Neutrophil CD64 as a marker of infection in patients admitted to the emergency department with acute respiratory failure

Antonino Giarratano, Santi Maurizio Raineri, Andrea Cortegiani, Francesca Montalto, Grazia Foresta, Vincenzo Russotto

Risultato della ricerca: Article

3 Citazioni (Scopus)

Abstract

Introduction: Cluster of differentiation 64 (CD64) is expressed on neutrophils during bacterial infections and sepsis. The aim of our study was to assess the CD64 expression in patients admitted to the emergency department (ED) with a triage diagnosis of acute respiratory failure (ARF) and/or dyspnea and to verify a relationship between its value and the presence of infection. Methods: We assessed neutrophil CD64 expression in peripheral blood of patients admitted to the ED with a diagnosis of ARF and/or dyspnea from September 2012 to April 2013. We mea- sured CD64 index by flow cytometry (Leuko64TM kit) and classified patients as infected within 12 hours from admission, without an infection within 12 hours but infected within 72 hours from admission, and not infected. The primary outcome was differentiating CD64 values of patients with a diagnosis of infection within 12 hours and 72 hours from admission, from those of patients without a diagnosis of infection. The secondary outcome was verifying a relationship between CD64 values and patients’ characteristics, Sequential Organ Failure Assessment score, and intensive care unit admission.Results: Of 212 patients included in the study, 40.1% were classified as infected within 12 hours from admission, 20.3% were without an infection 12 hours after admission but were infected within 72 hours, and 39.6% were not infected. The median CD64 index was higher in patients with an infection on admission (CD64 index: 3.58) than in those not considered infected (CD64 index: 1.37), P,0.0001. Among patients not infected at admission, the CD64 index was higher in those with an infection detected during the following hours of observation (CD64 index: 2.75) than in patients without a diagnosis of infection (CD64 index: 1.28), P,0.0001. A CD64 index .3.65 showed a sensitivity of 94.6%, a specificity of 86.8%, and an area under the receiver-operating characteristic curve of 0.952 for prediction of intensive care unit admission.Conclusion: CD64 index could represent a useful diagnostic tool for differential diagnosis of ARF in the ED.
Lingua originaleEnglish
pagine (da-a)37-44
Numero di pagine8
RivistaOpen Access Emergency Medicine
Volume6
Stato di pubblicazionePublished - 2014

Fingerprint

Respiratory Insufficiency
Hospital Emergency Service
Neutrophils
Infection
Dyspnea
Intensive Care Units
Organ Dysfunction Scores
Triage
Patient Admission
Bacterial Infections
ROC Curve
Sepsis
Flow Cytometry
Differential Diagnosis
Observation

All Science Journal Classification (ASJC) codes

  • Emergency Medicine
  • Emergency

Cita questo

@article{65105faf7a104d96a0971e4acd48fb12,
title = "Neutrophil CD64 as a marker of infection in patients admitted to the emergency department with acute respiratory failure",
abstract = "Introduction: Cluster of differentiation 64 (CD64) is expressed on neutrophils during bacterial infections and sepsis. The aim of our study was to assess the CD64 expression in patients admitted to the emergency department (ED) with a triage diagnosis of acute respiratory failure (ARF) and/or dyspnea and to verify a relationship between its value and the presence of infection. Methods: We assessed neutrophil CD64 expression in peripheral blood of patients admitted to the ED with a diagnosis of ARF and/or dyspnea from September 2012 to April 2013. We mea- sured CD64 index by flow cytometry (Leuko64TM kit) and classified patients as infected within 12 hours from admission, without an infection within 12 hours but infected within 72 hours from admission, and not infected. The primary outcome was differentiating CD64 values of patients with a diagnosis of infection within 12 hours and 72 hours from admission, from those of patients without a diagnosis of infection. The secondary outcome was verifying a relationship between CD64 values and patients’ characteristics, Sequential Organ Failure Assessment score, and intensive care unit admission.Results: Of 212 patients included in the study, 40.1{\%} were classified as infected within 12 hours from admission, 20.3{\%} were without an infection 12 hours after admission but were infected within 72 hours, and 39.6{\%} were not infected. The median CD64 index was higher in patients with an infection on admission (CD64 index: 3.58) than in those not considered infected (CD64 index: 1.37), P,0.0001. Among patients not infected at admission, the CD64 index was higher in those with an infection detected during the following hours of observation (CD64 index: 2.75) than in patients without a diagnosis of infection (CD64 index: 1.28), P,0.0001. A CD64 index .3.65 showed a sensitivity of 94.6{\%}, a specificity of 86.8{\%}, and an area under the receiver-operating characteristic curve of 0.952 for prediction of intensive care unit admission.Conclusion: CD64 index could represent a useful diagnostic tool for differential diagnosis of ARF in the ED.",
author = "Antonino Giarratano and Raineri, {Santi Maurizio} and Andrea Cortegiani and Francesca Montalto and Grazia Foresta and Vincenzo Russotto",
year = "2014",
language = "English",
volume = "6",
pages = "37--44",
journal = "Open Access Emergency Medicine",
issn = "1179-1500",
publisher = "Dove Medical Press Ltd.",

