Article: Association of the early absolute CD64-expressing neutrophil count and sepsis outcome

To evaluate the early absolute CD64/CD15/CD45 neutrophil count as a marker of prognosis of sepsis outcome the absolute CD64/CD15/CD45 count was measured by flow cytometry in 65 patients with confirmed or suspected Gram-negative sepsis and organ dysfunction. Serum interleukin(IL)-8 and interferon-gamma (IFNγ) were measured by an enzyme immunoassay. An absolute count lower than 2500 cells/mm could early discriminate non-survivors with sensitivity 82.9% (OR 3.46, 95%CIs 1.10-10.95, p 0.042). After forward step-wise Cox- regression analysis, it was found that acute coagulopathy, acute renal injury, and an early absolute CD64/CD15/CD45 count lower than 2500/mm were independently associated with unfavorable outcome. The OR for death among patients with an absolute CD64/CD15/CD45 neutrophil count greater than 2500/mm and circulating IL-8 greater than 95 pg/ml was 0.44; this was significantly increased to 7.44 among patients with an absolute CD64/CD15/CD45 neutrophil count lower than 2500/mm (p 0.045 by the Breslow-Day's test; p 0.046 by the Tarone's test). An absolute CD64/CD15/CD45 count below 2500/mm can be a useful prognosticator of sepsis outcome and a probable indicator of sepsis immunosuppression.

Citing Articles

A signature of immune-related genes correlating with clinical prognosis and immune microenvironment in sepsis.

Chen Z, Zhang W, Ye H, Guo Y, Zhang K, Fang X BMC Bioinformatics. 2023; 24(1):20.

PMID: 36650470 PMC: 9843880. DOI: 10.1186/s12859-023-05134-1.

Peptide-guided delivery improves the therapeutic efficacy and safety of glucocorticoid drugs for treating acute lung injury.

Guo H, Guan J, Wu X, Wei Y, Zhao J, Zhou Y Mol Ther. 2023; 31(3):875-889.

PMID: 36609145 PMC: 10014283. DOI: 10.1016/j.ymthe.2023.01.003.

IL-21/IL-21R Regulates the Neutrophil-Mediated Pathologic Immune Response during Chlamydial Respiratory Infection.

Zeng J, Xu Y, Tan L, Zha X, Yang S, Zhang H Mediators Inflamm. 2022; 2022:4322092.

PMID: 35693111 PMC: 9177341. DOI: 10.1155/2022/4322092.

Zhou J, Xu W, Wang J, Fan Z Front Pharmacol. 2022; 13:865303.

PMID: 35431963 PMC: 9010144. DOI: 10.3389/fphar.2022.865303.

Assessment of continuous neutrophil CD64 index measurement for diagnosing sepsis and predicting outcome in a Chinese pediatric intensive care unit: a prospective study.

Cui W, Xu Y, Fang H, Tong W, Zhu L, Jin D Transl Pediatr. 2021; 10(6):1668-1676.

PMID: 34295781 PMC: 8261578. DOI: 10.21037/tp-21-63.

References

1.

Fischer G, Schneider E, L Moldawer L, Karcher C, Barth E, Georgieff M . CD64 surface expression on neutrophils is transiently upregulated in patients with septic shock. Intensive Care Med. 2002; 27(12):1848-52. DOI: 10.1007/s00134-001-1135-z. View

2.

Livaditi O, Kotanidou A, Psarra A, Dimopoulou I, Sotiropoulou C, Augustatou K . Neutrophil CD64 expression and serum IL-8: sensitive early markers of severity and outcome in sepsis. Cytokine. 2007; 36(5-6):283-90. DOI: 10.1016/j.cyto.2007.02.007. View

3.

Danikas D, Karakantza M, Theodorou G, Sakellaropoulos G, Gogos C . Prognostic value of phagocytic activity of neutrophils and monocytes in sepsis. Correlation to CD64 and CD14 antigen expression. Clin Exp Immunol. 2008; 154(1):87-97. PMC: 2561092. DOI: 10.1111/j.1365-2249.2008.03737.x. View

4.

Cid J, Garcia-Pardo G, Aguinaco R, Sanchez R, Llorente A . Neutrophil CD64: diagnostic accuracy and prognostic value in patients presenting to the emergency department. Eur J Clin Microbiol Infect Dis. 2011; 30(7):845-52. DOI: 10.1007/s10096-011-1164-7. View

5.

Gamez-Diaz L, Enriquez L, Matute J, Velasquez S, Gomez I, Toro F . Diagnostic accuracy of HMGB-1, sTREM-1, and CD64 as markers of sepsis in patients recently admitted to the emergency department. Acad Emerg Med. 2011; 18(8):807-15. DOI: 10.1111/j.1553-2712.2011.01113.x. View

6.

Giamarellos-Bourboulis E, Mylona V, Antonopoulou A, Tsangaris I, Koutelidakis I, Marioli A . Effect of clarithromycin in patients with suspected Gram-negative sepsis: results of a randomized controlled trial. J Antimicrob Chemother. 2013; 69(4):1111-8. DOI: 10.1093/jac/dkt475. View

7.

Dimoula A, Pradier O, Kassengera Z, Dalcomune D, Turkan H, Vincent J . Serial determinations of neutrophil CD64 expression for the diagnosis and monitoring of sepsis in critically ill patients. Clin Infect Dis. 2013; 58(6):820-9. DOI: 10.1093/cid/cit936. View

8.

Chen Q, Shi J, Fei A, Wang F, Pan S, Wang W . Neutrophil CD64 expression is a predictor of mortality for patients in the intensive care unit. Int J Clin Exp Pathol. 2015; 7(11):7806-13. PMC: 4270525. View

9.

Papadimitriou-Olivgeris M, Lekka K, Zisimopoulos K, Spiliopoulou I, Logothetis D, Theodorou G . Role of CD64 expression on neutrophils in the diagnosis of sepsis and the prediction of mortality in adult critically ill patients. Diagn Microbiol Infect Dis. 2015; 82(3):234-9. DOI: 10.1016/j.diagmicrobio.2015.03.022. View

10.

Liu Y, Hou J, Li Q, Chen K, Wang S, Wang J . Biomarkers for diagnosis of sepsis in patients with systemic inflammatory response syndrome: a systematic review and meta-analysis. Springerplus. 2016; 5(1):2091. PMC: 5153391. DOI: 10.1186/s40064-016-3591-5. View

Association of the Early Absolute CD64-expressing Neutrophil Count and Sepsis Outcome