Division of Perinatal Medicine, Departments of Pediatrics, Yale University School of Medicine, New Haven, Connecticut.
Yale Center for Analytical Sciences, New Haven, Connecticut.
Am J Perinatol. 2014 Jan;31(1):21-30. doi: 10.1055/s-0033-1334453. Epub 2013 Mar 1.
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.
Prospective observational cohort over 18 months in a single-center neonatal intensive care unit.
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.
We conclude that neutrophil CD64 index can be incorporated with specific hematologic criteria as an additional marker for diagnosis of neonatal sepsis.
评估中性粒细胞 CD64 作为临床败血症（基于血液学评分）的诊断标志物的敏感性和特异性，以及作为一种附加标志物与血液学参数结合用于确诊新生儿败血症。
在单中心新生儿重症监护病房进行了为期 18 个月的前瞻性观察队列研究。
在 684 名婴儿中进行了 1156 次疑似败血症的评估，其中 411 例（36%）确诊为临床败血症。临床败血症的 CD64 指数的整体接收者操作特征曲线下面积为 0.71。计算出晚期临床败血症的最佳 CD64 截断值为 2.19，其敏感性为 78%，特异性为 59%，阴性预测值为 81%。对于早发型临床败血症，出生体重特异性的 CD64 截断值分别为 3.13、2.34 和 2.05，适用于极低体重、低体重和正常体重儿。中性粒细胞 CD64 与绝对中性粒细胞计数或绝对带状细胞计数相结合，对确诊败血症具有最高的敏感性（91%）和特异性（93%）。
我们得出结论，中性粒细胞 CD64 指数可以与特定的血液学标准结合作为新生儿败血症诊断的附加标志物。
