Examining the utility of the CD64 index compared with other conventional indices for early diagnosis of neonatal infection

Zongsheng Tang,Mengying Zhang,Shuanggen Mao,Mingfen Tao,Min Zhong,Daojian Qin,Xiaolong Zhu,Xueqin Li,Hui Yang,Shuli Chen,Tianbing Chen,Kun Lv,Yang Xu

doi:10.1038/s41598-018-28352-7

Zongsheng Tang, Mengying Zhang + Show 11 more

Open Access

https://doi.org/10.1038/s41598-018-28352-7

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Abstract

As specific clinical manifestations and detection tools for early neonatal infections are lacking, early detection and treatment are ongoing challenges. The present study aimed to investigate the role and clinical significance of the CD64 index in comparison with conventional examination indices (WBC, PCT and CRP) for the early diagnosis of neonatal infection. Of 74 in-patient newborns, non-sepsis (non-specific infection but free of sepsis), sepsis and control [newborns with ABO hemolytic disease of the newborn (ABOHDN) but without infection] groups involved 32, 16 and 26 cases, respectively. Peripheral blood WBC, PCT, CRP and CD64 indices were acquired for all groups. The sepsis group showed significantly higher WBC, PCT and CRP levels than the control group. Compared with the non-sepsis group, the sepsis group demonstrated significant increases in PCT but not in WBC or CRP. Compared with the control group, the non-sepsis and sepsis groups had higher CD64 indices. Combined, compared with the WBC, PCT and CRP indices, the CD64 index is unique in its capacity to diagnose neonatal infections early. The CD64 index combined with other conventional indices may lay a basis for the future early diagnosis and effective treatment of neonatal infections.

Highlights

Neonatal sepsis has become a global health problem due to its high morbidity and mortality[1]
We found that the traditional biomarkers of white blood cell (WBC), C-reactive protein (CRP) and PCT in the study of 43 cases of neonatal infection showed significant differences between the sepsis group and normal control group
The traditional biomarkers could not distinguish between the non-sepsis group and the control group, which, in clinical work, might mean that early non-sepsis would not be found in time

Summary

Introduction

Neonatal sepsis has become a global health problem due to its high morbidity and mortality[1]. The indicators commonly used in the clinic are white blood cell (WBC), procalcitonin (PCT) and C-reactive protein (CRP) levels, which play important roles in the diagnosis of neonatal infection. Due to the low sensitivity or specificity of WBC, CRP and PCT, it is easy to misdiagnose or miss the diagnosis of neonatal infection during clinical diagnosis and treatment. The current study aims to compare the differences in the CD64 index [the granulocyte:lymphocyte ratio of CD64 expression via mean fluorescence intensity (MFI)] and conventional clinical indicators (WBC, PCT and CRP) among the control, non-sepsis and sepsis groups by analyzing the receiver-operating characteristic curves (ROC), determining their value in clinical practice in the early diagnosis of neonatal infection

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Conclusion