A study of leukocyte surface antigen CD64, and monocyte surface antigen HLA DR as a marker of sepsis in preterm and full-term neonates

Abstract EN

Background : the diagnosis of sepsis is considered a real challenge as it requires a careful clinical suspicion, complete physical examination and tests.

no single test can diagnose sepsis in neonates ; however the combination of the above is the best method to diagnose.

aim : this prospective study aimed to determine the sensitivity and specificity of CD64 (neutrophil surface antigen) and HLA DR (monocyte surface antigen) and to compare them to other parameters used to diagnose early neonatal sepsis.

also, to define the optimal cut off value for HLA DR MFI and SI using the receiver operating characteristics (ROC) curve so it may be used later on as a reference to compare with other studies.

methodology : the study was conducted on 100 neonates collected from the NICUS of el Galaa teaching hospital and Cairo university children hospital.

50 infected cases and 50 healthy neonates (control group).

for each case the following investigations were ordered : flow cytometry assessment of CD64 and HLA DR.

results : we found that the percentage of neutrophils expressing CD64 was not higher in infected groups ; however, HLA DR% is lower in infected group in comparison with the control group and SI are more significantly higher.

conclusion : HLA DR MFI was proven to drop significantly in neonates with neonatal sepsis.

CD64 doesn’t show a significant role in diagnosing early neonatal sepsis.

other hematological tests such as CRP and TLC help in diagnosing and following sepsis.