Article

Neutrophil CD64 is an improved indicator of infection or sepsis in emergency department patients. Arch Pathol Lab Med

Trillium Diagnostics, LLC, Maine Medical Center Research Institute, Scarborough, ME, USA.
Archives of pathology & laboratory medicine (Impact Factor: 2.84). 06/2006; 130(5):654-61. DOI: 10.1043/1543-2165(2006)130[654:NCIAII]2.0.CO;2
Source: PubMed

ABSTRACT

Sepsis, affecting millions of individuals annually with an associated high mortality rate, is among the top 10 causes of death. In addition, improvements in diagnostic tests for detecting and monitoring sepsis and infection have been limited in the last 25 years. Neutrophil CD64 expression has been proposed as an improved diagnostic test for the evaluation of infection and sepsis.
To evaluate the diagnostic performance of a quantitative flow cytometric assay for leukocyte CD64 expression in comparison with the standard tests for infection/sepsis in an ambulatory care setting.
Prospective analysis of 100 blood samples from patients from an emergency department setting in a 965-bed tertiary care suburban community hospital was performed for neutrophil CD64 expression, C-reactive protein, erythrocyte sedimentation rate, and complete blood count. The laboratory findings were compared with a clinical score for the likelihood of infection/sepsis, which was obtained by a blinded retrospective chart review.
The diagnostic performance, as gauged by the clinical score, varied with neutrophil CD64 (sensitivity 87.9%, specificity 71.2%, efficiency 76.8%) and outperformed C-reactive protein (sensitivity 88.2%, specificity 59.4%, efficiency 69.4%), absolute neutrophil count (sensitivity 60.0%, specificity 50.8%, efficiency 53.8%), myeloid left shift (sensitivity 68.2%, specificity 76.3%, efficiency 73.3%), and sedimentation rate (sensitivity 50.0%, specificity 65.5%, efficiency 61.0%).
Neutrophil CD64 expression quantitation provides improved diagnostic detection of infection/sepsis compared with the standard diagnostic tests used in current medical practice.

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Available from: Bruce H Davis
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    • "Besides infection, especially sepsis [2] , three preleukemic and/or possibly clonal disorders warrant closer attention, namely large granular lymphocyte increases in a context of neutropenia or anemia [3, 4] , hypereosinophilia syndromes [5] , and disorders of the glycosylphosphatidylinositol (GPI) insertion of surface molecules associated with paroxysmal nocturnal hemoglobinuria (PNH) or other disorders [6] . Immediate hypersensitivity can be explored in functional assays demonstrating basophil degranulation [7]. "
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    Full-text · Article · Nov 2015 · International journal of laboratory hematology
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    • "Elevated monocyte CD64 expression was reported in adult patients with sepsis [4] and in a mixed group of neonates and children with SIRS and sepsis [5]. Neutrophil CD64 (nCD64) expression has been found to be a better diagnostic marker for sepsis than procalcitonin (PCT) [6] and C-reactive protein (CRP) [7] in adults and recently in children [8]. An increase in the expression of integrins of the beta 2 subfamily on neutrophils, in particular CD11b, is also considered to be a good marker of cell activation [9]. "
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    Full-text · Article · Mar 2013 · BMC Pediatrics
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    • "In antibodies, the Fab region opsonizes the antigen, and the Fc region is a ligand for the Fc receptor, presented as FcRIII on the quiescent polymorphonuclear leukocyte surface [7]. Upon activation of neutrophils, or during apoptosis, FcRIII is released from the cell surface by proteolytic cleavage, and the enzyme responsible for this process is probably a membrane-bound metalloprotease released from granules [62]. "
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    Full-text · Article · Apr 2012 · Protein and Peptide Letters
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