title: Neutrophil CD64 with hematologic criteria for diagnosis of neonatal sepsis.
abstract: OBJECTIVE
  To assess the sensitivity and specificity of neutrophil CD64 as a diagnostic marker for clinical sepsis (based on a hematologic score) and as an additional marker with hematologic parameters for culture-proven sepsis in neonates.
  
  
  METHODS
  Prospective observational cohort over 18 months in a single-center neonatal intensive care unit.
  
  
  RESULTS
  Hematologic and CD64 data were available on 1,156 sepsis evaluations done in 684 infants, of which 411 (36%) instances of positive clinical sepsis were identified. The CD64 index for clinical sepsis had an overall area under the receiver operating characteristic curve of 0.71. An optimum CD64 cut point value of 2.19 for late-onset clinical sepsis was calculated with a sensitivity of 78%, a specificity of 59%, and a negative predictive value of 81%. The birth weight-specific CD64 cut point for early onset clinical sepsis was 3.13, 2.34, and 2.05 for very low, low, and normal birth weight, respectively. Neutrophil CD64, in combination with the absolute neutrophil count or the absolute band count, had the highest sensitivity (91%) and specificity (93%), respectively, to diagnose culture-proven sepsis.
  
  
  CONCLUSIONS
  We conclude that neutrophil CD64 index can be incorporated with specific hematologic criteria as an additional marker for diagnosis of neonatal sepsis.
authors: Division of Perinatal Medicine, Departments of Pediatrics, Yale University School of Medicine, New Haven, Connecticut.
authors: Iris
authors: I
authors: Streimish
authors: Division of Perinatal Medicine, Departments of Pediatrics, Yale University School of Medicine, New Haven, Connecticut.
authors: Matthew
authors: M
authors: Bizzarro
authors: Yale Center for Analytical Sciences, New Haven, Connecticut.
authors: Veronika
authors: V
authors: Northrup
authors: Department of Laboratory Medicine, Yale University School of Medicine, New Haven, Connecticut.
authors: Chao
authors: C
authors: Wang
authors: Division of Perinatal Medicine, Departments of Pediatrics, Yale University School of Medicine, New Haven, Connecticut.
authors: Sara
authors: S
authors: Renna
authors: Division of Perinatal Medicine, Departments of Pediatrics, Yale University School of Medicine, New Haven, Connecticut.
authors: Nancy
authors: N
authors: Koval
authors: Yale Center for Analytical Sciences, New Haven, Connecticut.
authors: Fang-Yong
authors: FY
authors: Li
authors: Division of Perinatal Medicine, Departments of Pediatrics, Yale University School of Medicine, New Haven, Connecticut.
authors: Richard A
authors: RA
authors: Ehrenkranz
authors: Department of Laboratory Medicine, Yale University School of Medicine, New Haven, Connecticut.
authors: Henry M
authors: HM
authors: Rinder
authors: Division of Perinatal Medicine, Departments of Pediatrics, Yale University School of Medicine, New Haven, Connecticut.
authors: Vineet
authors: V
authors: Bhandari
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D019540:Area Under Curve; D015415:Biomarkers / Q000097:blood; D001724:Birth Weight; D001769:Blood / Q000382:microbiology; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007958:Leukocyte Count; D008297:Male; D009504:Neutrophils / Q000378:metabolism*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012372:ROC Curve; D017452:Receptors, IgG / Q000097:blood*; D018805:Sepsis / Q000097:blood* / Q000175:diagnosis* / Q000188:drug therapy; D013997:Time Factors
chemical_list: D000900:Anti-Bacterial Agents; D015415:Biomarkers; D017452:Receptors, IgG