Neutrophil and monocyte CD64 indexes, lipopolysaccharide-binding protein, procalcitonin and C-reactive protein in sepsis of critically ill neonates and children

Abstract

Neutrophil CD64 index (CD64in) is the best individual marker for bacterial sepsis in children, while in neonates the highest diagnostic accuracy at the time of suspected sepsis was achieved by LBP and 24 h later by CD64in.

Neutrophil Cd64 Index in Sepsis Diagnosis After Cardiac Surgery in Infants

“…Impact of septic etiology on levels of bacterial inflammation markers ought not to be negated as well. In the aforementioned study, gram-positive flora prevailed in all the cases of confirmed sepsis [17]. In our group of patients, both gram-positive and gram-negative causative agents were observed in the positive hemoculture.…”

“…In this study, white blood CD64 index reflecting the CD64 expression level on neutrophil membrane was compared to procalcitonin and C-reactive protein -indicators that are frequently used in cardiac surgical practice. The analysis revealed that the CD64 index is a good early marker of sepsis with high sensitivity (80%) and specificity (90%), AUC -0.895 (0.753-1.000) and cutoff point 2.00; this corresponds to the results of other studies of neonates and infants at multi-profile children's units [17,18]. For instance, in a study carried out on patients at the multi-profile pediatric intensive care unit, the highly informative values of the CD64 index were 2.38 or higher for infants (aging from 28 days to 12 months) and 1.86 or higher for neonates (respective AUC values amounted to 0.88 and 0.82, sensitivity values -to 71 and 77%, specificity values -to 100 and 79%, positive prognostic value -100 and 53%, negative prognostic value -96 and 92%) [17].…”

“…Recent immunological studies led to the discovery of new potential markers that could be instrumental in diagnosing bacterial sepsis. These markers could be roughly subdivided into 3 groups: cell membrane antigens, cytokines and acute phase proteins [17]. In this study, white blood CD64 index reflecting the CD64 expression level on neutrophil membrane was compared to procalcitonin and C-reactive protein -indicators that are frequently used in cardiac surgical practice.…”

“…Therefore, we may assume that the variability of neutrophil expression of FcγRI (СD64) receptors could potentially serve as a bacterial sepsis marker. Other authors demonstrated the possibility to use it as an early differential criterion of sepsis in adults [10−15], neonates [14−16] and infants [17]. Currently, no data from cardiac surgery units are available; also, no data are available on the possibility of using this parameter as a sepsis marker in infants after cardiosurgical interventions employing cardiac bypass, because all of the studies on this subject were carried out at general intensive care units.…”

Neutrophil CD64 as a sepsis biomarker

“…A smal ler study in cri ti cal ly ill neo na tes and in fan ts by Gro se ljGre nc used the stan dar di zed CD64 in dex for the fi r st ti me and de mon stra ted its su pe rio ri ty over all ot her in fec tion mar ke rs (29). In a fol low-up stu dy the sa me aut ho rs pre sen ted evi den ce that neutrop hil CD64 was the be st in di vi dual mar ker for bac te rial sep sis in chil dren, whe reas the te st perfor med so mewhat le ss in neo na tes (32). Howe ver, bo th pa tie nt grou ps we re of li mi ted si ze and might ac tual ly not war ra nt this con clu sion.…”