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Am J Perinatol 2015; 32(04): 331-336
DOI: 10.1055/s-0034-1384644
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Neutrophil CD64 as a Diagnostic Marker of Sepsis: Impact on Neonatal Care

Stephanie Lynema
1   Section of Neonatology, Perinatal and Pulmonary Biology, The Perinatal Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
,
Daniel Marmer
2   Cancer and Blood Diseases Institute Laboratory, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
,
Eric S. Hall
1   Section of Neonatology, Perinatal and Pulmonary Biology, The Perinatal Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
,
Jareen Meinzen-Derr
3   Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
,
Paul S. Kingma
1   Section of Neonatology, Perinatal and Pulmonary Biology, The Perinatal Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
4   The Cincinnati Fetal Center, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
› Author Affiliations
Further Information

Publication History

27 November 2013

05 June 2014

Publication Date:
31 July 2014 (online)

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Abstract

Objective The aim of this study is to determine the validity and reliability of neutrophil CD64 in identifying infected infants and to evaluate the impact of this marker on clinical care.

Study Design Neutrophil CD64 index was incorporated in 371 infection evaluations in 234 infants (ages 1–293 days) from 2005 to 2009 and the impact of this change on clinical care was evaluated.

Results The sensitivity of the neutrophil CD64 assay was 87% in identifying 31 episodes of culture positive sepsis and 83% in identifying 12 infants with ventilator-associated pneumonia. There was no difference in the mean number of antibiotic days in infants with a normal CD64 versus those with a normal complete blood count (CBC) (p = 0.89), but twofold more infants were identified as “not infected” by CD64 than by CBC.

Conclusion CD64 had a high sensitivity for identifying infected infants while also decreasing the number of infants that were exposed to unnecessary antibiotic use.

Keywords

CD64 - neonatal infection - sepsis - sepsis marker
 

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