Abstract：Objective To investigate the value of combined determination of neutrophil CD64 and procalcitonin (PCT) in the early diagnosis of neonatal bacterial infection.Methods According to discharge diagnosis, 37 neonates with bacterial infection were divided into sepsis (n =15) and ordinary infection (non-sepsis) groups (n =22). Twenty-one neonates without infection who were hospitalized during the same period of time were enrolled as the control group. Venous blood samples were collected immediately after admission. Flow cytometry was used to measure the serum level of neutrophil CD64. Chemiluminescence and immune transmission turbidimetry were used to measure the serum levels of PCT and CRP respectively.Results The sepsis group had higher serum levels of neutrophil CD64, PCT, and CRP than the control group (P < 0.01), the ordinary infection group had a higher serum level of neutrophil CD64 than the control group (P < 0.01), and the sepsis group had higher serum levels of PCT and CRP than the ordinary infection group (P < 0.01). The areas under the ROC curve (AUC) of neutrophil CD64, PCT, and CRP in diagnosing bacterial infection were 0.818, 0.818, and 0.704 respectively, and the AUC of combined neutrophil CD64 and PCT was 0.926. A combination of neutrophil CD64 and PCT had a sensitivity of 97.29% and an accuracy of 89.65% in the early diagnosis of neonatal bacterial infection.The sensitivity and accuracy were higher than those of a combination of CRP and neutrophil CD64 or PCT as well as neutrophil CD64, PCT, or CRP alone for the early diagnosis of neonatal bacterial infection.Conclusions The combined determination of neutrophil CD64 and PCT can improve the sensitivity and accuracy in the diagnosis of neonatal bacterial infection, which helps with early identification of bacterial infection.
QIN Dao-Jian,TANG Zong-Sheng,CHEN Shu-Li et al. Value of combined determination of neutrophil CD64 and procalcitonin in early diagnosis of neonatal bacterial infection[J]. CJCP, 2017, 19(8): 872-876.
Fitchett EJ, Seale AC, Vergnano S, et al. Strengthening the Reporting of Observational Studies in Epidemiology for Newborn Infection (STROBE-NI): an extension of the STROBE statement for neonatal infection research[J]. Lancet Infect Dis, 2016, 16 (10): e202-e213.
[2]
Kipfmueller F, Schneider J, Prusseit J, et al. Role of neutrophil CD64 index as a screening marker for late-onset sepsis in very low birth weight infants[J]. PLoS One, 2015, 10 (4): e0124634.
[3]
Delanghe JR, Speeckaert MM. Translational research and biomarkers in neonatal sepsis[J]. Clin Chim Acta, 2015, 451 (Pt A): 46-64.
[4]
Bhandari V. Effective biomarkers for diagnosis of neonatal sepsis[J]. J Pediatric Infect Dis Soc, 2014, 3 (3): 234-245.
[5]
Yang AP, Liu J, Yue LH, et al. Neutrophil CD64 combined with PCT, CRP and WBC improves the sensitivity for the early diagnosis of neonatal sepsis[J]. Clin Chem Lab Med, 2016, 54 (2): 345-351.
Simonsen KA, Anderson-Berry AL, Delair SF, et al. Early-onset neonatal sepsis[J]. Clin Microbiol Rev, 2014, 27 (1): 21-47.
[9]
Lynema S, Marmer D, Hall ES, et al. Neutrophil CD64 as a diagnostic marker of sepsis: impact on neonatal care[J]. Am J Perinatol, 2015, 32 (4): 331-336.
[10]
Hoffmann JJ. Neutrophil CD64 as a sepsis biomarker[J]. Biochem Med (Zagreb), 2011, 21 (3): 282-290.
[11]
Kayange N, Kamugisha E, Mwizamholya DL, et al. Predictors of positive blood culture and deaths among neonates with suspected neonatal sepsis in a tertiary hospital, Mwanza-Tanzania[J]. BMC Pediatr, 2010, 10: 39.
[12]
Wang K, Bhandari V, Chepustanova S, et al. Which biomarkers reveal neonatal sepsis?[J]. PLoS One, 2013, 8 (12): e82700.
[13]
Matsuki T, Watanabe K, Tanaka R. Genus- and species-specific PCR primers for the detection and identification of bifidobacteria[J]. Curr Issues Intest Microbiol, 2003, 4 (2): 61-69.
de Jong E, de Lange DW, Beishuizen A, et al. Neutrophil CD64 expression as a longitudinal biomarker for severe disease and acute infection in critically ill patients[J]. Int J Lab Hematol, 2016, 38 (5): 576-584.
[16]
Pradhan R, Jain P, Paria A, et al. Ratio of neutrophilic CD64 and monocytic HLA-DR: A novel parameter in diagnosis and prognostication of neonatal sepsis[J]. Cytometry B Clin Cytom, 2016, 90 (3): 295-302.
[17]
Ten OJ, Netea MG, Kullberg BJ. Utility of immune response-derived biomarkers in the differential diagnosis of inflammatory disorders[J]. J Infect, 2016, 72 (1): 1-18.
[18]
Naess A, Nilssen SS, Mo R, et al. Role of neutrophil to lymphocyte and monocyte to lymphocyte ratios in the diagnosis of bacterial infection in patients with fever[J]. Infection, 2017, 45 (3): 299-307.
Cortegiani A, Russotto V, Montalto F, et al. Neutrophil CD64 as a marker of infection in patients admitted to the emergency department with acute respiratory failure[J]. Open Access Emerg Med, 2014, 6: 37-44.
Sandquist M, Wong HR. Biomarkers of sepsis and their potential value in diagnosis, prognosis and treatment[J]. Expert Rev Clin Immunol, 2014, 10 (10): 1349-1356.
[23]
Miyake F, Ishii M, Hoshina T, et al. Analysis of the physiological variation in neutrophil CD64 expression during the early neonatal period[J]. Am J Perinatol, 2016, 33 (14): 1377-1381.
[24]
Shi J, Tang J, Chen D. Meta-analysis of diagnostic accuracy of neutrophil CD64 for neonatal sepsis[J]. Ital J Pediatr, 2016, 42 (1): 57.
El Shimi MS, Abou Shady NM, Hamed GM, et al. Significance of neutrophilic CD64 as an early marker for detection of neonatal sepsis and prediction of disease outcome[J]. J Matern Fetal Neonatal Med, 2017, 30 (14): 1709-1714.
[27]
van Veen M, Nijman RG, Zijlstra M, et al. Neutrophil CD64 expression is not a useful biomarker for detecting serious bacterial infections in febrile children at the emergency department[J]. Infect Dis (Lond), 2016, 48 (5): 331-337.
