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Objective:To investigate the diagnostic value of neutrophil CD64 index (nCD64) in disseminated nontuberculous mycobacteria (NTM) infection.Methods:Thirty-six patients with NTM infection from January 2020 to June 2021 in Huashan Hospital, Fudan University were included. Patients were classified into groups of disseminated infection and focal infection according to their medical history and discharge diagnosis. The expressions of nCD64 in patients with focal infection and disseminated infection before treatment were collected and analyzed. Statistical analysis was performed using the Mann-Whitney U test, and the diagnostic value of nCD64 for disseminated NTM infection was analyzed using the receiver operator characteristic curve (ROC curve). Results:Among the 36 patients with NTM infection, 18 cases were focal infection (due to the low white blood cell count of the patient with myelodysplastic syndrome, the detection results were biased, which were excluded from the subsequent analysis) and 18 cases were disseminated infection. The expression of nCD64 in focal infection was 0.72(0.50, 1.55), and that in disseminated infection was 13.63(6.77, 32.31). The difference was statistically significant ( U=15.50, P<0.001). Using focal infection as a control, the area under the ROC curve for the operational characteristics of the subjects was 0.949 3 for disseminated NTM infection. The diagnostic cut-off value of nCD64 was 3.06, with the sensitivity and specificity of the disseminated NTM infection were 88.89% and 100.00%, respectively. Conclusions:In patients with NTM infection before effective treatment, the diagnostic cut-off value of nCD64 of 3.06 has high sensitivity and specificity, which is useful for the aided diagnosis of disseminated NTM infection.
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Objective:To investigate the diagnostic value of neutrophil CD64 index in sepsis patients in intensive care unit (ICU).Methods:A prospective case-control study was conducted, the patients admitted to ICU of Jiangbei People's Hospital Affiliated to Nantong University from December 2016 to June 2020 were enrolled. According to the criteria of Sepsis 3, 107 patients diagnosed with sepsis were classified as the sepsis group, 112 patients without infection were classified as control group. Peripheral venous blood samples were collected within 24 hours after ICU admission, neutrophil CD64 index, C-reactive protein (CRP), procalcitonin (PCT), white blood cell count (WBC) were detected. Receiver operating characteristic curve (ROC curve) was used to evaluate the diagnostic value of neutrophil CD64 index, CRP, PCT and WBC for sepsis.Results:The neutrophil CD64 index, CRP and PCT in sepsis group were significantly higher than those in control group [neutrophil CD64 index: 9.03±5.59 vs. 3.18±1.50, CRP (mg/L): 146.9±68.3 vs. 46.5±35.8, PCT (ng/L): 31.82±14.71 vs. 1.87±1.42, all P < 0.05]. ROC curve analysis showed that neutrophil CD64 index, CRP and PCT had certain diagnostic value for sepsis, the area under ROC curve (AUC) were 0.924, 0.915 and 0.879, respectively, the 95% confidence intervals (95% CI) were 0.871-0.978, 0.855-0.975, 0.807-0.951, respectively, P values were 0.016, 0.017 and 0.026, respectively. Among the three indicators, the diagnostic value of neutrophil CD64 index was much higher. When the optimal cut-off value was 4.32, the sensitivity and specificity were 83.6% and 88.7%, respectively, which were higher than the sensitivity (75.1%, 76.3%) and specificity (87.2%, 82.5%) of CRP and PCT. Conclusion:Neutrophil CD64 index is a valuable biomarker for the diagnosis of sepsis in ICU.
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@# BACKGROUND:The aim of this study is to investigate the diagnostic and prognostic value of neutrophil CD64 (nCD64) as a novel biomarker in sepsis patients. METHODS: One hundred fifty-one adult patients diagnosed with sepsis and 20 age-matched healthy controls were enrolled in the study. Patients with sepsis were further subdivided into a sepsis group and a septic shock group. nCD64 expression, serum procalcitonin (PCT) level, C-reactive protein (CRP) level, and white blood cell (WBC) count were obtained for each patient, and Sequential Organ Failure Assessment (SOFA) scores were calculated. RESULTS: nCD64 expression was higher in the sepsis group with confirmed infection than in the control group. The receiver operating characteristic (ROC) curve of nCD64 was higher than those of SOFA score, PCT, CRP and WBC for diagnosing infection. The area under the curve (AUC) of nCD64 combined with SOFA score was the highest for all parameters. The AUC of nCD64 for predicting 28-day mortality in sepsis was signifi cantly higher than those of PCT, CRP, and WBC, but slightly lower than that of SOFA score. The AUC of nCD64 or PCT combined with SOFA score was signifi cantly higher than that of any single parameter for predicting 28-day mortality. CONCLUSION: nCD64 expression and SOFA score are valuable parameters for early diagnosis of infection and prognostic evaluation of sepsis patients.
