Diagnostic value of CD64 in early detection of neonatal sepsis

Elkareem, Rehab M. Abd; Ahmed, Heba Mostafa; Meabed, Mohammed Hussien; Elias, Sara Sobhy; Elmaraghy, Mohhamed Adel

doi:10.1007/s00580-020-03100-4

Cited by 11 publications

(17 citation statements)

References 13 publications

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“…In the current study, nCD64% achieved a highly significant increase in sepsis patients compared to the controls with a maximum efficacy of 87.5%, sensitivity of 85.6%, and specificity of 93%. These findings come in concordance with other studies results [ 20 , 34 – 36 ].…”

Section: Discussionsupporting

confidence: 94%

“…nCD64 was tested in most sepsis patients at very early stages; once sepsis was suspected even before overt signs of sepsis have been manifested, this indicates a valuable role of CD64 if used as a sepsis marker in early stages of sepsis process which is agreed by previous studies [10,16,20,37].…”

Section: Biomed Research Internationalsupporting

confidence: 69%

“…nCD64 represents a membrane glycoprotein that mediates endocytosis, phagocytosis, antibody-dependent cellular toxicity (ADCC), cytokine release, and superoxide generation [19]. It is constitutively expressed on monocytes and macrophages; however, it is expressed at low concentration on nonactivated neutrophils but can be markedly upregulated at the onset of the sepsis process [20,21].…”

Section: Introductionmentioning

confidence: 99%

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Valuable Role of Neutrophil CD64 and Highly Sensitive CRP Biomarkers for Diagnostic, Monitoring, and Prognostic Evaluations of Sepsis Patients in Neonatal ICUs

Hashem

Masry

Mokhtar

et al. 2020

BioMed Research International

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Background. Neonatal sepsis (NS) is a very critical medical situation associated with high morbidities and mortalities. There is an utmost need for a new tool helping in early diagnosis and proper management of sepsis neonates. Neutrophil CD64 (nCD64) shows a very promising value in this concerning issue. Aim. Evaluate the diagnostic, monitoring, and prognostic performances of nCD64 and highly sensitive CRP (hs-CRP) in NS as well as the possible best panel of biomarkers that can achieve the most desirable results. Methods. Patients were enrolled from three neonatal intensive care units (NICUs) (n=121 patients) and classified according to their initial sepsis evaluation into three groups: disease control group (n=30), proven sepsis group (n=17), and clinical sepsis group (n=74). Laboratory evaluation included hs-CRP, complete blood count (CBC), and blood culture in addition to nCD64 (done by flow cytometry technique). Besides the diagnostic evaluations, follow-up evaluations were done for 40 patients after five days from the first time; patients were reclassified according to their outcome into the improved sepsis neonates’ group (n=26) and sepsis neonates without improvement (n=14). Results. Significant increase in nCD64 and hs-CRP results were present in sepsis groups compared to the disease controls (P<0.001); nCD64 at 43% cutoff value could detect the presence of sepsis with 85.6% sensitivity and 93% specificity. Additionally, delta change percentage (dC%) between improved sepsis neonates and sepsis neonates without improvement showed a significant difference in the levels of both nCD64 (P<0.001) and hs-CRP (P=0.001). Conclusion. Besides the promising diagnostic performance documented by nCD64 which is higher than the other laboratory sepsis biomarkers used routinely in NICUs, nCD64 has a valuable role in sepsis patients’ monitoring and prognostic evaluation. hs-CRP was moderate in its diagnostic and monitoring results being less than that achieved by nCD64. Combined measurement of nCD64% and hs-CRP gives better diagnostic and monitoring performance than that achieved by any of them alone.

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Section: Discussionsupporting

confidence: 94%

Section: Biomed Research Internationalsupporting

confidence: 69%

Section: Introductionmentioning

confidence: 99%

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Valuable Role of Neutrophil CD64 and Highly Sensitive CRP Biomarkers for Diagnostic, Monitoring, and Prognostic Evaluations of Sepsis Patients in Neonatal ICUs

Hashem

Masry

Mokhtar

et al. 2020

BioMed Research International

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“…Early diagnosis of sepsis is a clinical challenge as clinical symptoms and signs of the disease are subtle, late, and nonspecific making it hard to be discriminated from that of noninfectious causes [ 6 ]. Blood culture is still the gold standard for sepsis diagnosis, but minimum two days are required for the earliest result, in addition to the presence of many confounding factors giving false positive and false negative results which add another diagnostic obstacle [ 4 , 7 ].…”

