title: Diagnostic utility of neutrophil CD64 as a marker for early-onset sepsis in preterm neonates.
abstract: BACKGROUND
  Neutrophil CD64 has been proposed as an early marker of sepsis. This study aims to evaluate the diagnostic utility of neutrophil CD64 for identification of early-onset sepsis in preterm neonates.
  
  
  METHODS
  The prospective study was conducted in a neonatal intensive care unit between November 2010 and June 2011. Preterm neonates in whom infection was suspected when they were <12 hours of age were enrolled. Complete blood count with differential, blood culture, neutrophil CD11b and CD64 measurement were performed. Receiver operating characteristic curve analysis was performed to evaluate the performance of neutrophil CD64 as biomarker of sepsis.
  
  
  RESULTS
  A total of 158 preterm neonates was enrolled, 88 of whom were suspected infection. The suspected sepsis group was of lesser gestational age (P<0.001) and lower birth weight (P<0.001), compared with controls. The hematologic profiles of the suspected sepsis group were characterized by higher white blood cell count, neutrophil counts and C-reactive protein. The suspected sepsis neonates had significantly higher neutrophil CD64 expression compared with controls. Neutrophil CD64 had an area value under the curve of 0.869 with an optimal cutoff values of 1010 phycoerythrin molecules bound/cell and it had a high sensitivity (81.82%) and negative predictive value (77.4%). The level of neutrophil CD64 was independent of antibiotic therapy within 24 hours after the onset of sepsis in preterm neonates.
  
  
  CONCLUSIONS
  Neutrophil CD64 is a highly sensitive marker for suspected early-onset sepsis in preterm neonates. Our study suggests that neutrophil CD64 may be incorporated as a valuable marker to diagnose infection.
authors.affiliation: Department of Clinical Laboratory, Shenzhen Shajing Hospital Affiliated of Guangzhou Medical University, Shenzhen, China.
authors.forename: Jikun
authors.initials: J
authors.lastname: Du
authors.affiliation: Department of Pharmacology, Guangdong Medical College, Dongguan, China.
authors.forename: Li
authors.initials: L
authors.lastname: Li
authors.affiliation: Department of Clinical Laboratory, Shenzhen Shajing Hospital Affiliated of Guangzhou Medical University, Shenzhen, China.
authors.forename: Yuhong
authors.initials: Y
authors.lastname: Dou
authors.affiliation: Department of Clinical Laboratory, Shenzhen Shajing Hospital Affiliated of Guangzhou Medical University, Shenzhen, China.
authors.forename: Peipei
authors.initials: P
authors.lastname: Li
authors.affiliation: Shenzhen Baoan Maternal and Child Health Hospital, Shenzhen, China.
authors.forename: Rui
authors.initials: R
authors.lastname: Chen
authors.affiliation: Department of Clinical Laboratory, Shenzhen Shajing Hospital Affiliated of Guangzhou Medical University, Shenzhen, China.
authors.forename: Helu
authors.initials: H
authors.lastname: Liu
mesh_terms: D015415:Biomarkers / Q000097:blood*; D002097:C-Reactive Protein / Q000032:analysis; D039481:CD11b Antigen / Q000097:blood; D004906:Erythrocyte Count; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000175:diagnosis / Q000382:microbiology; D007234:Infant, Premature; D007363:Intensive Care Units, Neonatal; D007958:Leukocyte Count; D008297:Male; D009504:Neutrophils / Q000276:immunology*; D011446:Prospective Studies; D012372:ROC Curve; D017452:Receptors, IgG / Q000097:blood*; D018805:Sepsis / Q000175:diagnosis* / Q000276:immunology / Q000382:microbiology
chemical_list: D015415:Biomarkers; D039481:CD11b Antigen; C509295:ITGAM protein, human; D017452:Receptors, IgG; D002097:C-Reactive Protein