Department of Infectious Diseases, Affiliated Hangzhou First People's Hospital Zhejiang University School of Medicine Hangzhou China.
Key Laboratory of Microbial Technology and Bioinformatics of Zhejiang Province Hangzhou China.
Influenza Other Respir Viruses. 2023 Aug 25;17(8):e13191. doi: 10.1111/irv.13191. eCollection 2023 Aug.
Pregnant women are at high risk of developing febrile illness during the flu season. Early identification of a viral or bacterial infection is crucial in the management of febrile pregnant patients. Neutrophil CD64 (nCD64) has been shown to have more important diagnostic value in sepsis than traditional inflammatory indicators.
The pregnant women enrolled were divided into three groups according to disease: influenza A infection, bacterial infection and healthy controls. Peripheral blood CD64, leukocyte, C-reactive protein (CRP), procalcitonin (PCT) and human Th1/Th2-related cytokines levels were routinely measured. The correlation between and diagnostic value of the nCD64 index and other biomarkers were evaluated using Spearman's correlation test and receiver operating characteristic (ROC) curve analysis.
Pregnant women with bacterial infection had significantly elevated levels of leukocytes (8.4 vs. 5.95, 10/L; = 0.004), CRP (89.70 vs. 50.05 mg/mL; = 0.031), PCT (0.13 vs. 0.04 ng/mL; = 0.010) and TNF-α (0.46 vs. 0.38 pg/mL; = 0.012) and an elevated nCD64 index (12.16 vs. 0.81; < 0.001) compared with those with influenza A infection. The area under the receiver operating characteristic (AUROC) curve of the nCD64 index to discriminate bacterial infection among pregnant women (AUROC = 0.9183, < 0.0001) was the largest. The sensitivity and specificity of the nCD64 index at an optimal cut-off value of 3.16 were 84% and 100%, respectively, with a negative predictive value (NPV) of 94%.
Our study demonstrates the clinical value of the nCD64 index in distinguishing between bacterial infection and influenza A in pregnant women.
孕妇在流感季节患发热性疾病的风险很高。早期识别病毒或细菌感染对于发热孕妇的治疗至关重要。中性粒细胞 CD64（nCD64）在脓毒症中的诊断价值优于传统炎症指标。
根据疾病将纳入的孕妇分为三组：甲型流感感染组、细菌感染组和健康对照组。常规测量外周血 CD64、白细胞、C 反应蛋白（CRP）、降钙素原（PCT）和人 Th1/Th2 相关细胞因子水平。采用 Spearman 相关检验和受试者工作特征（ROC）曲线分析评估 nCD64 指数与其他生物标志物的相关性及其诊断价值。
与甲型流感感染相比，细菌感染的孕妇白细胞（8.4 比 5.95，10/L；=0.004）、CRP（89.70 比 50.05 mg/mL；=0.031）、PCT（0.13 比 0.04 ng/mL；=0.010）和 TNF-α（0.46 比 0.38 pg/mL；=0.012）水平显著升高，nCD64 指数（12.16 比 0.81；<0.001）升高。nCD64 指数区分孕妇细菌感染的受试者工作特征（ROC）曲线下面积（AUROC）最大（AUROC=0.9183，<0.0001）。nCD64 指数最佳截断值为 3.16 时的敏感性和特异性分别为 84%和 100%，阴性预测值（NPV）为 94%。
本研究表明，nCD64 指数在区分孕妇细菌感染和甲型流感方面具有临床价值。
