Neutrophil CD64 as a diagnostic marker of sepsis in children

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 50 children 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) p<0.001. CD64 expression had a significant positive correlation with CRP level (r=0.416, p<0.003). ROC curve for CD64 expression showed 100% 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.