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Objective To explore the clinical diagnostic value of CD64 index of neutrophil and serum amy-loid A(SAA)in early bacterial infections of children with respiratory tract.Methods A total of 152 children with respiratory tract infection admitted to Xianning Central Hospital from January 2017 to December 2017 were retrospectively analyzed.According to whether the pathogens were isolated,they were divided into 84 ca-ses of bacterial infection group and 68 cases of suspected respiratory tract infection group,at the same time,50 cases of healthy children in the same period were selected as the control group,the level of CD64 and SAA in three groups of patients was compared and analyzed,and the sensitivity,specificity,positive predictive value and negative predictive value of CD64 and SAA for the diagnosis of bacterial infection were also analyzed.Re-sults The CD64 index and SAA level in the bacterial infection group were higher than those of the suspected respiratory infection group(P< 0.05),after effective treatment,the two were significantly decreased(P<0.05).T he sensitivity,specificity,positive predictive value and negative predictive value of CD 64 index in diag-nosing bacterial infection were 92.9%,98.0%,98.7% and 89.1%,respectively,SAA was 96.4%,96.0%, 97.6% and 94.1%,respectively.Conclusion The detection of CD64 index and SAA level can help the early diagnosis,differential diagnosis and prognosis evaluation of respiratory tract bacterial infection in children, which is worthy of clinical promotion.
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Objective To investigate the relationship between serum levels of PCT and neutrophil CD64 contents with the effect of hormone therapy and complications in the patients with primary nephrotic syndrome.Methods Sixty-five patients with primary nephrotic syndrome in our hospital from September 2015 to September 2016 were selected as the research subjects,all cases were treated with hormonal therapy,the serum levels of PCT and neutrophil CD64 were detected and their relationship with the curative effect and complications of nephrotic syndrome was analyzed.Results According to the PCT and neutrophil CD64 median levels,the cases were divided into the high level group and low level group,the results found that serum creatinine,serum protein,urine protein and pathological types had no statistical difference between the high level group and low level group.The hormone sensitivity had 15 cases in the patients with high PCT level,which was significantly lower than 21 cases in the patients with low PCT level;the hormone sensitivity had 14 cases in the patients with high neutrophil CD64 level,acute renal failure,infection and thrombus in the patients with high PCT level had 8,10,6 cases,which were significantly lower than those in the patients with low PCT level;acute renal failure,infection and thrombus in the patients with high neutrophil CD64 level had 7,11,6 cases,which were significantly higher than those in the patients with low neutrophil CD64 level (P<0.05).Conclusion The levels of serum PCT and neutrophil CD64 are significantly correlated with the therapeutic effect and clinical prognosis in the patients with nephrotic syndrome.
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Objective To examine the expression levels of procalcitonin (PCT),neutrophils apolipoprotein (human neutrophil lipocalin,HNL) and neutrophil CD64 (CD64) in the blood of patients with bacterial infection and investigate their utility in early diagnosis and treatment of bacterial infection.Methods A total of 210 patients with confirmed infection who were treated in hospital from February 2013 to May 2017 were enrolled.The patients were classified into bacterial infection group (105 cases) and viral infection group (105 cases).Additionally,a cohort of 80 healthy subjects were randomly selected from health checkup during the same period as the control group.PCT and HNL were determined on the UPT up-converting phosphor microbial immunity analyzer provided by Beijing Hotgen Biotech Company.BD FACS calibur flow cytometer was used to measure and calculate CD64 percentage.Results The levels of PCT,HNL,CD64 and WBC were compared between bacterial infection group,viral infection group and control group.The between-group difference was statistically significant (P＜0.05).The CD64 and WBC levels were significantly different between viral infection group and control group (P＜0.05),but the PCT and HNL levels were not different significantly between viral infection group and control group (P＞0.05).The area under the ROC curve of PCT,namely AUC PCT,was 0.855,and AUC (HNL) was 0.930,AUC (CD64) 0.928,and AUC (WBC) 0.729.The cutoff value of PCT,HNL and CD64 for diagnosis of bacterial infections was ＞0.79 ng/mL,＞87.43 ng/mL,and ＞9.01％,respectively.Conclusions Bacterial infection is associated with elevated levels of PCT,HNL and CD64,which can be used in early diagnosis of bacterial infections.HNL may provide the highest diagnostic value.
