Neutrophil CD64 expression as a longitudinal biomarker for severe disease and acute infection in critically ill patients
Neutrophil CD64 expression as a longitudinal biomarker for severe disease and acute infection in critically ill patients
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DOI：
10.1111/ijlh.12545
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发表时间：
2016-10-01
影响因子：
3
通讯作者：
Huisman, A.
中科院分区：
文献类型：
--
作者：
De Jong, E.;De Lange, D. W.;Huisman, A.
简介中性粒细胞在激活后表达分化簇 64 (CD64) 抗原。 CD64可作为细菌感染和败血症的标志物。本研究的目的是确定 CD64 是否是危重患者的有用生物标志物，并分析关于结果和脓毒症严重程度的纵向测量。方法在这项前瞻性观察研究中，每天进行 CD64 分析，直到从 ICU 出院或死亡。记录人口统计学、临床、实验室数据和定义为 28 天生存率的结果。患者因脓毒症、严重脓毒症或脓毒性休克入住 ICU，且在抗生素治疗开始后 24 小时内被纳入。 结果 连续纳入 155 名患者。基线时，培养阳性和培养阴性患者之间的 CD64 差异为 2.26 (1.33-4.47) 与 1.49 (0.89-2.24) (P=0.004)。与脓毒症患者相比，感染性休克患者第 1 天的 CD64 更高（P=0.012）。幸存者和非幸存者之间的 CD64 没有差异。结论本研究表明，CD64 可区分脓毒症培养阳性和阴性的危重患者，并与疾病的严重程度相关。然而，CD64 指数并不能很好地预测危重患者 28 天死亡率。
IntroductionNeutrophilic granulocytes express cluster of differentiation 64 (CD64) antigen upon activation. CD64 can be used as a marker of bacterial infection and sepsis. The goal of this study was to determine whether CD64 is a useful biomarker for critically ill patients and analyze longitudinal measurements with regard to outcome and sepsis severity.MethodsIn this prospective observational study, CD64 analysis was performed daily until discharge from ICU or death. Demographics, clinical, laboratory data, and outcome defined as 28-day survival were recorded. Patients were included when admitted to the ICU with sepsis, severe sepsis, or septic shock and within 24h from start of antibiotic treatment.ResultsHundred and fifty-five consecutive patients were enrolled. At baseline, a difference in CD64 of 2.26 (1.33-4.47) vs. 1.49 (0.89-2.24) (P=0.004) was seen between patients with a positive culture and negative culture. CD64 at day 1 was higher with patients with septic shock when compared with sepsis (P=0.012). No difference of CD64 between survivors and nonsurvivors was seen.ConclusionThis study demonstrated that CD64 discriminates between critically ill patients with culture positive and negative sepsis and correlates with severity of disease. However, CD64 index is not a good predictor for 28-day mortality in the critically ill patient.