The role of the neutrophil Fcγ receptor I (CD64) index in diagnosing spontaneous bacterial peritonitis in cirrhotic patients

Dang, Yan; Lou, Jinli; Yan, Yan; Yu, Yanhua; Sun, Guizhen; Li, Ning

doi:10.1016/j.ijid.2016.06.021

Cited by 11 publications

(9 citation statements)

References 23 publications

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“…Definition and diagnosis: The definition of primary SBP covers an infection of the ascitic fluid that was formerly sterile with no intra-abdominal infection source [3]. The diagnosis of SBP was confirmed when the polymorphonuclear (PMN) count in the ascitic fluid was greater than or equal to 250 cells/mm 3 [4,17,18].…”

Section: Methodsmentioning

confidence: 99%

Lymphocyte-To-Monocyte Ratio as the Best Simple Predictor of Bacterial Infection in Patients with Liver Cirrhosis

Piotrowski

Sączewska-Piotrowska

Jaroszewicz

et al. 2020

IJERPH

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Background and aim: The aim of this study was to assess the diagnostic performance of new morphology-related indices and Child–Turcotte–Pugh (CTP) and Model for End-Stage Liver Disease (MELD) scores during hospitalization in predicting the onset of bacterial infection in patients with liver cirrhosis. Material and methods: A total of 171 patients (56.9% males; median age 59 years; total number of hospitalizations 209) with liver cirrhosis were included in this observational study. The diagnosis of cirrhosis was made on the basis of clinical, biochemical, ultrasonic, histological, and endoscopic findings. The neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR), modified aspartate aminotransferase-to-platelet ratio index (APRI), aspartate aminotransferase-to-alanine aminotransferase ratio (AAR), Fibrosis-4 index (FIB-4), platelet-to-lymphocyte ratio (PLR), neutrophil-to-monocyte ratio (NMR), and CTP and MELD scores were calculated for the cases of patients with cirrhosis. Results: Bacterial infection was diagnosed in 60 of the 209 (28.7%) hospitalizations of patients with cirrhosis. The most common infections were urinary tract infection (UTI), followed by pneumonia and sepsis. The more severe the liver failure, the greater the bacterial infection prevalence and mortality. Patients with decompensated liver cirrhosis were infected more often than subjects with compensated cirrhosis (50.0% vs. 12.9%, p = 0.003). The calculated MELD score, CTP, NLR, LMR, AAR, monocyte count, and C-reactive protein (CRP) concentration were also related to the bacterial infection prevalence, and mortality areas under the curve (AUC) were 0.629, 0.687, 0.606, 0.715, 0.610, 0.648, and 0.685, respectively. The combined model with two variables (LMR and CTP) had the best AUC of 0.757. The most common bacteria isolated from patients with UTI were Escherichia coli, Enterococcus faecalis, and Klebsiella pneumonia. Gram-negative bacteria were also responsible for spontaneous bacterial peritonitis (SBP), and together with gram-positive streptococci and staphylococci, these microorganisms were isolated from blood cultures of patients with sepsis. Significant differences were found between CTP classification, MELD score, NLR, LMR, AAR, CRP, and PLR in patients with cirrhosis with, or without, bacterial infection. Conclusions: Bacterial infection prevalence is relatively high in patients with liver cirrhosis. Although all analyzed scores, including the LMR, NLR, aspartate aminotransferase (AST)/alanine aminotransferase (ALT), CRP, CTP, and MELD, allowed the prediction of bacterial occurrence, the LMR had the highest clinical utility, according to the area under the curve (AUC) and odds ratio (OR).

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Section: Methodsmentioning

confidence: 99%

Lymphocyte-To-Monocyte Ratio as the Best Simple Predictor of Bacterial Infection in Patients with Liver Cirrhosis

Piotrowski

Sączewska-Piotrowska

Jaroszewicz

et al. 2020

IJERPH

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“…In our study, 41/150 (27.3%) patients with ascites were confirmed to have SBP, while others identified with CNNA. In previous studies, the frequency of SBP among patients with ascetic fluid infection (AFI) has been reported as 25% -51% (1,(5)(6)(7). The different reported ratios of SBP in AFI may be due to different diagnostic criteria recruited by these studies as some authors may consider culture-positive patients as SBP, while others define SBP merely based on PMN count of ascetic fluid, as we recruited in our study (6,8).…”

Section: Discussionmentioning

confidence: 99%

“…WBC count in AF also rendered the highest level of sensitivity, specificity, PPV, and NPV (95.1%, 88.1%, 75%, and 98%). Ascetic PMN count has been noted to correlate with relatively novel diagnostic makers including calprotectin (23), procalcitonin (3), neutrophil Fc gamma receptor I (CD64) (6), and lactoferrin (24). A disadvantage of cell counts in AF is that it is timeconsuming and subject-oriented accentuating the possibility of man-dependent errors.…”

