Role of Neutrophil CD64 in Early Detection of Neonatal Sepsis and its Correlation with Other Sepsis Biomarkers

Early diagnosis of neonatal sepsis may be helpful in decreasing neonatal mortality. Neutrophil CD64 (nCD64) is a leukocyte surface antigen whose expression increases about an hour after bacterial invasion. We aimed to study the expression and diagnostic utility of nCD64 in the early detection of neonatal sepsis compared to existing sepsis indicators.

This prospective observational study was conducted on 140 neonates in a tertiary healthcare center. Those having clinical sepsis were taken as cases and healthy neonates were enrolled as controls. In cases, blood samples were collected for blood culture, sepsis screen and nCD64 expression. Neonates were divided into three groups: Group 1 (n = 3) with both blood culture and sepsis screen positive, Group 2 (n = 40) with blood culture negative but sepsis screen positive and Group 3 (n = 27) with both blood culture and sepsis screen negative. Group 4 (n = 70) was the control.

The data was entered in an MS EXCEL spreadsheet and was analyzed using SPSS version 21.0. Paired T test/Wilcoxon test was used for comparing nCD64. Quantitative and qualitative variables were also compared. The McNemar test was used to compare sensitivity and specificity.

nCD64 expression was highest in Group 1 (23.2%), followed by Groups 2 and 3. It showed high sensitivity (78.57%) and specificity (100%) in sepsis cases. Significant positive correlation was also noted between nCD64 and other sepsis biomarkers.

CD64 expression may, thus, be considered as a rapid and reliable marker for early diagnosis of neonatal sepsis.