Original Research
Tuesday, October 15, 2024
08:30 AM–10:00 AM
Abstract
Introduction: Innate immune response involves the recruitment of various myeloid cells that integrate to recognize and combat invading pathogens. Bacterial infections are characterized by an elevated total white blood cell(WBC) count, neutrophils/lymphocytes ratio(NLR) and inflammatory markers, commonly used as diagnostic indicators of disease severity and prognosis.
G6PD deficiency is an inherited hematological disorder that affects immune cell integrity making them more susceptible to infection-induced oxidative stress and consequently compromising the immune capability to fight bacterial infections.
Research Question or Hypothesis: To evaluate the diagnostic value of WBC in assessing the immune response of G6PD deficient patients and its relation to infection-related mortality.
Study Design: Retrospective review
Methods: Comprehensive data (demographics, clinical manifestations, laboratory parameters, and microbiological details) were extracted records of genetically confirmed G6PD-deficient adult patients with documented bacterial infections . Statistical analysis was performed using R software
Results: A total of 202 G6PD-deficient patients with 334 unique bacterial cultures were included in the study. Male gender, older age, long hospitalization, admission to critical care, and multiple comorbidities were associated with higher 28-day mortality rates. Bacteremia, hospital-acquired infections, and polymicrobial infections were also linked to increased mortality risk. The CBC parameters, including WBC count, neutrophil%, lymphocyte%, monocyte%, eosinophil%, and NLR, were analyzed for their correlation with 28-day mortality. Cox regression analysis indicated a significant association betweenWBC count below the median(>9.8×109/L) and mortality, with a crude hazard ratio[HR=1.94,95%CI:1.17-3.22,p=0.009]. Notably, even after adjusting for confounding factors, the significance persisted[HR=3.07,95%CI:1.05-9.02,p=0.041].
Conclusion: G6PD-deficient patients with bacterial infections exhibited distinct immunocompromised characteristics and increased susceptibility to mortality. The patient’s CBC during infections showed no cellular immune response to infection, particularly WBC and NLR that didn’t show any potential diagnostic value in predicting disease severity and prognosis in this patient population. Further research is needed to validate these findings and explore potential interventions to improve outcomes in G6PD-deficient individuals with bacterial infections.
Presenting Author
Islam Ghazi PharmDArnold and Marie Schwartz College of Pharmacy
Authors
Diaa Alrahmany BSc Pharm
3- Pharmaceutical Care Department, Directorate General of Medical Supplies, Ministry of Health, Muscat 3110, Oman
Wasim Elnekidy PharmD, BCPS, BCACP
Cleveland Clinic Abu Dhabi
Gehan Harb B.Sc. Phamr
Harb Statisitics