Skip to main content
SpringerLink
Log in

Effects of bacteria and yeast on WBC counting in three automated hematology counters

  • Original Article
  • Published:
Annals of Hematology Aims and scope Submit manuscript

Abstract

Bacteria or yeast may be observed on peripheral blood smears and may lead to spuriously elevated platelet counts. They have been reported to disturb the white blood cell (WBC) differential count if they clumped together, and a large number of such microorganisms have been shown to increase WBC counts. The purpose of this study was to evaluate the spurious rise in WBC counts according to species of microorganisms and automated hematology analyzers. The species we selected were Staphylococcus aureus, Escherichia coli, Candida albicans, C. tropicalis, C. krusei, C. dubliniensis, C. glabrata, and C. parapsilosis. We investigated the effects of bacteria and yeast on peripheral blood samples by the ADVIA 120/2120 Hematology System, Sysmex XE-2100 (TOA Medical Electronics, Kobe, Japan) and Coulter LH 750 (Beckman Coulter, Miami, FL, USA). C. albicans, C. tropicalis, C. krusei, and C. dubliniensis had an overt effect on the WBC count at concentrations of up to 1–5 × 107 colony-forming units (CFU)/mL in three automated cell counters, and C. glabrata and C. parapsilosis, when present at concentrations of 1–5 × 108 CFU/mL, caused a significant increase in the WBC count obtained by the Sysmex XE-2100 but not by the ADVIA 120/2120 system and Coulter LH 750 (p < 0.05). In conclusion, yeast may influence the results of peripheral blood smears only when the yeast concentration is unusually high. The results differed among analyzers and among species of yeast. Hematologists should be aware that samples containing bacteria and yeast may give erroneously high WBC counts and differential leukocyte counts and should review the peripheral blood smear by microscopy.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Bentley SA, Johnson A, Bishop CA (1993) A parallel evaluation of four automated hematology analyzers. Am J Clin Pathol 100:626–632

    PubMed  CAS  Google Scholar 

  2. Zandecki M, Genevieve F, Gerard J, Godon A (2007) Spurious counts and spurious results on haematology analysers: a review. Part I: platelets. Int J Lab Hematol 29:4–20

    Article  PubMed  CAS  Google Scholar 

  3. Branda JA, Kratz A (2006) Effects of yeast on automated cell counting. Am J Clin Pathol 126:248–254

    Article  PubMed  Google Scholar 

  4. Hur M, Lee YK, Lee KM, Kim HJ, Cho HI (2004) Pseudobasophilia as an erroneous white blood cell differential count with a discrepancy between automated cell counters: report of two cases. Clin Lab Haematol 26:287–290

    Article  PubMed  CAS  Google Scholar 

  5. Zandecki M, Genevieve F, Gerard J, Godon A (2007) Spurious counts and spurious results on haematology analysers: a review. Part II: white blood cells, red blood cells, haemoglobin, red cell indices and reticulocytes. Int J Lab Hematol 29:21–41

    Article  PubMed  CAS  Google Scholar 

  6. Grimaldi E, Carandente P, Scopacasa F, Romano MF, Pellegrino M, Bisogni R, De Caterina M (2005) Evaluation of the monocyte counting by two automated haematology analysers compared with flow cytometry. Clin Lab Haematol 27:91–97

    Article  PubMed  CAS  Google Scholar 

  7. Huh J, Jung J, Yoon H, Chung W (2005) Pseudoeosinophilia associated with malaria infection determined in the Sysmex XE-2100 hematology analyzer. Ann Hematol 84:400–402

    Article  PubMed  Google Scholar 

  8. Ducrest S, Meier F, Tschopp C, Pavlovic R, Dahinden CA (2005) Flowcytometric analysis of basophil counts in human blood and inaccuracy of hematology analyzers. Allergy 60:1446–1450

    Article  PubMed  CAS  Google Scholar 

  9. Sandhaus LM, Osei ES, Agrawal NN, Dillman CA, Meyerson HJ (2002) Platelet counting by the Coulter LH 750, Sysmex XE 2100, and Advia 120: a comparative analysis using the RBC/platelet ratio reference method. Am J Clin Pathol 118:235–241

    Article  PubMed  Google Scholar 

  10. Elghetany MT, Hudnall SD (1996) Spurious automated white cell count with Coulter STKS in the myelodysplastic syndromes suggests the presence of a red cell membrane defect. Am J Hematol 52:69

    Article  PubMed  CAS  Google Scholar 

  11. Bourner G, Dhaliwal J, Sumner J (2005) Performance evaluation of the latest fully automated hematology analyzers in a large, commercial laboratory setting: a 4-way, side-by-side study. Lab Hematol 11:285–297

    Article  PubMed  CAS  Google Scholar 

  12. Nakul-Aquaronne D, Sudaka-Sammarcelli I, Ferrero-Vacher C, Starck B, Bayle J (2003) Evaluation of the Sysmex Xe-2100 hematology analyzer in hospital use. J Clin Lab Anal 17:113–123

    Article  PubMed  Google Scholar 

  13. Kakkar N (2004) Spurious rise in the automated platelet count because of bacteria. J Clin Pathol 57:1096–1097

    Article  PubMed  CAS  Google Scholar 

  14. Latif S, Veillon DM, Brown D, Kaltenbach J, Curry S, Linscott AJ, Oberle A, Cotelingam JD (2003) Spurious automated platelet count. Enumeration of yeast forms as platelets by the cell-DYN 4000. Am J Clin Pathol 120:882–885

    Article  PubMed  Google Scholar 

  15. Arnold JA, Jowzi Z (1999) Images in haematology. Candida glabrata in a blood film. Br J Haematol 104:1

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Departments of Laboratory Medicine, Chung-Ang University College of Medicine, 65-207, 3-Ka Hangang-Ro Yongsan-Ku, Seoul, 140-757, South Korea

    Hye Ryoun Kim, Bo Rae G. Park & Mi Kyung Lee

Authors
  1. Hye Ryoun Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Bo Rae G. Park
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Mi Kyung Lee
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Mi Kyung Lee.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Kim, H.R., Park, B.R.G. & Lee, M.K. Effects of bacteria and yeast on WBC counting in three automated hematology counters. Ann Hematol 87, 557–562 (2008). https://doi.org/10.1007/s00277-008-0464-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00277-008-0464-1

Keywords

Search

Navigation