ORIGINAL ARTICLE   Free access

Minerva Anestesiologica 2019 September;85(9):943-50

DOI: 10.23736/S0375-9393.19.13420-7

Copyright © 2019 EDIZIONI MINERVA MEDICA

language: English

Automated measurement of neutrophil CD64 expression for diagnosing sepsis in critically ill patients

Claire THIRIET ^{1, 2}, Khaoula MAHJOUB ^{1, 2}, Guilhem COURTE ^{1, 2}, Pierre LABROCA ^{1, 2}, Aurélie CRAVOISY ^{1, 2}, Jérémie LEMARIE ^{1, 2}, Marie CONRAD ^{1, 2}, Lionel NACE ^{1, 2}, Pierre-Edouard BOLLAERT ^{1, 2}, Sébastien GIBOT ^{1, 2} ✉

¹ Service of Reanimation, Central Hospital, Nancy, France; ² Inserm U1116, Faculty of Medicine, University of Lorraine, Nancy, France

BACKGROUND: Although early identification of sepsis improves outcome, prompt and correct diagnostic remains often challenging. The expression of the high affinity immunoglobulin-Fc fragment receptor I CD64 on neutrophils is upregulated during acute inflammation. We here aimed at determining the usefulness of its rapid measurement in diagnosing sepsis.
METHODS: Seventy-two consecutive patients were enrolled upon admission to Intensive Care Unit within a two-month period. Sequential determination of serum C-reactive protein (CRP) and procalcitonin (PCT) concentrations was obtained. The neutrophil CD64 index was measured using Accellix-CD64® device, an in vitro diagnosis system allowing for an automatic and standardized measure.
RESULTS: Serum concentrations of CRP and PCT as well as the neutrophil CD64 index were higher in septic patients compared to all others (P<0.05 for the three markers). Only CD64 index was an independent predictor of sepsis, though with modest sensitivity and specificity (78% and 70%, respectively). Repeat determination of CD64 index at day 2 correctly classified 85% of patients.
CONCLUSIONS: This prospective study demonstrates the moderate performance of the neutrophil CD64 index, assessed through the Accellix-CD64® device, in diagnosing sepsis in the critically ill patient. However, repeat measurements improve its accuracy and may help to predict ICU-acquired infections.

KEY WORDS: Sepsis; Diagnosis; Biomarkers; Procalcitonin; IgG receptors