Correlation of neutrophil CD64 with clinical profile and outcome of sepsis patients during intensive care unit stay

Abstract

Introduction:Neutrophil CD64 (nCD64) has been found to identify sepsis from nonseptic patients. It is also reported to be a predictor of survival and severity of sepsis. The goal of this study was to correlate serial nCD64 with Intensive Care Unit (ICU) outcome and severity of sepsis.Materials and Methods:A prospective observational study was conducted in 12-bedded critical care unit of a tertiary care center. Adult patients with sepsis were included in this study. Demographics, illness severity scores, clinical parameters, laboratory data, and 28-day outcome were recorded. Serial nCD64 analysis was done (on days 0, 4, and 8) in consecutive patients.Results:Fifty-one consecutive patients were included in the study. Median Acute Physiology and Chronic Health Evaluation II was 16 (12–20) and mean Sequential Organ Failure Assessment was 9 (8–10). Compared to survivors, nonsurvivors had higher nCD64 on day 8 (P = 0.001). nCD64 was higher in the septic shock group compared to sepsis group on days 0 and 8 (P < 0.05). Survivors showed improving trend of nCD64 over time while nonsurvivors did not. This trend was similar in the presence or absence of septic shock. nCD64 count was a good predictor of the septic shock on day 0 (area under the curve [AUC] = 0.747, P = 0.010) and moderate predictor at day 8 (AUC = 0.679, P = 0.028).Conclusion:Monitoring serial nCD64 during ICU stay may be helpful in determining the clinical course of septic patients.

Comparison of neutrophil CD64 and monocytic HLA-DR with existing biomarkers for the diagnosis and prognosis of sepsis

“…There was no significant difference in the levels of nCD64 between non-survivors and survivors among patients with sepsis ( Table 6 ). A recent study has also reported that there was no difference in mean nCD64 levels between survivors and non-survivors on days 0 and 4; however, a significant difference was observed on day 8 [ 21 ]. In our study, we found that nCD64 levels were distinguishable between sepsis(cases) and non-sepsis patients (disease controls).…”

Neutrophil CD64 a Diagnostic and Prognostic Marker of Sepsis in Adult Critically Ill Patients: A Brief Review

“…To summarize, CD64 as a biomarker has important utility of prognosis in critically ill patients in various aspects. Neutrophil CD64 has been found to correlate with sepsis severity, 15 , 26 , 34 , 37 correlate with illness severity like APACHE II and SOFA score, 15 and predict survival/mortality during ICU stay. 15 , 21 , 31 , 35 , 37 For prognosis, CD64 has been found to be better than PCT and/or CRP.…”

“…Neutrophil CD64 has been found to correlate with sepsis severity, 15 , 26 , 34 , 37 correlate with illness severity like APACHE II and SOFA score, 15 and predict survival/mortality during ICU stay. 15 , 21 , 31 , 35 , 37 For prognosis, CD64 has been found to be better than PCT and/or CRP. 15 , 33 , 35 Some of the studies where CD64 levels measured serially, described added advantage in addition to above aspects.…”

“…Significantly decreasing trend of this biomarker over time periods was noted in patients who survived than who did not. 37 …”

“…Three studies described about significant decrease in level of this biomarker in patients who survived than their admission value. 29 , 33 , 37 …”