Neutrophil CD64 expression as a diagnostic marker for sepsis in adult patients: a meta-analysis

Abstract

IntroductionNeutrophil CD64 (nCD64) expression appears to be a promising marker of bacterial infections. The aim of this meta-analysis was to assess the accuracy of nCD64 expression for the diagnosis of sepsis in critically ill adult patients.MethodsWe systematically searched PubMed, Embase, ISI Web of Knowledge, and the Cochrane Library for literature published between database inception and 19 May 2014, as well as reference lists of identified primary studies. Studies were included if they included assessment of the accuracy of nCD64 expression for sepsis diagnosis in adult patients and provided sufficient information to construct a 2×2 contingency table.ResultsA total of 8 studies comprising 1986 patients fulfilled the inclusion criteria for the final analysis. The pooled sensitivity and specificity were 0.76 (95 % confidence interval [CI], 0.73–0.78) and 0.85 (95 % CI, 0.82–0.87), respectively. The positive likelihood ratio, negative likelihood ratio and diagnostic odds ratio were 8.15 (95 % CI, 3.82–17.36), 0.16 (95 % CI, 0.09–0.30), and 60.41 (95 % CI, 15.87–229.90), respectively. The area under the summary receiver operating characteristic curve of nCD64 expression with Q* value were 0.95 (Q* =0.89).ConclusionsOn the basis of our meta-analysis, nCD64 expression is a helpful marker for early diagnosis of sepsis in critically ill patients. The results of the test should not be used alone to diagnose sepsis, but instead should be interpreted in combination with medical history, physical examination, and other test results.

Diagnostic accuracy and clinical relevance of an inflammatory biomarker panel for sepsis in adult critically ill patients

“…Cluster of differentiation 64 (CD64, FcγRI) antigen is involved in neutrophil phagocytosis, oxidative burst and target killing [12] and has been promising in the early detection of bacterial infection [13-18]. Monocyte/macrophages are also key players in the innate immune response to infection.…”

Emerging infection and sepsis biomarkers: will they change current therapies?

“…A 2015 meta-analysis using adult studies sought to determine the relationship between nCD64 and the diagnosis of sepsis [85]. The AUC of the summary ROC curve was 0.95 with a Q* value of 0.89, and pooled specificity and sensitivity of 85% and 76% respectively [85].…”

“…The AUC of the summary ROC curve was 0.95 with a Q* value of 0.89, and pooled specificity and sensitivity of 85% and 76% respectively [85]. A prior meta-analysis by Cid et al included studies performed on patients of all ages, and found the pooled sensitivity to be 79%, specificity 91%, and AUC 0.94 for nCD64 expression to predict bacterial infection [86].…”

Laboratory in Diagnosis and Monitoring of Systemic Inflammatory Response Syndrome or Sepsis

“…Proinflamatuvar sitokinler (IL-6, IL-1β, IFN-γ, TNF-α), antiinflamatuvar sitokinler (IL-4, IL-10, TGF-β), kemokinler (GRO-α, IL-8, IP-10, MIG), akut faz reaktanları (CRP, PCT, SAA, inter α inhibitör protein, LPS bağlayıcı protein), lökosit yüzey antijenleri (CD11b, CD64) ve diğer (mannoz bağlayıcı lektin, pro-adrenomedullin, pro-endotelin, pro-atrial natriüretik peptid gibi) belirteçlerin kullanımı önerilmektedir (34,35). Sepsis için ideal biyobelirteç özellikleri şu şekilde sıralanabilir:…”