Evaluation of CD64 Expression on Neutrophils as an Early Indicator of Neonatal Sepsis

Soni, S. K.; Wadhwa, Neelam; Kumar, Rajive; Faridi, M. M. A.; Sharma, Satendra; Chopra, Anita; Singh, Saroj

doi:10.1097/inf.0b013e31826faede

Cited by 28 publications

(29 citation statements)

References 16 publications

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“…This is in contrast to the majority of other infection biomarker studies for which patients are usually recruited shortly after clinical presentation (9,12,13 ). Thus, diagnostic utilities derived from these studies would also reflect the clinical assessment skills of frontline neonatologists who decided whether or not to recruit the patients.…”

Section: Discussionmentioning

confidence: 85%

“…However, rapid upregulation of the surface antigen occurs upon exposure to bacteria or their components (3 ). Our previous studies indicated that neutrophil CD64 possessed excellent diagnostic utility for identification of early-and late-onset sepsis and NEC at the time of clinical manifestation of these conditions (4,(7)(8)(9)(10)15 ). Nonetheless, the surveillance properties of neutrophil CD64 have not been determined.…”

mentioning

confidence: 99%

“…These conditions remain important causes of morbidity and mortality, despite advances in neonatal intensive care (2 ). Over the past 2 decades, studies on biomarkers of neonatal sepsis have focused on diagnosing these conditions as early as the time of clinical manifestation (3)(4)(5)(6)(7)(8)(9). Although many infection biomarkers have been found to perform satisfactorily during the early phase of illness (at or within 12 h of clinical presentation) (4 -6, 9, 10 ), clinical presentation in infants may occur hours or even days after initial bacterial invasion.…”

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confidence: 99%

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Neutrophil CD64 for Daily Surveillance of Systemic Infection and Necrotizing Enterocolitis in Preterm Infants

et al. 2013

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BACKGROUND Early detection and treatment of infected preterm infants could decrease morbidity and mortality. Neutrophil CD64 has been shown to be an excellent early diagnostic biomarker of late-onset sepsis (LOS) and necrotizing enterocolitis (NEC). We aimed to study whether using CD64 as a daily surveillance biomarker could predict LOS/NEC before clinical manifestation. METHODS We collected 0.1 mL whole blood from very low birth weight (VLBW) infants from day 7 postnatal age until routine daily blood tests were no longer required. Four categories of responses were defined: proven sepsis, clinical sepsis, nonsepsis/non-NEC, and asymptomatic CD64 activation. RESULTS A total of 146 infants were consecutively recruited and 155 episodes of sepsis evaluation were performed. The biomarker screening utility, sensitivity, specificity, positive predictive value, and negative predictive value for surveillance of LOS/NEC using a cutoff of 5655 antibody-PE (phycoerythrin) molecules bound/cell were 89%, 98%, 41%, and 99.8%, respectively. LOS/NEC was detected a mean of 1.5 days before clinical presentation. However, 63 episodes of CD64 activation occurred in asymptomatic infants who would not otherwise have required sepsis evaluations. CONCLUSIONS As a surveillance biomarker, neutrophil CD64 detected LOS/NEC 1.5 days before clinical presentation, but at the expense of performing 41% additional sepsis evaluations. This was mainly attributed to an unexpected group of asymptomatic infants with CD64 activation, who recovered spontaneously and did not require antimicrobial treatment. The latter group has not been previously recognized in VLBW infants and could represent subclinical infection secondary to transient bacterial translocation or mild viral infection.

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Section: Discussionmentioning

confidence: 85%

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confidence: 99%

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confidence: 99%

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Neutrophil CD64 for Daily Surveillance of Systemic Infection and Necrotizing Enterocolitis in Preterm Infants

et al. 2013

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“…Out of the 12 included studies, seven focused specifically on neonatal sepsis. 20,[21][22][23][24]27,28 Pooled estimates of the sensitivity, specificity and accuracy of CD64 expression testing are presented in Table 2.…”

Section: Resultsmentioning

confidence: 99%

“…The initial literature search identified 67 potential studies, of which 55 were excluded to leave a total of 12 studies [11][12][13][20][21][22][23][24][25][26][27][28] for detailed review. The main reasons for excluding studies were that the study: (i) was a duplicate between the PubMed and EMBASE Õ databases; (ii) was not diagnostic; (iii) included children or adults; (iv) did not allow reconstruction of the diagnostic two-by-two table.…”

Section: Resultsmentioning

confidence: 99%

Diagnostic accuracy of neutrophil CD64 expression in neonatal infection: A meta-analysis

Jia

Shen

et al. 2013

J Int Med Res

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Objective: The aim of the present study was to establish the predictive values of neutrophil CD64 expression in diagnosing neonatal infection. Methods: A comprehensive search of the PubMed and Embase Õ literature databases identified outcome data from published studies estimating the diagnostic accuracy of neutrophil CD64 expression for neonatal infection. Summary estimates for sensitivity, specificity, diagnostic odds ratios (DOR) and the area under the summary receiver operating characteristic curve (AUC) were calculated using a bivariate random-effects approach. Results: Twelve studies including 1915 neonates were analysed. Summary estimates (95% confidence intervals) for CD64 expression in the diagnosis of neonatal infection were: sensitivity, 0.78 (0.75, 0.81); specificity, 0.81 (0.78, 0.83); DOR, 21.27 (11.71, 38.65); positive-likelihood ratio, 4.53 (3.22, 6.36); negative-likelihood ratio, 0.23 (0.14, 0.37); AUC, 0.89. Conclusions: Neutrophil CD64 expression can be used as an additional test in the diagnosis of neonatal infection. Results of a CD64 assay should not be used alone to diagnose such infections, but should be interpreted in combination with other test results and clinical findings.

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Impact of T cell activation, HIV replication and hepatitis C virus infection on neutrophil CD64 expression

Morquin

Tuaillon

Makinson

et al. 2016

Cytometry Part B Clinical

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Evaluation of CD64 Expression on Neutrophils as an Early Indicator of Neonatal Sepsis

Abstract: Enhanced nCD64 reported as median M/N CD64 ratio is a highly sensitive marker of culture-positive neonatal sepsis. It additionally identifies a separate group among culture-negative sick neonates and may be useful to guide antibiotic administration especially in these neonates.

Cited by 28 publications

References 16 publications

Neutrophil CD64 for Daily Surveillance of Systemic Infection and Necrotizing Enterocolitis in Preterm Infants

Neutrophil CD64 for Daily Surveillance of Systemic Infection and Necrotizing Enterocolitis in Preterm Infants

Diagnostic accuracy of neutrophil CD64 expression in neonatal infection: A meta-analysis

Impact of T cell activation, HIV replication and hepatitis C virus infection on neutrophil CD64 expression

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