Section: Introductionmentioning

confidence: 99%

“…Neutrophil CD64 (nCD64) is one of the most researchable sepsis biomarkers; it shows a valuable role in both diagnosing and monitoring infections in both early-onset and late-onset sepsis in either term or preterm newborns [ 4 , 6 , 9 – 13 ]. Further studies postulated a valuable prognostic role for nCD64 and diagnostic efficacy to discriminate between infectious and noninfectious systemic inflammatory response syndrome (SIRS) in ICU settings [ 14 , 15 ].…”

Section: Introductionmentioning

confidence: 99%

The Utility of Neutrophil CD64 and Presepsin as Diagnostic, Prognostic, and Monitoring Biomarkers in Neonatal Sepsis

Hashem

Halim

Masry

et al. 2020

International Journal of Microbiology

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Background. Neonatal septicemia is a critical medical situation; current conventional laboratory methods still have many limitations and diagnostic obstacles. For this purpose, last decades have witnessed a challenge between the battery of sepsis biomarkers including many leukocyte surface antigens, not only for early diagnostic purposes but also for better follow-up and good management of sepsis patients. Aim. To evaluate the diagnostic, prognostic, and monitoring performance of both neutrophil CD64 (nCD64) and presepsin as sepsis biomarkers compared to each other and to the conventional laboratory sepsis parameters aiming to decide which is the best fitting for routine daily use in neonatal intensive care units (NICUs). Methods. 235 neonates were enrolled from three Egyptian neonatal ICUs, during the period from November 2015 till March 2018; they were classified into two main groups: the control group (n = 102) and the sepsis group (n = 133). Laboratory sepsis evaluation included highly sensitive CRP (hs-CRP), CBC, in addition to nCD64 (flow cytometry technique), and presepsin measurement (CLEIA technique combined with Magtration® technology); the diagnosis was confirmed thereafter by positive blood culture results (BacT/Alert system). Sixty-two of the enrolled sepsis neonates were subjected to follow-up assessment; they were reclassified according to their clinical improvement at the second time assessment into (group 1: sepsis group without improvement) (n = 20) and (group 2: improved sepsis group) (n = 42). Results. Significant increase in nCD64 and presepsin values was found in sepsis groups compared to the controls. At cutoff 41.6%, nCD64% could discriminate the presence of septicemia with sensitivity 94.7%, specificity 93.6 %, and AUC 0.925, while presepsin at cutoff 686 pg/ml achieves sensitivity 82.7%, specificity 95.5%, and AUC 0.887, respectively. Significant increase in nCD64 ( P < 0.001 ) and hs-CRP ( P = 0.018 ) values was observed in severe sepsis/septic shock patients compared to nonsevere sepsis patients. Delta change percentage (dC%) between initial and follow-up evaluations for both improved and nonimproved sepsis patients was dC Z value −5.904 for nCD64% followed by dC Z value −4.494 for presepsin. Conclusion. nCD64 and presepsin are valuable early diagnostic and monitoring sepsis biomarkers; the highest sensitivity could be achieved by a univariant sepsis marker in this study was recorded by the nCD64% biomarker, while the highest specificity was documented by presepsin. Combined measurement of both achieves the highest diagnostic performance in sepsis neonates. Either of CD64 or presepsin combined with hs-CRP associated with better performance than any of them alone. nCD64 carries an additional promising role in reflecting sepsis prognosis.

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Future electrodes for sepsis detection: digital microfluidic biosensors from plant waste

Prathaban,

Zambry,

Ibrahim

et al. 2024

Microfluid Nanofluid

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Diagnostic value of CD64 in early detection of neonatal sepsis

Cited by 11 publications

References 13 publications

Valuable Role of Neutrophil CD64 and Highly Sensitive CRP Biomarkers for Diagnostic, Monitoring, and Prognostic Evaluations of Sepsis Patients in Neonatal ICUs

Valuable Role of Neutrophil CD64 and Highly Sensitive CRP Biomarkers for Diagnostic, Monitoring, and Prognostic Evaluations of Sepsis Patients in Neonatal ICUs

The Utility of Neutrophil CD64 and Presepsin as Diagnostic, Prognostic, and Monitoring Biomarkers in Neonatal Sepsis

Future electrodes for sepsis detection: digital microfluidic biosensors from plant waste

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