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Objective To observe the changes of neutrophil CD64 (nCD64) index and serum procalcitonin (PCT) in hemodialysis patients with bacterial pneumonia,and to evaluate the effect of these two indicators in the course of diagnosis and treatment.Methods Fifty-three cases of bacterial pneumonia undergoing hemodialysis were enrolled in this study from November 2012 to November 2016 (infection group).At the same time,56 patients undergoing hemodialysis without bacterial infection (noninfection group) and fifty volunteers (control group) were also enrolled.The infection pathogen distribution,changes of nCD64 index and serum PCT in three groups were analyzed.And the changes of nCD64 index and serun.PCT before and after treatment in the infection group were analyzed too.Results Totally 53 strains of pathogens in the infection group were isolated,including 36 strains of gram-positive bacteria (accounting for 67.92％) and 17 strains of gram-negative bacteria (accounting for 32.08％).The nCD64 index of infection group,non-infection group and control group were as following:4.13 ± 0.43,0.82 ± 0.08 and 0.78 ± 0.08,and the serum PCT levels of infection group,non-infection group and control group were as following:(3.64 ± 0.29),(0.45 ± 0.04) and (0.45-± 0.04) μg/L.There were significant differences (P ＜ 0.01).The nCD64 index before and after treatment of infection group were 4.13 ± 0.43 and 0.86 ± 0.09.And serum PCT level before and after treatment of infection group were (3.64 ± 0.29) and (0.74 ± 0.07) μg/L.There were significant differences (P＜0.01).Conclusions The nCD64 index and serum PCT are sensitive indicators to determine the happening of bacterial pneumonia in patients undergoing hemodialysis,and it provides critical evidence for the evaluation of treatment in patients.
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Objective:To explore the neutrophil CD64 and sTREM-1 in elderly patients with community-acquired pneumonia ( CAP) in the diagnosis of clinical value. Methods: 76 elderly CAP hospitalized patients were divided into severe pneumonia group (n=23) (live in 15 cases,8 deaths)and ordinary pneumonia group(n=53) according to severity;45 patients in the control group compared with healthy older persons. Peripheral blood neutrophil CD64 was measured by automatic flow cytometry,sTREM-1 levels was measured by double-antibody sandwich enzyme-linked immunosorbent assay. The receiver operating characteristic curve ( ROC curve) was used to check diagnostic value of the detection. Results: Median concentrations of CD64 and sTREM-1 in the severe pneumonia group,general pneumonia group and control group were 37. 49,18. 82 and 10. 63 MFI,and 75. 39,65. 31 and 43. 96 pg/ml, respective-ly. Although there was significant differences among the three groups ( P<0. 05 ); CD64 and sTREM-1 in Severe pneumonia survival group reduced to a normal level as his condition improved gradually,death group continued to rise as the disease,and peaked at the time of death;the area under the ROC curve of CD64,sTREM-1were respectively 0. 876,0. 843,which was 0. 917 by combination of CD64 and sTREM-1. Conclusion: Both CD64 and sTREM-1 are good markers in the diagnosis value of CAP, the dynamic changes of two may reflect the condition and prognosis of CAP.
