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Published on: June 10, 2025

Adjunctive Value of Admission CBC-Derived Inflammation Indices for Catheter-Related Bloodstream Infection in

Muhammed Ali Coşkuner1, Gökhan Köker2, Gülhan Özçelik Köker3

  • 1Department of Internal Medicine, Antalya City Hospital, 07080 Antalya, Turkey.

Diagnostics (Basel, Switzerland)
|June 26, 2026
PubMed

Insights

Catheter-related bloodstream infections (CRBSI) in hemodialysis patients can be identified using admission blood count indices. The neutrophil-to-lymphocyte ratio (NLR) demonstrated the best performance in distinguishing CRBSI from other conditions.

Area of Science:

  • Hematology
  • Infectious Diseases
  • Nephrology

Background:

  • Catheter-related bloodstream infection (CRBSI) is a significant complication for catheter-dependent maintenance hemodialysis patients.
  • Rapid risk stratification for CRBSI is crucial while awaiting microbiological culture results.
  • Complete blood count (CBC)-derived inflammatory indices may offer early diagnostic clues.

Purpose of the Study:

  • To evaluate the diagnostic performance of admission CBC-derived indices, including neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR), platelet-to-lymphocyte ratio (PLR), systemic immune-inflammation index (SII), and pan-immune-inflammation value (PIV), for identifying CRBSI in hemodialysis patients.
  • To assess the association of these indices with CRBSI after adjusting for clinical confounders.

Main Methods:

  • Retrospective single-center study of adult catheter-dependent hemodialysis patients.
  • Patients were classified as CRBSI (based on clinical findings and positive blood cultures) or controls (non-infectious admissions).
  • Admission CBC data were used to calculate inflammatory indices. Receiver operating characteristic (ROC) analysis and multivariable logistic regression were employed.

Main Results:

  • CRBSI cases exhibited higher NLR, SII, and PIV, and lower LMR compared to controls; PLR showed no significant difference.
  • NLR demonstrated the highest discriminatory performance (AUC 0.737), followed by SII (AUC 0.693), PIV (AUC 0.686), and LMR (AUC 0.642).
  • Adjusted logistic regression indicated that NLR remained significantly associated with CRBSI (OR 1.159, p < 0.001), alongside hypertension and cardiovascular disease.

Conclusions:

  • Admission hematologic inflammatory indices, particularly NLR, possess moderate discriminatory ability for CRBSI in catheter-dependent hemodialysis patients.
  • These indices can provide rapid, adjunctive information to support clinical decision-making while awaiting definitive microbiological confirmation.
  • NLR may serve as a valuable, readily available biomarker for early CRBSI risk assessment in this vulnerable population.

Keywords:
biomarkerscatheter-related infectionscentral venous cathetersrenal dialysis

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