Role of CD64 expression on neutrophils in the diagnosis of sepsis and the prediction of mortality in adult critically ill patients.
Intensive care unit patients who developed systemic inflammatory response syndrome (SIRS) with proven microbial etiology were assigned to the infectious causes (n = 29), while patients with negative cultures and more probable other etiology were assigned to the noninfectious causes (n = 37). Flow cytometry was used to detect the presence of CD64 on neutrophils. The multivariate analysis revealed that KPC-producing Klebsiella pneumoniae rectal colonization and >1.39 mean fluorescence intensity (MFI) of CD64 expression on neutrophils upon day 1 of SIRS were significantly associated with an infectious SIRS. The overall mortality was 29% (19 patients) and was independently associated with Simplified Acute Physiology Score II >44 points and multiple-organ dysfunction syndrome, while appropriate antibiotic treatment was identified as predictor of good prognosis. MFI of CD64 expression on neutrophils showed high sensitivity, specificity, and accuracy in the diagnosis of sepsis but not for the prediction of survival.
Division of Infectious Diseases, School of Medicine, University of Patras, Patras, Greece.
Matthaios
M
Papadimitriou-Olivgeris
Department of Hematology, School of Medicine, University of Patras, Patras, Greece.
Kalliopi
K
Lekka
Division of Anaesthesiology and Critical Care Medicine, School of Medicine, University of Patras, Patras, Greece.
Konstantinos
K
Zisimopoulos
Department of Microbiology, School of Medicine, University of Patras, Patras, Greece.
Iris
I
Spiliopoulou
Division of Anaesthesiology and Critical Care Medicine, School of Medicine, University of Patras, Patras, Greece.
Dionysios
D
Logothetis
Department of Hematology, School of Medicine, University of Patras, Patras, Greece.
Georgios
G
Theodorou
Department of Microbiology, School of Medicine, University of Patras, Patras, Greece.
Evangelos D
ED
Anastassiou
Division of Anaesthesiology and Critical Care Medicine, School of Medicine, University of Patras, Patras, Greece.
Fotini
F
Fligou
Department of Hematology, School of Medicine, University of Patras, Patras, Greece.
Marina
M
Karakantza
Division of Infectious Diseases, School of Medicine, University of Patras, Patras, Greece. Electronic address: mmarangos@upatras.gr.
Markos
M
Marangos
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D016638:Critical Illness; D005260:Female; D005434:Flow Cytometry; D006801:Humans; D007711:Klebsiella pneumoniae / Q000302:isolation & purification; D008297:Male; D008875:Middle Aged; D009504:Neutrophils / Q000737:chemistry*; D011379:Prognosis; D011446:Prospective Studies; D017452:Receptors, IgG / Q000032:analysis*; D012307:Risk Factors; D012720:Severity of Illness Index; D016019:Survival Analysis; D018746:Systemic Inflammatory Response Syndrome / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology / Q000401:mortality*; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents; D017452:Receptors, IgG
Flow cytometry; Infection; Intensive care unit; Systemic inflammatory response syndrome