Neutrophil CD64 as a Marker for Postoperative Infection: A Pilot Study

Abstract

The aim of this pilot study was to evaluate the clinical utility of quantitative CD64 measurements to differentiate between systemic inflammation in response to surgical trauma and postoperative bacterial infection. In a consecutive series of 153 patients undergoing elective vascular surgery, peripheral venous blood samples were taken preoperatively on admission and postoperatively during the first 24h. The samples were analysed for C-reactive protein (CRP), total leucocyte counts (white blood cell (WBC)), serum procalcitonin (PCT) and neutrophil CD64 expression. Of the 153 patients, the focus is on those with (1) postoperative infection alone (group 1; n=1 4); (2) pre- and postoperative infection (group 2; n=6); and (3) postoperative fever with no other signs of infection (group 3; n=29). In group 1, all four markers were significantly increased in the 24h after surgery: CD64 (p=0.001), CRP (p=0.001), WBC (p=0.002) and PCT (p=0.012); in group 2, there was no significant difference in the CD64 (p=0.116), WBC (p=0.249) and PCT (p=0.138) values, whereas a marginal significance was shown for CRP (p=0.046); and the results for group 3 were similar to those of group 1. This pilot study suggests that the role of neutrophil CD64 measurements in facilitating the diagnosis of early postoperative infection merits further investigation.

A point-of-care microfluidic biochip for quantification of CD64 expression from whole blood for sepsis stratification

“…Neutrophil activation has also been reported to increase in burn and trauma patients and many have investigated their utility to migrate towards infections4041. Similarly, changes in the nCD64 expression have also been reported in patients with postoperative infections who are undergoing vascular42, cardiac43 or musculoskeletal surgeries44. Some other diseases like inflammatory bowel disease45 and familial Mediterranean fever46 have also reported neutrophil activation and have shown changes in the expression level of nCD64.…”

Utility of CD64 on Neutrophils in Orthopedic Infection

“…Although CD64 has been shown to have good sen- sitivity for the diagnosis of systemic infection, there are conflicting results regarding its diagnostic utility in local infection. 11,16,17 When the CD64-positive cut-off level was set at 2000 molecules/cell, 4 the sensitivity of CD64 in diagnosing systemic infection was 92.7% and the specificity was 96.5%. For local infection, on the other hand, the sensitivity was 66.0% and the specificity was 95.7%.…”

“…4,7,8 In the early phase after joint replacement, CD64 helped to differentiate whether elevations in other infection markers were due to infection or surgical stress. [9][10][11] Furthermore, CD64 was shown to have decreased sensitivity for old or local infections. 5,12 However, few studies have evaluated the efficacy of CD64 in the diagnosis of usual infections that did not occur in the context of RA or after joint replacement.…”

Morpho-Pathological Review on the Healing of Synthetic Vascular Grafts

“…When synthetic graft infection appears, the prosthesis and the adherent bacteria, generally found in a bio lm, act as one, forming an in ammatory stimulus for the immune system, for the pro-in ammatory cytokines [11]. is results in an in ammatory process which tries to localize the infection, but induces tissue-damaging e ects, such as the recruitment of polymorphonuclear granulocytes and the production of other cytokines.…”