Automated Blood Cell Counting in Candidaemia: A Comparative Study of Sysmex-X Series 500 and KX-21 Counters

Hidden fungal infections may lead to errors in blood cell counts and inappropriate treatment selection with serious consequences in many patients. This study aimed to evaluate the results of two automated blood cell counters Sysmex-X 500 and KX-21 in samples containing Candida albicans and Candida glabrata.

In this study, 144 blood samples of O- blood type were examined in the presence and absence of C. glabrata and C. albicans fungi at different concentrations by two automated blood cell counters Sysmex-X 500 and KX-21 in Lorestan University of Medical Sciences in 2017. Fungal samples were prepared at a concentration of 0.5 McFarland, equally added to the blood samples, and read by Sysmex-X 500 and KX-21.

The average number of erythrocytes, leukocytes, and platelets read by Sysmex-X 500 and KX-21 devices increased in the presence of both fungal samples compared to the primary samples. In addition, the number of lymphocytes, neutrophils, and monocytes read by Sysmex-X 500 and KX-21 devices in the presence of fungal samples was significantly higher compared to the primary samples (p< .05). The increase in mean blood cell counts in the presence of both fungal samples was significantly higher in X 500 than in KX-21 (p< .05).

This study results showed that among these two devices, the Sysmex-X Series 500 device showed less variation compared to the actual values of blood cells. The use of this device seems to reduce measurement error in blood cell counting.