Neutrophil CD64 Expression as a Diagnostic Marker of Bacterial Infection in Febrile Children Presenting to a Hospital Emergency Department

Rudensky, Bernard; Sirota, Gisella; Erlichman, Mattityahu; Yinnon, Amos M.; Schlesinger, Yechiel

doi:10.1097/pec.0b013e31818c2679

Cited by 37 publications

(23 citation statements)

References 17 publications

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“…32,33 Similarly, the PMN CD64 index has been utilized in other disciplines, most notably in the early recognition of neonatal sepsis 34 and other bacterial infections in children. 35 When we compared these two biomarkers in their ability to identify new diagnosis CD, the PMN CD64 demonstrated a superior specificity when a fecal calprotectin cut off of 50 mcg/gm was utilized (90% specificity for PMN CD64 index compared to 29% specificity for fecal calprotectin). While a fecal calprotectin level of >50 mcg/gm has been suggested as the cut point to distinguish IBD from non-IBD, we found that only 4/14 non-IBD controls had a fecal calprotectin <50 mcg/gm.…”

Section: Discussionmentioning

confidence: 99%

Utility of Neutrophil Fcγ Receptor I (CD64) Index as a Biomarker for Mucosal Inflammation in Pediatric Crohnʼs Disease

Minar

Haberman

Jurickova

et al. 2014

Inflammatory Bowel Diseases

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Background Neutrophil expression of the Fcγ receptor I (CD64) is upregulated in adult patients with clinically active inflammatory bowel disease (IBD). We tested the relationship of CD64 with mucosal inflammation and clinical relapse in pediatric Crohn's disease (CD). Methods In a cohort of 208 newly diagnosed CD and 43 non-IBD controls, ileal expression of FcγRI/S100A9 was determined by RNA sequencing from biopsies obtained at ileocolonoscopy. In a second cohort, we tested for the peripheral blood polymorphonuclear neutrophil (PMN) CD64 index from 26 newly diagnosed CD, 30 non-IBD controls and 83 children with established CD. Results Ileal FcγRIA mRNA expression was significantly elevated in CD at diagnosis compared with non-IBD controls (p<0.001), and correlated with ileal S100A9 (calprotectin) expression (r=0.83, p<0.001). The median(range) PMN CD64 index for newly diagnosed CD was 2.3(0.74-9.3) compared with 0.76(0.39-1.2) for non-IBD controls (p<0.001) with 96% sensitivity and 90% specificity at the cut point of 1.0. The PMN CD64 index significantly correlated with mucosal injury as measured by the Simple Endoscopic Score-CD (SES-CD, r=0.62, p<0.001). CD patients in clinical remission receiving maintenance therapy with a PMN CD64 index <1.0 had a sustained remission rate of 95% over the following 12 months compared with 56% in those with a PMN CD64 index >1.0 (p<0.01). Conclusions An elevated PMN CD64 index is associated with both mucosal inflammation and an increased risk for clinical relapse in pediatric CD. The PMN CD64 index is a reliable marker for sustained remission in CD patients receiving maintenance therapy.

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Section: Discussionmentioning

confidence: 99%

Utility of Neutrophil Fcγ Receptor I (CD64) Index as a Biomarker for Mucosal Inflammation in Pediatric Crohnʼs Disease

Minar

Haberman

Jurickova

et al. 2014

Inflammatory Bowel Diseases

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“…Neutrophils have been used as diagnostic tools in clinical settings: neutrophil absolute count (Wile et al, 2001;Pratt and Attia, 2007;Bressan et al, 2010;Manzano et al, 2011), enumeration of band neutrophils (band count) (Seebach et al, 1997;Al-Gwaiz and Babay, 2007), and the expression levels of neutrophil surface proteins (Nupponen et Rudensky et al, 2008;Dilli et al, 2010;Genel et al, 2012;Jia et al, 2013) to predict bacterial infections and severity outcomes. Due to the increasing evidence of neutrophils being involved in mediating viral diseases (Tumpey et al, 2005;Duffy et al, 2012), it is now possible to develop new diagnostic tools capable of distinguishing between viral and bacterial diseases.…”

