Advances in Clinical and Experimental Medicine

Title abbreviation: Adv Clin Exp Med
JCR Impact Factor (IF) – 2.1
5-Year Impact Factor – 2.2
Scopus CiteScore – 3.4 (CiteScore Tracker 3.4)
Index Copernicus  – 161.11; MEiN – 140 pts

ISSN 1899–5276 (print)
ISSN 2451-2680 (online)
Periodicity – monthly

Download original text (EN)

Advances in Clinical and Experimental Medicine

2017, vol. 26, nr 2, March-April, p. 327–332

doi: 10.17219/acem/58782

Publication type: original article

Language: English

Download citation:

  • BIBTEX (JabRef, Mendeley)
  • RIS (Papers, Reference Manager, RefWorks, Zotero)

Neutrophil CD64 as a diagnostic marker for neonatal sepsis: Meta-analysis

Ji Dai1,B,C, Wenjie Jiang2,B,D, Zhigang Min3,B,E, Jian Yang4,B,E, Yongfei Tan5,F, Tieliang Ma6,E,F, Zhijun Ge1,A,E,F

1 Department of Critical Care Medicine, the Affiliated Yixing Hospital of Jiangsu University, Yixing, Jiangsu, China

2 Department of Anesthesiology, the Affiliated Yixing Hospital of Jiangsu University, Yixing, Jiangsu, China

3 Department of Radiology, the Affiliated Yixing Hospital of Jiangsu University, Yixing, Jiangsu, China

4 Department of Oncology, the Affiliated Yixing Hospital of Jiangsu University, Yixing, Jiangsu, China

5 Department of Cardiac & Thoracic Surgery, the Affiliated Yixing Hospital of Jiangsu University, Yixing, Jiangsu, China

6 Central Laboratory, the Affiliated Yixing Hospital of Jiangsu University, Yixing, Jiangsu, China

Abstract

Background. Neutrophil CD64 (nCD64) is a promising marker for diagnosing bacterial infections. Several studies have investigated the performance of nCD64 for diagnosing neonatal sepsis and the results are variable. Interest in nCD64 for detecting serious bacterial infections is increasing rapidly.
Objectives. The aim of the present study was to carry out a meta-analysis to systematically evaluate the diagnostic accuracy of nCD64 in neonatal sepsis. As far as the authors know, no previous studies have undertaken this.
Material and Methods. A review of studies from Pubmed, Embase and the Cochrane Library, from inception through June 2015, found 7 studies (involving 2213 neonates) fulfilling the inclusion criteria. These 7 studies were subjected to a bivariate meta-analysis of sensitivity and specificity and a summary receiveroperating characteristic (SROC) curve; I2 was used to test heterogeneity, and the source of heterogeneity was investigated by influence analysis and meta-regression.
Results. The pooled sensitivity and specificity were 80% (95%CI, 69–88%) and 83% (95%CI, 71–90%), respectively. The area under the SROC curve (AUC) was 0.88 (95%CI, 0.85–0.91). The studies had substantial heterogeneity (I2 = 87.1%).
Conclusion. The results showed that nCD64 is a reliable biomarker for diagnosing neonatal sepsis (AUC = 0.88).

Key words

meta-analysis, neonatal infection, CD64, neonatal sepsis

References (33)

