title: Predictive values of neutrophil CD64 expression compared with interleukin-6 and C-reactive protein in early diagnosis of neonatal sepsis.
abstract: BACKGROUND
  Despite major advances in the management of newborn infants, neonatal sepsis (NS) remain important causes of neonatal morbidity and mortality in the newborn, mainly among preterm and low birth weight infants.
  
  
  OBJECTIVE
  The aim of this study was to investigate the usefulness of neutrophil CD64 expression alone and together with other infection markers in NS.
  
  
  METHODS
  Peripheral blood samples were taken from 109 neonates, who were categorized into three groups: proven or clinical sepsis (n=35); disease without infection (n=42); and healthy controls (n=32). Complete blood count with differential, interleukin-6 (IL-6), C-reactive protein (CRP), and cell surface expression of CD64 on neutrophils have been evaluated in a prospective manner as a diagnostic aid for NS.
  
  
  RESULTS
  Expression of CD64 was significantly enhanced in neonates with sepsis compared with newborns with disease without infection and healthy controls (P=0.001 and P=0.001, respectively). Cutoff values of IL-6, CRP, CD64(MFI), and CD64(i) were 24.9  pg/ml, 4.05  mg/l, 87.7, and 4.39, respectively. Sensitivity-negative predictive values of IL-6, CRP, and CD64(MFI)/CD64(i) were 80.0-90.6%, 80.0-88.8%, and 88.6-94.0%, respectively. Combining all three tests increased the sensitivity to 100%; however, specificity and positive predictive value decreased to 62.1 and 55.5%, respectively.
  
  
  CONCLUSIONS
  CD64 might be used either alone or combined with IL-6 and CRP for early diagnosis of NS. The advantages of CD64 when compared with IL-6 and CRP are rapid quantitation, very small blood volume required, and easy handling.
authors.affiliation: Department of Neonatology, Zekai Tahir Burak Maternity Teaching and Research Hospital, Ankara, Turkey. dilekdilli2@yahoo.com
authors.forename: Dilek
authors.initials: D
authors.lastname: Dilli
authors.forename: Ş Suna
authors.initials: ŞS
authors.lastname: Oğuz
authors.forename: Uğur
authors.initials: U
authors.lastname: Dilmen
authors.forename: M Yavuz
authors.initials: MY
authors.lastname: Köker
authors.forename: Murat
authors.initials: M
authors.lastname: Kızılgün
mesh_terms: D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000096:biosynthesis*; D042241:Early Diagnosis; D005260:Female; D005434:Flow Cytometry; D006801:Humans; D007118:Immunoassay; D007231:Infant, Newborn; D015850:Interleukin-6 / Q000096:biosynthesis*; D008297:Male; D009504:Neutrophils / Q000378:metabolism*; D011237:Predictive Value of Tests; D017452:Receptors, IgG / Q000096:biosynthesis*; D012680:Sensitivity and Specificity; D018805:Sepsis / Q000097:blood / Q000175:diagnosis*
chemical_list: D015415:Biomarkers; C508600:IL6 protein, human; D015850:Interleukin-6; D017452:Receptors, IgG; D002097:C-Reactive Protein