Diagnostic value of neutrophil CD64 index combined with procalcitonin and hypersensitive C-reactive protein in neonatal intrauterine bacterial infection

doi:10.3877/cma.j.issn.1674-1358.2019.05.013

Abstract

Abstract:

Objective

To investigate the diagnostic value of neutrophil CD64 index combined with procalcitonin (PCT) and hypersensitive C-reactive protein (hs-CRP) in neonatal intrauterine bacterial infection.

Methods

Total of 138 neonates with high risk factors of intrauterine bacterial infection in Department of Neonatology, Haikou Maternal and Child Health Hospital from August 2017 to August 2018 were selected, according to the infection outcomes, 138 neonates were divided into infection group (28 cases) and non-infection group (110 case), CD64 index of neutrophils was measured by flow cytometry, the levels of serum PCT and hs-CRP were detected by immunofluorescence assay. CD64 index, expressions of PCT and hs-CRP in neutrophils of the two groups were observed, respectively; the diagnostic value of combined detection for neonatal intrauterine bacterial infection was also analyzed by receiver operating characteristic curve (ROC curve).

Results

CD64 index [(0.89 ± 0.25)% ], PCT [(2.24 ± 0.53) ng/ml] and hs-CRP [(21.25 ± 2.37) mg/L] of neutrophils in the infection group were significantly higher than those in the non-infection group [CD64: (0.26 ± 0.08)%, PCT: (0.42 ± 0.09) ng/ml, hs-CRP: (6.37 ± 1.33) mg/L], with significant differences (t = 22.475, P < 0.001; t = 34.459, P < 0.001; t = 44.171, P < 0.001). ROC curve analysis showed that the area under CD64 index + PCT + hs-CRP combined detection curve was 0.897, with the sensitivity for 85.71%, specificity for 92.73%, accuracy for 91.30%, which were higher than that of the two indicators combined detection and single indicator detection, and the misdiagnosis rate of the three indicators combined detection was 7.27% and the missed diagnosis rate was 14.29%.

Conclusions

Neutrophil CD64 index and PCT could be taken as early diagnostic indexes for neonatal intrauterine bacterial infection, the combined detection of CD64 index, PCT, and hs-CRP could significantly improve the sensitivity, specificity and accuracy of diagnosis.

Key words: Neutrophil CD64, Procalcitonin, High sensitivity C-reactive protein, Newborn, Intrauterine bacterial infection, Diagnostic value

Zhiling Wang, Jiangyun Cai, Danhong Wang. Diagnostic value of neutrophil CD64 index combined with procalcitonin and hypersensitive C-reactive protein in neonatal intrauterine bacterial infection[J]. Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Edition), 2019, 13(05): 421-425.

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References 25

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组别	例数	性别（男/女，例）	早产[例（%）]	顺产[例（%）]	剖宫产[例（%）]
非感染组	110	64/46	29（26.36）	80（72.73）	30（27.27）
感染组	28	16/12	8（28.57）	21（75.00）	7（25.00）
χ²值	?	0.010	0.055	0.059	0.059
P值	?	0.921	0.814	0.808	0.808

组别	例数	性别（男/女，例）	早产[例（%）]	顺产[例（%）]	剖宫产[例（%）]
非感染组	110	64/46	29（26.36）	80（72.73）	30（27.27）
感染组	28	16/12	8（28.57）	21（75.00）	7（25.00）
χ²值	?	0.010	0.055	0.059	0.059
P值	?	0.921	0.814	0.808	0.808

项目	曲线下面积	敏感性（%）	特异性（%）	95%CI	约登指数
CD64指数	0.813	71.43	86.36	0.736～0.892	0.5779
PCT	0.848	82.14	89.09	0.761～0.916	0.7123
hs-CRP	0.712	46.43	90.91	0.635～0.841	0.3734
联合检测	0.897	85.71	92.73	0.802～0.947	0.7844
项目	阳性预测值（%）	阴性预测值（%）	准确度（%）	误诊率（%）	漏诊率（%）
CD64指数	57.14	92.23	83.33	13.64	28.57
PCT	65.71	95.15	87.68	10.91	17.86
hs-CRP	56.52	86.96	81.88	9.09	53.57
联合检测	75.00	96.23	91.30	7.27	14.29

项目	曲线下面积	敏感性（%）	特异性（%）	95%CI	约登指数
CD64指数	0.813	71.43	86.36	0.736～0.892	0.5779
PCT	0.848	82.14	89.09	0.761～0.916	0.7123
hs-CRP	0.712	46.43	90.91	0.635～0.841	0.3734
联合检测	0.897	85.71	92.73	0.802～0.947	0.7844
项目	阳性预测值（%）	阴性预测值（%）	准确度（%）	误诊率（%）	漏诊率（%）
CD64指数	57.14	92.23	83.33	13.64	28.57
PCT	65.71	95.15	87.68	10.91	17.86
hs-CRP	56.52	86.96	81.88	9.09	53.57
联合检测	75.00	96.23	91.30	7.27	14.29

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