Evaluation of CD64 Expression on Peripheral Blood Neutrophils for Early Detection of Neonatal Sepsis

Neonatal sepsis is a life-threatening disease with an incidence of 1 to10 per 1000 live births and a mortality rate of 5% to 25%. The clinical signs arenon-specific and indistinguishable from those caused by a variety of neonatal noninfectious disorders. The aim of this study was to determine the importance of CD64 (FcgRI), a neutrophil surface marker, in early diagnosis of neonatal sepsis. The studied population comprised of 65 neonates with gestational ages of 27 to 38 weeks, suspected of having sepsis in the first 28 days of life and 12 healthy term neonates with physiologic hyperbilirubinemia. One ml of whole blood was obtained to determine CD64 expression on peripheral blood neutrophils by flow cytometry. CD64 expression was significantly higher in the group with sepsisthan the control (P < 0.001). Sensitivity and specificity of CD64 were 92.3% and 100%, respectively. The negative and positive predictive values of CD64 for identifying sepsis were 100% and 88%, respectively. Change in cell surface expression of CD64 on peripheral blood neutrophils may be considered as a sensitive marker for detection of neonatal sepsis if used in combination with other laboratory parameters.