Ratio of neutrophilic CD64 and monocytic HLA‐DR: A novel parameter in diagnosis and prognostication of neonatal sepsis

Abstract

Objective: Approaches to monitoring of sepsis have traditionally relied upon the pro-inflammatory component of the sepsis response. This study evaluated the diagnostic and prognostic potential of the ratio of neutrophilic CD64 (nCD64) and monocytic HLA-DR (mHLA-DR) median fluorescence index in monitoring of neonatal sepsis.Methods: Blood from 100 neonates suspected of sepsis and 29 healthy controls was collected on clinical suspicion of sepsis, and the expression of nCD64, mHLA-DR was evaluated by Flow Cytometry; thereby, a derived parameter "Sepsis index," SI 5 nCD64/mHLA-DR 3 100 was estimated.Results: At day 1, sensitivity and specificity to detect sepsis using nCD64 was 73.01% and 89.18%, respectively, while for SI it was 73.01% and 72.22%, respectively. On Kaplan-Meier analysis, neonates with SI > cut-off showed a higher 30 day-mortality than those with low SI (P 5 0.096). On multivariate analysis, the factor associated with mortality in our cohort was Apgar score 3, while SI showed a trend toward significance.Conclusions: At day1, nCD64 is useful for the diagnosis of neonatal sepsis whereas mHLA-DR is beneficial for monitoring patients at a later time point. The SI is a marker of moderate diagnostic sensitivity and supplements the current arsenal of laboratory investigations to detect neonatal sepsis. As a marker of prognosis, a high SI shows a trend towards greater mortality. V C 2015 Clinical Cytometry Society

In neonates S100A8/S100A9 alarmins prevent the expansion of a specific inflammatory monocyte population promoting septic shock

“…Collectively, these findings suggested that S100A8/S100A9 are negative regulators for the expansion of both human DR 2 Mos and murine CD11b + /Gr-1 int /Ly6G 2 /Ly6C hi cells at birth. In human newborns, DR 2 Mos have been shown to be expanded in late-onset neonatal sepsis (LONS) (50,(54)(55)(56). These studies with LONS were performed during days 3 to 9 of life, which is when DR 2 Mos in healthy neonates are no longer expanded (Fig.…”

Sepsis‐induced immune alterations monitoring by flow cytometry as a promising tool for individualized therapy

“…First reports in neonatology/pediatric sepsis indicate interesting results as similar immune alterations seem to be associated with poor outcome and/or HAI risk (decreased mHLA‐DR, decreased lymphocyte cytokine production, lymphopenia) . As sepsis remains a major cause of death in pediatrics, further investigations in immunological monitoring appear of major importance.…”

Issue Highlights ‐ November 2017 (92:B6)

“…The objective was to associate neutrophil CD64 expression with CD8 T‐cell activation, CD4 T‐cells numbers, and relate the above to HIV and HCV replications. They report overexpression of CD64 on neutrophils in co‐infected individuals . It is in line with HIV infection and corresponding up‐regulation of neutrophil CD64 expression.…”

“…A flow cytometric application to study the impact of T‐cell activation associated with viral co‐infection with HIV and hepatitis C. Morquin, et al describe CD64 expression on neutrophils and developed a method to study the role of dual viral infection on this cell type using a protocol derived from one used for neonatal sepsis . The objective was to associate neutrophil CD64 expression with CD8 T‐cell activation, CD4 T‐cells numbers, and relate the above to HIV and HCV replications.…”