Neutrophil CD64 as a diagnostic marker of sepsis in children

Background: Sepsis is one of the leading causes of mortality amongchildren worldwide. Reliable evidence was insufficient in pediatric sepsisand many aspects in clinical practice actually depend on expert consensuswith some evidence in adult sepsis. Objective: This study aimed toinvestigate neutrophil expression of CD64 in septic children and in healthycontrols. We hypothesized that these receptors are elevated during sepsisand can be used as a diagnostic marker. Methods: This study was carriedout on 50children with pediatric sepsis and 40 apparently healthy childrenas controls. Cases were recruited from the PICU of Al Zahraa UniversityHospital, Al-Azhar University for Girls in the period from May 2014 toMarch 2015. All the cases were assessed clinically and by routinelaboratory investigations. Expression of neutrophil CD64 was measured byflow cytometry. Results: The mean CD64 expression in children with sepsis(66.49 ± 23.45) was significantly higher than in the control group (9.39 ±6.17) pCRP level (r=0.416, p<0.003). ROC curve for CD64 expressionshowed100% sensitivity and specificity. The most common isolatedorganisms were gram negative organisms mainly E. coli. A highlysignificant increase was demonstrated in CRP and TLC values in the cultureproven sepsis group compared to clinical sepsis group, while there was nostatistical significant difference in CD64 values between the two groups.Conclusion: change in cell surface expression of CD64 on peripheral bloodneutrophils can be considered a sensitive marker for the detection ofpediatric sepsis.