title: Ratio of neutrophilic CD64 and monocytic HLA-DR: A novel parameter in diagnosis and prognostication of neonatal sepsis.
abstract: Approaches to monitoring of sepsis have traditionally relied upon the pro-inflammatory component of the sepsis response. This study evaluated the diagnostic and prognostic potential of the ratio of neutrophilic CD64 (nCD64) and monocytic HLA-DR (mHLA-DR) median fluorescence index in monitoring of neonatal sepsis.
  
  
  
  Blood from 100 neonates suspected of sepsis and 29 healthy controls was collected on clinical suspicion of sepsis, and the expression of nCD64, mHLA-DR was evaluated by Flow Cytometry; thereby, a derived parameter "Sepsis index," SI = nCD64/mHLA-DR × 100 was estimated.
  
  
  
  At day 1, sensitivity and specificity to detect sepsis using nCD64 was 73.01% and 89.18%, respectively, while for SI it was 73.01% and 72.22%, respectively. On Kaplan-Meier analysis, neonates with SI > cut-off showed a higher 30 day-mortality than those with low SI (P = 0.096). On multivariate analysis, the factor associated with mortality in our cohort was Apgar score ≤3, while SI showed a trend toward significance.
  
  
  
  At day1, nCD64 is useful for the diagnosis of neonatal sepsis whereas mHLA-DR is beneficial for monitoring patients at a later time point. The SI is a marker of moderate diagnostic sensitivity and supplements the current arsenal of laboratory investigations to detect neonatal sepsis. As a marker of prognosis, a high SI shows a trend towards greater mortality. © 2015 Clinical Cytometry Society.
authors: Department of Pharmacology, Institute of Postgraduate Medical Education & Research, 244 B Acharya JC Bose Road, Kolkata, 700 020, India.
authors: Richeek
authors: R
authors: Pradhan
authors: BD Biosciences India Gurgaon, Haryana, 122001, India.
authors: Paresh
authors: P
authors: Jain
authors: Department of Neonatology, Institute of Postgraduate Medical Education & Research, 244 B Acharya JC Bose Road, Kolkata, 700 020, India.
authors: Anshuman
authors: A
authors: Paria
authors: Department of Neonatology, Institute of Postgraduate Medical Education & Research, 244 B Acharya JC Bose Road, Kolkata, 700 020, India.
authors: Anindya
authors: A
authors: Saha
authors: Department of Neonatology, Institute of Postgraduate Medical Education & Research, 244 B Acharya JC Bose Road, Kolkata, 700 020, India.
authors: Jagdish
authors: J
authors: Sahoo
authors: Department of Pathology, Institute of Postgraduate Medical Education & Research, 244 B Acharya JC Bose Road, Kolkata, 700, 020, India.
authors: Anway
authors: A
authors: Sen
authors: Department of Neonatology, Institute of Postgraduate Medical Education & Research, 244 B Acharya JC Bose Road, Kolkata, 700 020, India.
authors: Suchandra
authors: S
authors: Mukherjee
authors: Department of Neonatology, Institute of Postgraduate Medical Education & Research, 244 B Acharya JC Bose Road, Kolkata, 700 020, India.
authors: Tapas
authors: T
authors: Som
authors: Department of Pharmacology, Institute of Postgraduate Medical Education & Research, 244 B Acharya JC Bose Road, Kolkata, 700 020, India.
authors: Avijit
authors: A
authors: Hazra
authors: BD Biosciences San Jose, San Jose, California, 95131.
authors: Noel
authors: N
authors: Warner
authors: Department of Neonatology, Institute of Postgraduate Medical Education & Research, 244 B Acharya JC Bose Road, Kolkata, 700 020, India.
authors: Arun K
authors: AK
authors: Singh
authors: Department of Pharmacology, Institute of Postgraduate Medical Education & Research, 244 B Acharya JC Bose Road, Kolkata, 700 020, India.
authors: Mitali
authors: M
authors: Chatterjee
mesh_terms: D015415:Biomarkers / Q000097:blood; D005260:Female; D005434:Flow Cytometry / Q000379:methods; D006684:HLA-DR Antigens / Q000032:analysis* / Q000276:immunology; D006801:Humans; D008297:Male; D009000:Monocytes / Q000276:immunology*; D000071074:Neonatal Sepsis / Q000175:diagnosis* / Q000276:immunology / Q000473:pathology*; D011379:Prognosis; D017452:Receptors, IgG / Q000032:analysis* / Q000276:immunology
chemical_list: D015415:Biomarkers; D006684:HLA-DR Antigens; D017452:Receptors, IgG
keywords: HLA-DR; cd64; neonatal sepsis; sepsis index