
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