Significance of neutrophilic CD64 as an early marker for detection of neonatal sepsis and prediction of disease outcome

Abstract

Background: Neonatal sepsis (NS) is a global health problem owing to its significant contribution to morbidity and mortality. We evaluated the significance of neutrophilic CD64 (nCD64) expression as an early marker for diagnosis of NS compared to CRP and assessed its relation to disease outcome.Methods: High sensitivity CRP (hs-CRP) and nCD64 were measured in 60 neonates with symptoms and signs of sepsis (40% were culture-proved) and 30 age- and sex-matched controls.Results: Baseline hs-CRP and nCD64% were significantly higher among septic neonates compared with the controls (p < 0.05), while, no significant difference was found between the two septic groups (p > 0.05). nCD64 cutoff value > 34.1% was able to discriminate septic neonates from controls with higher sensitivity and specificity than hs-CRP. The mortality rate was 21.7% among septic neonates. Baseline nCD64% was significantly higher among died patients compared with recovered neonates (p = 0.009) while no significant difference was found between baseline hs-CRP and disease outcome (p = 0.117).Conclusion: Flow cytometric assessment of nCD64 was able to discriminate neonates with sepsis from controls with higher accuracy than hs-CRP; however, the combination of both nCD64% and hs-CRP enhances the ability to diagnose NS. Quantitative measurement of nCD64 can predict disease outcome in NS.