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The use of neutrophil CD64 as a diagnostic marker of early onset neonatal sepsis

Thesis

Last updated: 06 Feb 2023

Subjects

-

Tags

Pediatrics

Advisors

El-Badawi, Ayman A., Abdel-Lattif, Dalya A., Mukhtar, Dhuha A.

Authors

Farag-Allah, Hala Hasan

Accessioned

2017-07-12 06:42:31

Available

2017-07-12 06:42:31

type

M.Sc. Thesis

Abstract

Introduction: Infections are the single largest cause of neonatal deaths globally. Although treatment of sepsis has evolved in the last decades with newer therapeutic options, little has changed to improve diagnosis or therapeutic monitoring. CD64 (Cluster of Differentiation 64) is a high-affinity FcγRI receptor expressed on macrophages, monocytes, neutrophils, and eosinophils. Neutrophil expression of CD64 is upregulated under the influence of inflammatory-related cytokines such as interleukin 12, interferon gamma, and granulocyte colony-stimulating factor. High CD64 expression on monocytes accompanying high CD64 expression on neutrophils has been reported in some adult and neonatal studies. Objective: This prospective study aimed to evaluate the diagnostic utilities of neutrophil and monocyte CD64 expression for the identification of early-onset neonatal sepsis in newborns. Subjects and methods: The study was performed on neonates admitted in the Neonatal Intensive Care Unit (NICU) of Gynecology and Obstetrics department, Cairo University Hospitals; in whom infection was suspected when they were < 72 hours of age. A total of 112 neonates were studied; 61 were found to be clinically infected, while 31 were non-infected and 20 healthy neonates served as controls. Expression of CD64 on neutrophils and monocytes were measured at 0 h (at the time of sepsis evaluation) and 24 h later and was determined as (1) the percentage of cells expressing fluorescence and (2) mean fluorescence intensities (MFI). Results: There was a significant difference in the percentage of neutrophils expressing CD64 between the infected and non infected groups at both 0 h (p value 0.007) and 24 h (p value <0.001) and between the infected and the control groups (p value 0.01). A significant difference was also found in the results of MFI of neutrophil CD64 between the infected and non infected groups at both 0 h (p value 0.006) and 24 h (p value 0.001) but not between the infected and control groups (p value 0.4). However, there was no statistical difference between the 3 groups as regards CD64 expression on monocytes except for the results of MFI of CD64 between the infected and non infected groups at 0 hour (p value 0.02). On correlating the results of CD64 expression with other diagnostic markers of neonatal sepsis we found a significant correlation between the MFI of neutrophil CD64 and CRP values at 24 h (r = 0.3, p value 0.006) and between the monocytes expressing CD64 and thrombocytopenia at 0 h (r = 0.3, p value 0.01). In conclusion, while CD64 expression on monocytes was increased in neonates with EONS but with no statistical difference from non infected and control groups, CD64 expression on neutrophils increases significantly in neonates with EONS and can be considered a useful diagnostic marker for the early diagnosis of neonatal infection. However, its combination with CRP further increases its diagnostic value.

Issued

1 Jan 2012

DOI

http://dx.doi.org/10.21473/iknito-space/38042

Details

Type

Thesis

Created At

28 Jan 2023