Section: Discussionmentioning

confidence: 99%

A Comparative Study on Ascetic Fluid Biochemical Markers in Cirrhotic Children with and Without Spontaneous Bacterial Peritonitis: A Cross-Sectional Observation

et al. 2019

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Background: Cirrhotic ascites is frequently complicated with spontaneous bacterial peritonitis (SBP). Objectives: Here, we assessed the diagnostic validity of some inflammatory markers in children with SBP. Methods: This cross-sectional study was performed in the Pediatric Gastroenterology Ward of Namazi hospital of Shiraz. SBP was considered as ≥ 250 polymorphonuclear cell (PMN) /µL ascetic fluid (AF). Results: Out of 150 liver cirrhotic patients with ascites, 41 (27.3%) were diagnosed with SBP. Mean WBC count and PMN per µL of AF were significantly higher in SBP patients than non-SBP (P < 0.0001). The highest specificity for the diagnosis of SBP was recorded for AF smear test (100%). Positive AF smear and culture tests rendered the highest positive predictive values (PPV, 100% and 88.2% respectively). The highest negative predictive value (NPV) was related to AF leukocyte esterase test (94.2%). The highest area under the curve (AUC) for diagnosis of SBP belonged to WBC count (0.956), total cell count (0.817), and LDH concentration (0.814) of AF. A cut off value of 290 WBC per µL AF resulted in respective 95.1% and 88.1% sensitivity and specificity. Trespass of WBC count and lactate dehydrogenase (LDH) level of AF higher than cutoff values (290 cells/µL, and 175 (u/L), respectively) resulted in 82.9%, 92.7%, 81%, and 93.5% sensitivity, specificity, PPV and NPV, respectively. Conclusions: Total cell and WBC counts of AF strongly correlated with ascetic PMN count. Ascetic LDH, alone or in combination with WBC count of AF can be used as a potential surrogate for PMN counts in diagnosis of SBP.

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“…Экспрессия CD64-антигена также повышена в дооперационном периоде и на 24 сутки наблю-дения снижается до контрольных значений. CD64 (FcγRI) -является высокоаффинным рецепто-ром к Fc-фрагментам иммуноглобулинов G, яв-ляется биомаркером бактериальных инфекций [10,11,20]. Фагоцитирующие клетки при экспрес-сии данного рецептора могут удерживать на своей поверхности большое число молекул антител од-ной специфичности, что обеспечивает специфи-ческое распознавание патогена клетками.…”

Section: Discussionunclassified

“…Так, ми-грация клеток из кровеносного русла в опухоль определяется экспрессией адгезионных моле-кул [8,13,17]. Экспрессия рецепторов для Fc-фрагмента иммуноглобулинов на поверхности нейтрофилов формирует пул армированных фагоцитов, участвующих в процессе антитело-зависимой цитотоксичности [10,11,26]. Учи-тывая, что все регуляторные и антигенные мо-лекулы реализуют свое воздействие на клетку через рецепторы, влияя на экспрессию генов, модулируя энергетические и пластические реакции, функциональные проявления ней-трофилов не могут не иметь метаболической основы [3,12,23].…”

Section: Introductionunclassified

The Phenotype and Metabolism Relationship of Blood Neutrophils in Patients With Widespread Purulent Peritonitis in the Postoperative Period Dynamics

Савченко

Борисов

Кудрявцев

et al. 2017

Russian Journal of Infection and Immunity

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Резюме. Целью исследования явилось изучение взаимосвязи фенотипа и метаболизма нейтрофильных гра-нулоцитов у больных распространенным гнойным перитонитом (РГП) в динамике послеоперационного пе-риода. Обследовано 27 пациента с острыми хирургическими заболеваниями и травмами органов брюшной полости, осложнившимися РГП. Взятие крови производили перед операцией (дооперационный период), а также на 7, 14 и 24 сутки послеоперационного периода. В качестве контроля обследовано 67 относительно здоровых людей. Исследование фенотипа нейтрофильных гранулоцитов крови проводили методом проточ-ной цитометрии с использованием прямой иммунофлуоресценции цельной периферической крови. По сред-ней интенсивности флуоресценции оценивались уровни экспрессии поверхностных рецепторов. Активность НАД-и НАДФ-зависимых дегидрогеназ в нейтрофилах крови исследовали с помощью биолюминесцентного метода. Обнаружено, что у больных РГП уже в дооперационном периоде в периферической крови повышено со-держание CD62L + -, HLA-DR + -и CD64 + -нейтрофилов. Высокий уровень содержания CD62L + -клеток сохраня-ется в течение 24 суток послеоперационного периода, тогда как количество HLA-DR + -и CD64 + -нейтрофилов на 24 сутки послеоперационного периода снижается до уровня нормы. Динамике изменения содержания CD64 + -клеток в периферической крови больных РГП соответствует уровень экспрессии CD64-рецептора на мембране нейтрофильных гранулоцитов. Метаболизм нейтрофилов крови у больных РГП в до-и послеопе-рационном периоде характеризуется высокой интенсивностью субстратного потока по циклу трикарбоновых кислот, низкой активностью НАДФ-зависимой глутаматдегидрогеназы и аэробной реакции лактатдегидро-геназы. В дооперационном периоде и в течение 14 дней послеоперационного периода в нейтрофильных грану-лоцитах больных выявляется высокая активность анаэробной реакции лактатдегидрогеназы, характеризую-

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The role of the neutrophil Fcγ receptor I (CD64) index in diagnosing spontaneous bacterial peritonitis in cirrhotic patients

Abstract: The neutrophil CD64 index could be used as a sensitive and specific indicator for the diagnosis of SBP in cirrhotic patients with ascites and is also modulated by antibiotic therapy.

Cited by 11 publications

References 23 publications

Lymphocyte-To-Monocyte Ratio as the Best Simple Predictor of Bacterial Infection in Patients with Liver Cirrhosis

Lymphocyte-To-Monocyte Ratio as the Best Simple Predictor of Bacterial Infection in Patients with Liver Cirrhosis

A Comparative Study on Ascetic Fluid Biochemical Markers in Cirrhotic Children with and Without Spontaneous Bacterial Peritonitis: A Cross-Sectional Observation

The Phenotype and Metabolism Relationship of Blood Neutrophils in Patients With Widespread Purulent Peritonitis in the Postoperative Period Dynamics

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