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Updated: Dec 31, 2025
Characterization of Human Monocyte Subsets by Whole Blood Flow Cytometry Analysis
Published on: October 17, 2018
Comparison of Monocyte Distribution Width (MDW) and Procalcitonin for early recognition of sepsis
Ennio Polilli1, Federica Sozio2, Antonella Frattari3
1Clinical Pathology Unit, Pescara General Hospital, Pescara, Italy.
Abstract:
We carried out a prospective observational study to evaluate whether Monocyte Distribution Width (MDW) may play a role in identifying patients with sepsis in comparison with Procalcitonin (PCT). We prospectively enrolled all consecutive patients hospitalized at the Infectious Diseases Unit of Pescara General Hospital for bacterial infection or sepsis. MDW values were collected for all patients. Clinical characteristics, demographic data, past and present medical history, microbiological results, PCT, as well as neutrophil and monocytes indices at entry were compared in the 2 groups. Two-hundred-sixty patients were enrolled, 63.5% males, aged 59.1±19.5 years. Sepsis was diagnosed in 105 (40.4%); in 60 (57.1%) at least 1 microorganism was isolated from blood cultures. In multivariate models, MDW as a continuous variable (OR:1.57 for each unit increase; 95%CI: 1.31-1.87, p<0.001) and PCT˃1 ng/mL (OR: 48.5; 95%CI: 14.7-160.1, p<0.001) were independently associated with sepsis. Statistical best cut points associated with sepsis were 22.0 for MDW and 1.0 ng/mL for PCT whereas MDW values<20 were invariably associated with negative blood cultures. At ROC curve analysis, the AUC of MDW (0.87) was nearly overlapping that of PCT (0.88). Our data suggest that incorporating MDW within current routine WBC counts and indices may be of remarkable use for detection of sepsis. Further research is warranted.
Insights
Monocyte Distribution Width (MDW) shows promise in identifying sepsis, performing similarly to Procalcitonin (PCT). This new marker, when combined with routine blood counts, could aid in sepsis detection.
Area of Science:
- Clinical Medicine
- Infectious Diseases
- Hematology
Background:
- Early identification of sepsis is crucial for patient outcomes.
- Procalcitonin (PCT) is a recognized biomarker for bacterial infections and sepsis.
- Novel biomarkers are needed to complement existing diagnostic tools.
Purpose of the Study:
- To evaluate Monocyte Distribution Width (MDW) as a potential biomarker for sepsis detection.
- To compare the diagnostic performance of MDW against Procalcitonin (PCT).
- To assess the utility of MDW in conjunction with routine blood counts for sepsis identification.
Main Methods:
- Prospective observational study enrolling patients hospitalized for bacterial infection or sepsis.
- Collected data included clinical characteristics, demographics, medical history, microbiological results, PCT, and neutrophil/monocyte indices.
- Multivariate analysis and ROC curve analysis were used to evaluate MDW and PCT performance.
Main Results:
- Sepsis was diagnosed in 40.4% of 260 enrolled patients.
- Both MDW (OR: 1.57) and PCT >1 ng/mL (OR: 48.5) were independently associated with sepsis.
- MDW demonstrated a high diagnostic accuracy (AUC: 0.87), comparable to PCT (AUC: 0.88).
Conclusions:
- MDW is a promising biomarker for sepsis detection, with performance similar to PCT.
- Incorporating MDW into routine white blood cell counts may enhance sepsis detection capabilities.
- Further research is warranted to validate these findings and establish clinical utility.
