Evaluation of neutrophilic CD64, interleukin 10 and procalcitonin as diagnostic markers of early- and late-onset neonatal sepsis

• Published in: Scandinavian journal of infectious diseases 2010, Vol.42 (4), p.299-305
• Main Authors: Zeitoun, Alaa A.H., Gad, Suzan S., Attia, Fadia M., Abu Maziad, Asmaa S., Bell, Edward F.
• Format: Article
• Language: English
• Subjects: Bacterial diseases; Bacterial sepsis; Biological and medical sciences; Biomarkers; Calcitonin - blood; Calcitonin Gene-Related Peptide; Human bacterial diseases; Humans; Infant, Newborn; Infectious diseases; Interleukin-10 - blood; Medical sciences; Neutrophils - chemistry; Predictive Value of Tests; Protein Precursors - blood; Receptors, IgG - analysis; Sensitivity and Specificity; Sepsis - diagnosis; Sepsis - pathology
• ISSN: 0036-5548; 1651-1980
• DOI: 10.3109/00365540903449832

Abstract The assay of infection markers can improve diagnostic sensitivity in neonatal sepsis. We determined the levels of neutrophilic CD64 (nCD64), procalcitonin (PCT) and interleukin 10 (IL-10) in infants with neonatal sepsis. Forty-nine newborn infants who met the criteria of sepsis were subjected to a routine sepsis evaluation as well as measurement of PCT and IL-10 levels and nCD64 expression. Of these 49 'infected' infants, 16 had a positive blood culture (culture-positive sepsis) and 33 infants were diagnosed to have clinical sepsis with negative blood cultures (culture-negative sepsis). Another 49 healthy newborn infants were included as a control group. The sensitivity, specificity, positive predictive value and negative predictive value of PCT, IL-10 and nCD64 for the diagnosis of sepsis were determined. IL-10 had the highest sensitivity of 92% and specificity of 84% using a cut-off of ≥17.3 pg/ml. For PCT, the highest sensitivity of 65% and specificity of 60% were found at a cut-off value of ≥36.4 pg/ml. nCD64 had a maximal sensitivity of 92% and specificity of 71% at a cut-off value of 2.6%. Combinations of different markers may improve the sensitivity and specificity of biomarker tests. We found that the best combination was IL-10 and nCD64, which together provided sensitivity of 95% and specificity of 83%, and a negative predictive value of 86%.