Neutrophil CD64 as a diagnostic marker of sepsis in children

Document Type : Original Article

Authors

1 Department of pediatric, Faculty of Medicine for girls, Al- Azhar University, Cairo, Egypt.

2 Department of Clinical Pathology, Faculty of Medicine, Al- Azhar University, Cairo, Egypt

3 Faculty of Medicine, Al- Azhar University, Cairo, Egypt

Abstract

Background: Sepsis is one of the leading causes of mortality among
children worldwide. Reliable evidence was insufficient in pediatric sepsis
and many aspects in clinical practice actually depend on expert consensus
with some evidence in adult sepsis. Objective: This study aimed to
investigate neutrophil expression of CD64 in septic children and in healthy
controls. We hypothesized that these receptors are elevated during sepsis
and can be used as a diagnostic marker. Methods: This study was carried
out on 50children with pediatric sepsis and 40 apparently healthy children
as controls. Cases were recruited from the PICU of Al Zahraa University
Hospital, Al-Azhar University for Girls in the period from May 2014 to
March 2015. All the cases were assessed clinically and by routine
laboratory investigations. Expression of neutrophil CD64 was measured by
flow cytometry. Results: The mean CD64 expression in children with sepsis
(66.49 ± 23.45) was significantly higher than in the control group (9.39 ±
6.17) pCRP level (r=0.416, p<0.003). ROC curve for CD64 expression
showed100% sensitivity and specificity. The most common isolated
organisms were gram negative organisms mainly E. coli. A highly
significant increase was demonstrated in CRP and TLC values in the culture
proven sepsis group compared to clinical sepsis group, while there was no
statistical significant difference in CD64 values between the two groups.
Conclusion: change in cell surface expression of CD64 on peripheral blood
neutrophils can be considered a sensitive marker for the detection of
pediatric sepsis.

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