Abstract OBJECTIVE: To study the clinical value of the expression of neutrophil surface CD64 in the diagnosis of community acquired pneumonia in children. METHODS: Ninety-eight children with community acquired pneumonia were recruited into the study and were classified into three groups according to pathogene: bacterial pneumonia (n=48), viral pneumonia (n=29) and Mycoplasmal pneumonia (n=21). Twenty healthy children were enrolled as controls. The bacterial infection group was subdivided into mild infection (n=36) and severe infection groups (n=12). The levels of peripheral blood neutrophil CD64 were measured using flow cytometry. Dynamic changes of C-reactive protein were also detected for each patient. RESULTS: The CD64 index and CRP levels in the bacterial pneumonia group were significantly higher than in the other three groups (P<0.05). The CD64 index in the severe bacterial infection group was significantly higher than in the mild group (P<0.05). After antibiotic treatment, expression of CD64 in the severe bacterial infection group decreased significantly (P<0.05). The CD64 index was positively correlated with CRP value (r=0.545, P<0.01). ROC curve analysis showed that the threshold of CD64 and CRP was 2.8 and 8 mg/L respectively. Specificity of CD64 index (90%) was much higher than CRP (74%). CONCLUSIONS: The determination of peripheral blood neutrophil CD64 contributes to the early diagnosis of pulmonary bacterial infection and the evaluation of anti-infection effect.
［1］Bhandari V, Wang C, Rinder C, Rinder H. Hematologic profile of sepsis in neonates: neutrophil CD64 as a diagnostic marker［J］. Pediatrics, 2008, 121(1): 129-134.
［6］Jalava-Karvinen P, Hohenthal U, Laitinen I, Kotilainen P, Rajamaki A, Nikoskelainen J, et al. Simultaneous quantitative analysis of Fc gamma RI (CD64) and CR1 (CD35) on neutrophils in distinguishing between bacterial infections, viral infections, and inflammatory diseases［J］. Clin Immunol, 2009, 133(3): 314-323.
［7］Daryapeyma A, Pedersen G, Laxdal E, Corbascio M, Johannessen HB, Aune S, et al. Neutrophil CD64 as a marker for postoperative infection: a pilot study［J］. Eur J Vasc Endovasc Surg, 2009, 38(1): 100-103.
［8］Cid J, Aguinaco R, Sánchez R, García-Pardo G, Llorente A. Neutrophil CD64 expression as marker of bacterial infection: a systematic review and meta-analysis［J］. J Infect, 2010, 60(5): 313-319.
［9］Arce-Mendoza A, Rodriguez-de Ita J, Salinas-Carmona MC, Rosas-Taraco AG. Expression of CD64, CD206, and RAGE in adherent cells of diabetic patients infected with mycobacterium tuberculosis［J］. Arc Med Res, 2008, 39(3): 306-311.
［10］Pauksens K, Fjaertoft G, Douhan-Hakansson L, Venge P. Neutrophil and monocyte receptor expression in uncomplicated and complicated influenza A infection with pneumonia ［J］. Scan J Infect Dis, 2008, 40(4): 326-337.
［11］Rudensky B, Sirota G, Erlichman M, Yinnon A, Schlesinger Y. Neutrophil CD64 expression as a diagnostic marker of bacterial infection in febrile children presenting to a hospital emergency department［J］. Pediatr Emerg Care, 2008, 24(11): 745-748.
［12］Song SH, Kim HK, Park MH, Cho HI. Neutrophil CD64 expression is associated with severity and prognosis of disseminated intravascular coagulation［J］. Thromb Res, 2008, 121(4): 499-507.
