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Am J Perinatol 2014; 31(01): 021-030
DOI: 10.1055/s-0033-1334453
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Neutrophil CD64 with Hematologic Criteria for Diagnosis of Neonatal Sepsis

Iris Streimish
1   Division of Perinatal Medicine, Departments of Pediatrics, Yale University School of Medicine, New Haven, Connecticut
2   Section of Neonatology, Department of Pediatrics, Newton Wellesley Hospital, Special Care Nursery, Newton, Massachusetts
,
Matthew Bizzarro
1   Division of Perinatal Medicine, Departments of Pediatrics, Yale University School of Medicine, New Haven, Connecticut
,
Veronika Northrup
3   Yale Center for Analytical Sciences, New Haven, Connecticut
,
Chao Wang
4   Department of Laboratory Medicine, Yale University School of Medicine, New Haven, Connecticut
,
Sara Renna
1   Division of Perinatal Medicine, Departments of Pediatrics, Yale University School of Medicine, New Haven, Connecticut
,
Nancy Koval
1   Division of Perinatal Medicine, Departments of Pediatrics, Yale University School of Medicine, New Haven, Connecticut
,
Fang-Yong Li
3   Yale Center for Analytical Sciences, New Haven, Connecticut
,
Richard A. Ehrenkranz
1   Division of Perinatal Medicine, Departments of Pediatrics, Yale University School of Medicine, New Haven, Connecticut
,
Henry M. Rinder
4   Department of Laboratory Medicine, Yale University School of Medicine, New Haven, Connecticut
,
Vineet Bhandari
1   Division of Perinatal Medicine, Departments of Pediatrics, Yale University School of Medicine, New Haven, Connecticut
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Publikationsverlauf

21. September 2012

14. Dezember 2012

Publikationsdatum:
01. März 2013 (online)

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Abstract

Objective To assess the sensitivity and specificity of neutrophil CD64 as a diagnostic marker for clinical sepsis (based on a hematologic score) and as an additional marker with hematologic parameters for culture-proven sepsis in neonates.

Study Design Prospective observational cohort over 18 months in a single-center neonatal intensive care unit.

Results Hematologic and CD64 data were available on 1,156 sepsis evaluations done in 684 infants, of which 411 (36%) instances of positive clinical sepsis were identified. The CD64 index for clinical sepsis had an overall area under the receiver operating characteristic curve of 0.71. An optimum CD64 cut point value of 2.19 for late-onset clinical sepsis was calculated with a sensitivity of 78%, a specificity of 59%, and a negative predictive value of 81%. The birth weight–specific CD64 cut point for early onset clinical sepsis was 3.13, 2.34, and 2.05 for very low, low, and normal birth weight, respectively. Neutrophil CD64, in combination with the absolute neutrophil count or the absolute band count, had the highest sensitivity (91%) and specificity (93%), respectively, to diagnose culture-proven sepsis.

Conclusion We conclude that neutrophil CD64 index can be incorporated with specific hematologic criteria as an additional marker for diagnosis of neonatal sepsis.

Keywords

sensitivity - specificity - clinical infection - newborn
 

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