  1. Bizzarro MJ, Raskind C, Baltimore RS, et al. Seventy-five years of neonatal sepsis at Yale: 1928–2003. Pediatrics. 2005;116(3):595–602. doi: 10.1542/peds.2005-0552.
  2. Stoll BJ, Hansen NI, Adams-Chapman I, et al. Neurodevelopmental and growth impairment among extremely low-birth-weight infants with neonatal infection. Jama. 2004;292(19):2357–2365. doi: 10.1001/jama.292.19.2357.
  3. Lawn JE, Wilczynska-Ketende K, Cousens SN. Estimating the causes of 4 million neonatal deaths in the year 2000. Int J Epiemilol. 2006;35(3):706–718. doi: 10.1093/ije/dyl043.
  4. Osrin D, Vergnano S, Costello A. Serious bacterial infections in newborn infants in developing countries. Curr Opin Infect Dis. 2004;17:217–224.
  5. Persson E, Trollfors B, Brandberg LL, et al. Spticaemia and meningitis in neonates and during early infancy in the Göteborg area of Sweden. Acta Paediatr. 2002;91:1087–1092.
  6. Sundaram V, Kumar P, Dutta S, et al. Blood culture confirmed bacterial sepsis in neonates in a North Indian tertiary care center: Changes over the last decade. Jpn J Infect Dis. 2009; 62(1):46–50.
  7. Nupponen I, Andersson S, Järvenpää A-L, et al. Neutrophil CD11b expression and circulating interleukin-8 as diagnostic markers for ear-ly-onset neonatal sepsis. Pediatrics.2001; 108:e12–e12.
  8. Layseca‐Espinosa E, Pérez‐González LF, Torres-Montes A, et al. Expression of CD64 as a potential marker of neonatal sepsis. Pediatr Allergy Immu.2002; 13:319–327.
  9. Icardi M, Erickson Y, Kilborn S, et al. CD64 index provides simple and predictive testing for detection and monitoring of sepsis and bacterial infection in hospital patients. J Clinmicrobiol. 2009;47(12):3914–3919. doi: 10.1128/JCM.00628-09.
  10. Ng P. Diagnostic markers of infection in neonates. Arch DIs Child-fetal. 2004;89:F229–F235.
  11. Kolackova M, Kudlova M, Kunes P, et al. Early expression of FcgammaRI (CD64) on monocytes of cardiac surgical patients and higher density of monocyte anti-inflammatory scavenger CD163 receptor in “on-pump” patients. Mediat Inflamm. 2007;2008(2008):235461. doi: 10.1155/2008/235461.
  12. Hoffmeyer F, Witte K, Schmidt R. The high-affinity FcγRI on PMN: Regulation of expression and signal transduction. Immunology. 1997;92:544–552.
  13. van der Meer W, Pickkers P, Scott CS, et al. Hematological indices, inflammatory markers and neutrophil CD64 expression: Comparative trends during experimental human endotoxemia. J Endotoxin Res. 2007;13(2):94–100. doi: 10.1177/0968051907079101.
  14. Ng PC, Lam HS. Diagnostic markers for neonatal sepsis. Curr Opin Pediatr. 2006;18:125–131.
  15. Nuutila J, Hohenthal U, Laitinen I, et al. Simultaneous quantitative analysis of FcγRI (CD64) expression on neutrophils and monocytes: A new, improved way to detect infections. H Immunol Methods.2007;328:189–200.
  16. Livaditi O, Kotanidou A, Psarra A, et al. Neutrophil CD64 expression and serum IL-8: Sensitive early markers of severity and outcome in sepsis. Cytokine. 2006;36:283–290.
  17. Davis BH, Olsen SH, Ahmad E, et al. Neutrophil CD64 is an improved indicator of infection or sepsis in emergency department patients. Arch Pathol Lab Med. 2006;130:654–661.
  18. Whiting P, Rutjes AW, Reitsma JB,et al. The development of QUADAS: A tool for the quality assessment of studies of diagnostic accuracy included in systematic reviews. BMC Med Res Methodol.2003;3:25.
  19. Du J, Li L, Dou Y, Li P, et al. Diagnostic utility of neutrophil CD64 as a marker for early-onset sepsis in preterm neonates. PloS one. 2014; 9(7):e102647. doi:10.1371/journal.pone.0102647.
  20. Streimish I, Bizzarro M, Northrup V, et al. Neutrophil CD64 with hematologic criteria for diagnosis of neonatal sepsis. Am J Perinat. 2013;31:021–030.
  21. Lam HS, Cheung HM, Poon TCW, et al. Neutrophil CD64 for daily surveillance of systemic infection and necrotizing enterocolitis in preterm infants. Clin Biochem. 2013;59:1753–1760.
  22. Mazzucchelli I, Garofoli F, Ciardelli L, et al. Diagnostic performance of triggering receptor expressed on myeloid cells-1 and CD64 index as markers of sepsis in preterm newborns. Pediatr Crit Care Me. 2013;14:178–182.
  23. Lam HS, Wong SPS, Cheung HM, et al. Early diagnosis of intra-abdominal inflammation and sepsis by neutrophil CD64 expression in newborns. Neonatology. 2010;99:118–124.
  24. Dilli D, Oğuz ŞS, Dilmen Uu, Köker MY, et al. Predictive values of neutrophil CD64 expression compared with interleukin-6 and C-reactive protein in early diagnosis of neonatal sepsis. J Clin Lab Anal. 2010;24(6):363–370. doi: 10.1002/jcla.20370.
  25. Bhandari V, Wang C, Rinder C, et al. Hematologic profile of sepsis in neonates: Neutrophil CD64 as a diagnostic marker. Pediatrics. 2008;121:129–134.
  26. Magudumana O, Ballot D, Cooper P, et al. Serial interleukin-6 measurements in the early diagnosis of neonatal sepsis. J Trop Pediatrics. 2000;46:267–271.
  27. Vouloumanou EK, Plessa E, Karageorgopoulos DE, et al. Serum procalcitonin as a diagnostic marker for neonatal sepsis: A systematic review and meta-analysis. Intens Care Med. 2011;37(5):747–762. doi: 10.1007/s00134-011-2174-8.
  28. Levy MM, Fink MP, Marshall JC, et al. 2001 SCCM/ESICM/ACCP/ATS/SIS International Sepsis Definitions Conference. Intens Care Med. 2003;29:530–538.
  29. Chan T, Gu F. Early diagnosis of sepsis using serum biomarkers. Expert Rev Mol Diagn. 2014;11:487–496.
  30. Petitti DB. Approaches to heterogeneity in meta-analysis. Stat Med. 2001;20:3625–3633.
  31. Committee ACP. Clinical policy for children younger than three years presenting to the emergency department with fever. Ann Emerg Med. 2003;42:530–545.
  32. Goldstein B, Giroir B, Randolph A. International pediatric sepsis consensus conference: Definitions for sepsis and organ dysfunction in pedi-atrics. Pediatr Crit Care Me. 2005;6:2–8.
  33. Dhlamini M, Suchard M, Wiggill T, et al. Neutrophil CD64 has a high negative predictive value for exclusion of neonatal sepsis. South African of Child Health. 2013;7:25–29.
© Wroclaw Medical University