Section: Neutrophils As a Tool To Distinguish Between Bacterial And Vmentioning

confidence: 99%

Neutrophils: Neglected Players in Viral Diseases

Gabriel

Her

2013

DNA and Cell Biology

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“…They observed increased neutrophil surface CD64 expression in patients with bacterial and viral infections, but significantly more in those with bacterial infection [27]. Despite the very good sensitivity, they did not find that CD64 provided the necessary specificity for diagnosis of bacterial infection at several cutoff values [27]. Among other investigated surface molecules are CD11b, CD32, CD16, CD69, and CD15s [13,28].…”

Section: Discussionmentioning

confidence: 95%

“…One of the investigated leukocyte cell surface molecules is Fcγ receptor I (FcγRI) which is the high affinity receptor for monomeric IgG1 and IgG3, and is recognized by the monoclonal antibody CD64 [5]. Rudensky et al investigated the use of CD64 measurement in young children presenting to the ED with febrile illness [27]. They observed increased neutrophil surface CD64 expression in patients with bacterial and viral infections, but significantly more in those with bacterial infection [27].…”

Section: Discussionmentioning

confidence: 97%

“…Rudensky et al investigated the use of CD64 measurement in young children presenting to the ED with febrile illness [27]. They observed increased neutrophil surface CD64 expression in patients with bacterial and viral infections, but significantly more in those with bacterial infection [27]. Despite the very good sensitivity, they did not find that CD64 provided the necessary specificity for diagnosis of bacterial infection at several cutoff values [27].…”

Section: Discussionmentioning

confidence: 97%

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Lab-score is a valuable predictor of serious bacterial infection in infants admitted to hospital

Markić

Kovačević

Krželj

et al. 2015

Wien Klin Wochenschr

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Parents frequently bring their children to the Emergency Department (ED) because of the fever without apparent source (FWAS). To avoid possible complications, it is important to recognize serious bacterial infection (SBI) as early as possible. Various tests, including different clinical scores and scales, are used in the laboratory evaluation of patients. However, it is still impossible to predict the presence of SBI with complete certainty. Galetto-Lacour et al. developed and validated a risk index score, named Lab-score. Lab-score is based on the three predictive variables independently associated with SBI: procalcitonin (PCT), C-reactive protein (CRP), and urinary dipstick. The objective of this study was to assess the performance of the Lab-score in predicting SBI in well-appearing infants ≤ 180 days of age with FWAS, who presented to ED and were hospitalized with suspicion of having SBI. Based on this study findings, white blood cells count (WBC), CRP, PCT, and lab-score ≥ 3 were confirmed as useful biomarkers for differentiation between SBI and non-SBI. Also, receiver operating characteristic curve (ROC) analysis confirmed that all of them were useful for differentiation between SBI and non-SBI patients with the highest area under curve (AUC) calculated for the Lab-score. The results of this research confirmed its value, with calculated sensitivity of 67.7% and specificity of 98.6% in prediction of SBI in infants aged ≤ 180 days. Its value was even better in infants aged ≤ 90 days with sensitivity of 75% and specificity of 97.7%. In conclusion, we demonstrated the high value of lab-score in detecting SBI in infants under 6 months of age with FWAS.

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Neutrophil CD64 Expression as a Diagnostic Marker of Bacterial Infection in Febrile Children Presenting to a Hospital Emergency Department

Abstract: Neutrophil CD64 expression is a sensitive marker for diagnosing bacterial infection in young children, but as it is also raised in viral infection, it lacks specificity.

Cited by 37 publications

References 17 publications

Utility of Neutrophil Fcγ Receptor I (CD64) Index as a Biomarker for Mucosal Inflammation in Pediatric Crohnʼs Disease

Utility of Neutrophil Fcγ Receptor I (CD64) Index as a Biomarker for Mucosal Inflammation in Pediatric Crohnʼs Disease

Neutrophils: Neglected Players in Viral Diseases

Lab-score is a valuable predictor of serious bacterial infection in infants admitted to hospital

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