Diagnostic Performance of Neutrophil CD64 as an Early Predictor of Postoperative Sepsis | ||
| Ain Shams Medical Journal | ||
| Volume 76, Issue 1, March 2025, Pages 134-145 PDF (462.18 K) | ||
| Document Type: Case Report | ||
| DOI: 10.21608/asmj.2025.355584.1376 | ||
| Authors | ||
| Zeinab Mahmoud Mostafa* 1; Omnia Abuel Makarem Shaker2; Mohammad Ahmad Abd-erRazik3; Rania Abd el Halim4 | ||
| 1Clinical pathology department, ainshams child care center, ainshams, Cairo,Egypt | ||
| 2Professor, Clinical Pathology, Faculty of MedicineClinical Pathology, faculty of Medicine, Ain Shams University, Cairo, Egypt | ||
| 3Department of General Surgery, Faculty of Medicine, Ain Shams University,Cairo,Egypt | ||
| 4Clinical pathology department, Ain shams universityClinical Pathology, faculty of Medicine, Ain Shams University, Cairo, Egypt, Cairo, Egypt | ||
| Abstract | ||
| Background: Sepsis is a serious impaired organ function as a result of immune dysregulation for infection. Blood culture is considered the gold standard for diagnosis of blood-stream infections, but it can be delayed up to 7 days to give a negative result. This delay makes clinicians often depend on further parameters as CBC, C-reactive protein (CRP) and proacalcitonin. Neutrophil CD64 is a glyco-protein produced at low concentration on inactive neutrophilic cell surface and obviously up regulated with the beginning of sepsis. Methods: This study is a prospective cohort study done on 55 postoperative adult patients of elective surgeries, 33 postoperative patients with sepsis and 22 postoperative patients without sepsis, the majority of patients had more than 2 evaluations. The following parameters were done for each patient as CBC, CRP, neutrophil CD64 and blood culture. Also, follow-up samples were taken from septic group and depending on outcome, reclassification was performed for them as continued sepsis group (n = 18) and improved group (n = 15). Results: Neutrophil CD64, N/L ratio and CRP levels were significantly increased in patients with sepsis when compared with those without sepsis (P < 0.05). The cutoff values of CD64 at 43.6% and 65.2 detected sepsis at 1st and 3rd postoperative days with 90.9%, 78.8% sensitivity and 86.4%, 90% specificity. When CD64 was combined with CRP measurement, improved diagnostic performance was noticed with specificity 100%, PPV 100%, sensitivity 72.7% and NPV 50%. Combining CD64 with N/L ratio also improved the diagnostic performance with specificity 100%, sensitivity 66.7%, NPV 45% and PPV 100%. A significant difference in levels of neutrophil CD64, N/L ratio and CRP (P < 0.01) were found between continued sepsis group and clinically improved group by using delta change percentage (dc%). Conclusion: For postoperative sepsis, neutrophil CD64 is a good promising maker in diagnosis and follow up of patients. Combination of neutrophil CD64 with CRP and N/L ratio are better for diagnosis. | ||
| Keywords | ||
| Blood culture; CRP; neutrophil CD64; N/L ratio; sepsis | ||
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