Motta Mario, Zini Alice, Regazzoli Antonio, Garzoli Elena, Chirico Gaetano, Caimi Luigi, Calarco Marinella
From the Neonatology and Neonatal Intensive Care Unit, Children's Hospital of Brescia , Brescia , Italy.
Scand J Infect Dis. 2014 Jun;46(6):433-9. doi: 10.3109/00365548.2014.896028. Epub 2014 Apr 2.
To assess the diagnostic and prognostic utility of CD64 expression as a marker of early-onset sepsis (EOS) in very low birth weight (VLBW) neonates.
Neutrophil CD64 expression (CD64 index) was assessed in 129 VLBW neonates within 72 h after birth. The accuracy of the CD64 index in predicting EOS was determined by receiver operating characteristic curve analysis. The relationship between the expression of the CD64 index and neonatal outcomes was evaluated by multivariate analysis.
The highest performance of the CD64 index was achieved at 24 h after birth; accuracy, sensitivity, and negative predictive values were 0.85, 0.89, and 0.99, respectively, with a cut-off value of 2.4. The increased expression of CD64 index was significantly associated with subsequent infections (relative risk 1.54; 95% confidence interval 1.02-2.33).
The CD64 index could be used as a reliable marker of EOS in VLBW neonates and it is an independent risk factor for late-onset infections.
评估CD64表达作为极低出生体重（VLBW）新生儿早发型败血症（EOS）标志物的诊断和预后效用。
对129例VLBW新生儿在出生后72小时内评估中性粒细胞CD64表达（CD64指数）。通过受试者工作特征曲线分析确定CD64指数预测EOS的准确性。通过多变量分析评估CD64指数表达与新生儿结局之间的关系。
出生后24小时CD64指数表现最佳；准确性、敏感性和阴性预测值分别为0.85、0.89和0.99，临界值为2.4。CD64指数表达增加与随后的感染显著相关（相对风险1.54；95%置信区间1.02 - 2.33）。
CD64指数可作为VLBW新生儿EOS的可靠标志物，并且是晚发型感染的独立危险因素。
