title: Polymorphic mononuclear neutrophils CD64 index for diagnosis of sepsis in postoperative surgical patients and critically ill patients.
abstract: BACKGROUND
  Surface neutrophil CD64 expression is upregulated in patients with bacterial infection. As it was suggested that the CD64 index could be used to detect sepsis in hospitalized patients, we questioned whether the CD64 index could discriminate between septic patients and postoperative surgical patients, defined as systemic inflammatory response syndrome (SIRS), both admitted at the intensive care unit (ICU). Furthermore, we wondered whether the CD64 index was an improved diagnostic compared to standard assays used at the laboratory. For this, outclinic (OC) patients were included as controls.
  
  
  METHODS
  The Leuko64™ assay was used to determine the CD64 index in residual EDTA blood samples from selected septic patients (n=25), SIRS patients (n=19), and OC patients (n=24). Additionally, WBC count, neutrophilic and eosinophilic granulocyte count, C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) were measured simultaneously.
  
  
  RESULTS
  The CD64 index was higher in septic patients compared to both the SIRS and OC group (p<0.0001). In addition, the WBC count, neutrophil count, ESR and CRP were also higher in septic patients than the OC group (p<0.0001). However, only the WBC count, eosinopenia, and ESR were comparable between the SIRS and the sepsis group and proved to be discriminative to the OC group (p<0.05). The CD64 index demonstrated higher sensitivity and specificity than CRP, WBC count, neutrophilic and eosinophilic granulocyte count, and ESR.
  
  
  CONCLUSIONS
  A high CD64 index was found in septic intensive care patients, while a low CD64 index was observed in OC and SIRS patients, demonstrating that the CD64 index can be used for routine diagnostics in the ICU setting.
authors.affiliation: LabNoord, Clinical Chemistry Laboratory, Martini Hospital, Room 5D106, Van Swietenplein 1, 9728 NT Groningen, The Netherlands. j.h.gerrits@mzh.nl
authors.forename: Jeroen H
authors.initials: JH
authors.lastname: Gerrits
authors.forename: Pamela M J
authors.initials: PM
authors.lastname: McLaughlin
authors.forename: Bert N
authors.initials: BN
authors.lastname: Nienhuis
authors.forename: Jan W
authors.initials: JW
authors.lastname: Smit
authors.forename: Bert
authors.initials: B
authors.lastname: Loef
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001419:Bacteria / Q000302:isolation & purification; D001799:Blood Sedimentation; D002097:C-Reactive Protein / Q000032:analysis; D016638:Critical Illness; D005260:Female; D006098:Granulocytes / Q000166:cytology; D006801:Humans; D007362:Intensive Care Units; D007958:Leukocyte Count; D007962:Leukocytes / Q000166:cytology; D008297:Male; D008875:Middle Aged; D009504:Neutrophils / Q000378:metabolism*; D011184:Postoperative Period; D012372:ROC Curve; D017452:Receptors, IgG / Q000032:analysis*; D018805:Sepsis / Q000175:diagnosis* / Q000382:microbiology / Q000601:surgery; D012720:Severity of Illness Index; D018746:Systemic Inflammatory Response Syndrome / Q000175:diagnosis
chemical_list: D017452:Receptors, IgG; D002097:C-Reactive Protein