Neutrophil CD64 as a marker for postoperative infection: a pilot study

Area of Science:

• Clinical diagnostics
• Immunology
• Surgical outcomes

Background:

• Differentiating systemic inflammation from bacterial infection post-surgery is clinically challenging.
• Existing biomarkers like C-reactive protein (CRP), white blood cell (WBC) counts, and procalcitonin (PCT) have limitations in early postoperative infection detection.

Purpose of the Study:

• To assess the clinical utility of quantitative neutrophil CD64 expression for differentiating surgical trauma-induced inflammation from postoperative bacterial infection.
• To evaluate CD64 alongside established inflammatory markers (CRP, WBC, PCT) in vascular surgery patients.

Main Methods:

• Pilot study involving 153 patients undergoing elective vascular surgery.
• Blood samples collected preoperatively and within 24 hours postoperatively.
• Analysis of C-reactive protein (CRP), total leucocyte counts (WBC), serum procalcitonin (PCT), and neutrophil CD64 expression.

Main Results:

• In patients with confirmed postoperative infection (n=14), CD64, CRP, WBC, and PCT were significantly elevated post-surgery.
• Patients with pre- and postoperative infection (n=6) showed no significant changes in CD64, WBC, or PCT, with only marginal significance for CRP.
• Patients with postoperative fever but no infection (n=29) exhibited marker elevations similar to those with infection.

Conclusions:

• Neutrophil CD64 expression may serve as a valuable biomarker for early postoperative bacterial infection diagnosis.
• Quantitative CD64 measurements warrant further investigation to establish their role in differentiating infection from surgical inflammation.
• CD64 holds potential for improving diagnostic accuracy in the early postoperative period.