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Neutrophil CD64 expression as marker of bacterial infection: a systematic review and meta-analysis
Joan Cid1, Reyes Aguinaco, Rafael Sánchez
1Haematology Service, Hospital Universitari Joan XXIII, IISPV, Universitat Rovira i Virgili, Tarragona, Spain. jcid.hj23.ics@gencat.cat
Objective:
We performed a systematic review and meta-analysis of studies to evaluate the diagnostic accuracy of expression of CD64 on polymorphonuclear neutrophils (PMN) as a marker for bacterial infection.
Methods:
The analysis included studies of patients from all age groups that prospectively evaluated CD64 expression on PMNs for the diagnosis of bacterial infection. We evaluated the methodological quality of the studies according to the 25-item criteria developed by the Standards for Reporting of Diagnostic Accuracy (STARD) committee. We calculated a summary receiver operating characteristic (SROC) curve across studies included in the meta-analysis.
Results:
The methodological quality score of the 13 included studies ranged from 9 to 16 points (maximum score was 25 points). The pooled sensitivity and specificity for CD64 expression on PMNs were 79% (95% CI: 70-86%) and 91% (95% CI: 85-95%), respectively. The area under curve (AUC) was 0.94.
Conclusions:
On the basis of this meta-analysis, CD64 expression on PMNs could be a useful diagnostic cell-based parameter of bacterial infections. However, published studies about this topic showed a low methodological quality.
Insights
CD64 expression on polymorphonuclear neutrophils (PMN) shows promise as a diagnostic marker for bacterial infections, with high pooled sensitivity and specificity. However, the overall methodological quality of existing studies is low.
Area of Science:
- Immunology
- Infectious Diseases
- Diagnostic Accuracy
Background:
- Bacterial infections pose a significant global health challenge.
- Accurate and timely diagnosis is crucial for effective treatment.
- Novel diagnostic markers are continuously being investigated.
Purpose of the Study:
- To systematically review and meta-analyze studies evaluating CD64 expression on polymorphonuclear neutrophils (PMN) as a diagnostic marker for bacterial infections.
- To assess the diagnostic accuracy, including sensitivity and specificity, of CD64 expression in identifying bacterial infections across diverse patient populations.
Main Methods:
- Systematic review and meta-analysis of prospective studies.
- Inclusion of patients from all age groups.
- Evaluation of study quality using STARD criteria.
- Calculation of pooled sensitivity, specificity, and summary receiver operating characteristic (SROC) curve.
Main Results:
- Thirteen studies were included, with methodological quality scores ranging from 9 to 16 (maximum 25).
- Pooled sensitivity for CD64 expression on PMNs was 79% (95% CI: 70-86%).
- Pooled specificity was 91% (95% CI: 85-95%), with an area under the curve (AUC) of 0.94.
Conclusions:
- CD64 expression on PMNs demonstrates potential as a valuable cell-based diagnostic parameter for bacterial infections.
- Despite promising accuracy, the published studies exhibit low methodological quality, necessitating further high-quality research.
- Future studies should focus on improving methodological rigor to confirm the clinical utility of CD64 as a biomarker.