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Objective To analyze the clinical values of combined detection of procalcitonin (PCT), interleukin-6 (IL-6), C-reaction protein (CRP), neutrophil CD64, white blood cell (WBC) count and neutrophil ratio for diagnosis of infection in patients with liver cirrhosis. Methods The hospitalized patients with liver cirrhosis were divided into the infection group and the non-infection group according to the bacterial culture and clinical symptoms. The serum levels of PCT and IL-6 were detected by Chemiluminescence immunoassay. The serum CRP was detected by biochemistry analyzer. The neutrophil CD64 was detected by flow cytometer, and WBC count and neutrophil ratio were detected by blood cell analyzer. The collected data were analyzed by logistic regression and receiver operating characteristic (ROC) curves. ResultsAll the markers in the infection group were higher than those in the non-infection group (P<0.01). The results of logistic regression analysis showed that PCT, IL-6 and neutrophil CD64 could predict the infection in patients with liver cirrhosis,with the odd ratio being 7.199 (95%CI, 2.180-23.771),1.010 (95%CI,1.002-1.017)and 2.312 (95%CI,1.485-3.600), respectively. However, CRP, WBC count and neutrophil ratio showed no predictive values. The ROC curves showed that the area under curves (AUC) of PCT, IL-6 and neutrophil CD64 were 0.791 (95%CI,0.727-0.856),0.762 (95%CI,0.693-0.832)and 0.884 (95%CI,0.835-0.933), respectively. The AUC of combined detection of the three markers was 0.932 (95%CI,0.897-0.967), with a diagnostic accuracy of 86.9%. Conclusion PCT, IL-6 and neutrophil CD64 can predict infection in patients with liver cirrhosis, and combined detection of the three markers can improve the diagnostic efficiency.
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Objective To compare the sensitivity and specificity of neutrophil CD64 and C-reactive protein( CRP) in the diagnosis of bacterial infection by Meta-analysis. Methods A computerized literature search of PubMed,Embase and Science Citation Index Expanded was conducted to retrieve studies related to evaluating the diagnosis value both of neutrophil CD64 and CRP in bacterial infectious diseases before January 2015. The methodological quality of each included study was assessed. The method of statistical analysis was dichotomous Meta- analysis using STATA 12. 0 software. Results Ultimately we included a total of 10 studies with 1 057 specimens in neutrophil CD64 group and 1 063 specimens in CRP group. Neutrophil CD64 compared with CRP in the sensitivity,OR=1. 755,95%CI(1. 041,2. 958),P=0. 035,while in the specifici-ty,OR=0. 620,95% CI(0. 442,0. 870),P=0. 006. Conclusion In the diagnosis of bacterial infectious dis-eases,neutrophil CD64 is better than CRP in the sensitivity,but,CRP is better than neutrophil CD64 in the specificity.
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Objective To evaluate the value of neutrophil CD64 positive cells percentage(CD64%)detec-tion to stop using antibiotic in patients with severe pneumonia.Methods 60 accepted antibiotic therapy patients with severe pneumonia,in accordance with the random number table,were separated into observation group(n =30)and control group(n =30).Antibiotics were stopped according to CD64% in observation group,while it according to the clinical symptoms,the plasma level of white blood cell and C -reactive protein in control group.The main observation indexes included the days of antibiotics use,the length of Intensive Care Unit(ICU)stay,clinical efficacy and the case fatality rate.Results The days of antibiotics use in the observation group was (10.3 ±5.2)d,while it was (16.8 ± 5.8)d for patients in the control group,and it had significant difference(t =-4.570,P 0.05).Conclusion Stop using antibiotics according to the neutrophil CD64 % is safe,reliable,and can effectively reduce the excessive use of antibiotics and shorten the length of ICU stay in patients with severe pneumonia.
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PURPOSE: Early identification of neonatal sepsis is a global issue because of limitations in diagnostic procedures. The objective of this study was to compare the diagnostic accuracy of neutrophil CD64 and C-reactive protein (CRP) as a single test for the early detection of neonatal sepsis. METHODS: A prospective study enrolled newborns with documented sepsis (n=11), clinical sepsis (n=12) and control newborns (n=14). CRP, neutrophil CD64, complete blood counts and blood culture were taken at the time of the suspected sepsis for the documented or clinical group and at the time of venipuncture for laboratory tests in control newborns. Neutrophil CD64 was analyzed by flow cytometry. RESULTS: CD64 was significantly elevated in the groups with documented or clinical sepsis, whereas CRP was not significantly increased compared with controls. For documented sepsis, CD64 and CRP had a sensitivity of 91% and 9%, a specificity of 83% and 83%, a positive predictive value of 83% and 33% and a negative predictive value of 91% and 50%, respectively, with a cutoff value of 3.0 mg/dL for CD64 and 1.0 mg/dL for CRP. The area under the receiver-operating characteristic curves for CD64 index and CRP were 0.955 and 0.527 (P<0.01), respectively. CONCLUSION: These preliminary data show that diagnostic accuracy of CD64 is superior to CRP when measured at the time of suspected sepsis, which implies that CD64 is a more reliable marker for the early identification of neonatal sepsis as a single determination compared with CRP.