Richeek Pradhan1, Paresh Jain2, Anshuman Paria3, Anindya Saha3, Jagdish Sahoo3, Anway Sen4, Suchandra Mukherjee3, Tapas Som3, Avijit Hazra1, Noel Warner5, Arun K Singh3, Mitali Chatterjee1. 1. Department of Pharmacology, Institute of Postgraduate Medical Education & Research, 244 B Acharya JC Bose Road, Kolkata, 700 020, India. 2. BD Biosciences India Gurgaon, Haryana, 122001, India. 3. Department of Neonatology, Institute of Postgraduate Medical Education & Research, 244 B Acharya JC Bose Road, Kolkata, 700 020, India. 4. Department of Pathology, Institute of Postgraduate Medical Education & Research, 244 B Acharya JC Bose Road, Kolkata, 700, 020, India. 5. BD Biosciences San Jose, San Jose, California, 95131.
Abstract
OBJECTIVE: Approaches to monitoring of sepsis have traditionally relied upon the pro-inflammatory component of the sepsis response. This study evaluated the diagnostic and prognostic potential of the ratio of neutrophilic CD64 (nCD64) and monocytic HLA-DR (mHLA-DR) median fluorescence index in monitoring of neonatal sepsis. METHODS: Blood from 100 neonates suspected of sepsis and 29 healthy controls was collected on clinical suspicion of sepsis, and the expression of nCD64, mHLA-DR was evaluated by Flow Cytometry; thereby, a derived parameter "Sepsis index," SI = nCD64/mHLA-DR × 100 was estimated. RESULTS: At day 1, sensitivity and specificity to detect sepsis using nCD64 was 73.01% and 89.18%, respectively, while for SI it was 73.01% and 72.22%, respectively. On Kaplan-Meier analysis, neonates with SI > cut-off showed a higher 30 day-mortality than those with low SI (P = 0.096). On multivariate analysis, the factor associated with mortality in our cohort was Apgar score ≤3, while SI showed a trend toward significance. CONCLUSIONS: At day1, nCD64 is useful for the diagnosis of neonatal sepsis whereas mHLA-DR is beneficial for monitoring patients at a later time point. The SI is a marker of moderate diagnostic sensitivity and supplements the current arsenal of laboratory investigations to detect neonatal sepsis. As a marker of prognosis, a high SI shows a trend towards greater mortality.
OBJECTIVE: Approaches to monitoring of sepsis have traditionally relied upon the pro-inflammatory component of the sepsis response. This study evaluated the diagnostic and prognostic potential of the ratio of neutrophilic CD64 (nCD64) and monocytic HLA-DR (mHLA-DR) median fluorescence index in monitoring of neonatal sepsis. METHODS: Blood from 100 neonates suspected of sepsis and 29 healthy controls was collected on clinical suspicion of sepsis, and the expression of nCD64, mHLA-DR was evaluated by Flow Cytometry; thereby, a derived parameter "Sepsis index," SI = nCD64/mHLA-DR × 100 was estimated. RESULTS: At day 1, sensitivity and specificity to detect sepsis using nCD64 was 73.01% and 89.18%, respectively, while for SI it was 73.01% and 72.22%, respectively. On Kaplan-Meier analysis, neonates with SI > cut-off showed a higher 30 day-mortality than those with low SI (P = 0.096). On multivariate analysis, the factor associated with mortality in our cohort was Apgar score ≤3, while SI showed a trend toward significance. CONCLUSIONS: At day1, nCD64 is useful for the diagnosis of neonatal sepsis whereas mHLA-DR is beneficial for monitoring patients at a later time point. The SI is a marker of moderate diagnostic sensitivity and supplements the current arsenal of laboratory investigations to detect neonatal sepsis. As a marker of prognosis, a high SI shows a trend towards greater mortality.
Authors: Ming Ying Gan; Wen Li Lee; Bei Jun Yap; Shu Ting Tammie Seethor; Rachel G Greenberg; Jen Heng Pek; Bobby Tan; Christoph Paul Vincent Hornik; Jan Hau Lee; Shu-Ling Chong Journal: Front Pediatr Date: 2022-06-03 Impact factor: 3.569
Authors: Alejandra Comins-Boo; Maria Gutiérrez-Larrañaga; Adriel Roa-Bautista; Sandra Guiral Foz; Mónica Renuncio García; Elena González López; Juan Irure Ventura; María Carmen Fariñas-Álvarez; David San Segundo; Marcos López Hoyos Journal: Front Med (Lausanne) Date: 2021-03-23