Zeitoun Alaa A H, Gad Suzan S, Attia Fadia M, Abu Maziad Asmaa S, Bell Edward F
Paediatric Department, Suez Canal University, Egypt.
Scand J Infect Dis. 2010 Apr;42(4):299-305. doi: 10.3109/00365540903449832.
The assay of infection markers can improve diagnostic sensitivity in neonatal sepsis. We determined the levels of neutrophilic CD64 (nCD64), procalcitonin (PCT) and interleukin 10 (IL-10) in infants with neonatal sepsis. Forty-nine newborn infants who met the criteria of sepsis were subjected to a routine sepsis evaluation as well as measurement of PCT and IL-10 levels and nCD64 expression. Of these 49 'infected' infants, 16 had a positive blood culture (culture-positive sepsis) and 33 infants were diagnosed to have clinical sepsis with negative blood cultures (culture-negative sepsis). Another 49 healthy newborn infants were included as a control group. The sensitivity, specificity, positive predictive value and negative predictive value of PCT, IL-10 and nCD64 for the diagnosis of sepsis were determined. IL-10 had the highest sensitivity of 92% and specificity of 84% using a cut-off of > or =17.3 pg/ml. For PCT, the highest sensitivity of 65% and specificity of 60% were found at a cut-off value of > or =36.4 pg/ml. nCD64 had a maximal sensitivity of 92% and specificity of 71% at a cut-off value of 2.6%. Combinations of different markers may improve the sensitivity and specificity of biomarker tests. We found that the best combination was IL-10 and nCD64, which together provided sensitivity of 95% and specificity of 83%, and a negative predictive value of 86%.
感染标志物检测可提高新生儿败血症的诊断敏感性。我们测定了新生儿败血症患儿中性粒细胞CD64（nCD64）、降钙素原（PCT）和白细胞介素10（IL-10）的水平。49例符合败血症标准的新生儿接受了常规败血症评估以及PCT和IL-10水平测定及nCD64表达检测。在这49例“感染”婴儿中，16例血培养阳性（血培养阳性败血症），33例被诊断为临床败血症但血培养阴性（血培养阴性败血症）。另外49例健康新生儿作为对照组。测定了PCT、IL-10和nCD64诊断败血症的敏感性、特异性、阳性预测值和阴性预测值。IL-10的敏感性最高，为92%，特异性为84%，临界值为≥17.3 pg/ml。对于PCT，临界值≥36.4 pg/ml时，敏感性最高为65%，特异性为60%。nCD64临界值为2.6%时，最大敏感性为92%，特异性为71%。不同标志物的联合使用可能会提高生物标志物检测的敏感性和特异性。我们发现最佳组合是IL-10和nCD64，二者联合使用时敏感性为95%，特异性为83%，阴性预测值为86%。