}

TY - JOUR

T1 - Neutrophil CD64 as a marker of infection in patients admitted to the emergency department with acute respiratory failure

AU - Giarratano, Antonino

AU - Raineri, Santi Maurizio

AU - Cortegiani, Andrea

AU - Montalto, Francesca

AU - Foresta, Grazia

AU - Russotto, Vincenzo

PY - 2014

Y1 - 2014

N2 - Introduction: Cluster of differentiation 64 (CD64) is expressed on neutrophils during bacterial infections and sepsis. The aim of our study was to assess the CD64 expression in patients admitted to the emergency department (ED) with a triage diagnosis of acute respiratory failure (ARF) and/or dyspnea and to verify a relationship between its value and the presence of infection. Methods: We assessed neutrophil CD64 expression in peripheral blood of patients admitted to the ED with a diagnosis of ARF and/or dyspnea from September 2012 to April 2013. We mea- sured CD64 index by flow cytometry (Leuko64TM kit) and classified patients as infected within 12 hours from admission, without an infection within 12 hours but infected within 72 hours from admission, and not infected. The primary outcome was differentiating CD64 values of patients with a diagnosis of infection within 12 hours and 72 hours from admission, from those of patients without a diagnosis of infection. The secondary outcome was verifying a relationship between CD64 values and patients’ characteristics, Sequential Organ Failure Assessment score, and intensive care unit admission.Results: Of 212 patients included in the study, 40.1% were classified as infected within 12 hours from admission, 20.3% were without an infection 12 hours after admission but were infected within 72 hours, and 39.6% were not infected. The median CD64 index was higher in patients with an infection on admission (CD64 index: 3.58) than in those not considered infected (CD64 index: 1.37), P,0.0001. Among patients not infected at admission, the CD64 index was higher in those with an infection detected during the following hours of observation (CD64 index: 2.75) than in patients without a diagnosis of infection (CD64 index: 1.28), P,0.0001. A CD64 index .3.65 showed a sensitivity of 94.6%, a specificity of 86.8%, and an area under the receiver-operating characteristic curve of 0.952 for prediction of intensive care unit admission.Conclusion: CD64 index could represent a useful diagnostic tool for differential diagnosis of ARF in the ED.

AB - Introduction: Cluster of differentiation 64 (CD64) is expressed on neutrophils during bacterial infections and sepsis. The aim of our study was to assess the CD64 expression in patients admitted to the emergency department (ED) with a triage diagnosis of acute respiratory failure (ARF) and/or dyspnea and to verify a relationship between its value and the presence of infection. Methods: We assessed neutrophil CD64 expression in peripheral blood of patients admitted to the ED with a diagnosis of ARF and/or dyspnea from September 2012 to April 2013. We mea- sured CD64 index by flow cytometry (Leuko64TM kit) and classified patients as infected within 12 hours from admission, without an infection within 12 hours but infected within 72 hours from admission, and not infected. The primary outcome was differentiating CD64 values of patients with a diagnosis of infection within 12 hours and 72 hours from admission, from those of patients without a diagnosis of infection. The secondary outcome was verifying a relationship between CD64 values and patients’ characteristics, Sequential Organ Failure Assessment score, and intensive care unit admission.Results: Of 212 patients included in the study, 40.1% were classified as infected within 12 hours from admission, 20.3% were without an infection 12 hours after admission but were infected within 72 hours, and 39.6% were not infected. The median CD64 index was higher in patients with an infection on admission (CD64 index: 3.58) than in those not considered infected (CD64 index: 1.37), P,0.0001. Among patients not infected at admission, the CD64 index was higher in those with an infection detected during the following hours of observation (CD64 index: 2.75) than in patients without a diagnosis of infection (CD64 index: 1.28), P,0.0001. A CD64 index .3.65 showed a sensitivity of 94.6%, a specificity of 86.8%, and an area under the receiver-operating characteristic curve of 0.952 for prediction of intensive care unit admission.Conclusion: CD64 index could represent a useful diagnostic tool for differential diagnosis of ARF in the ED.

UR - http://hdl.handle.net/10447/96403

M3 - Article

VL - 6

SP - 37

EP - 44

JO - Open Access Emergency Medicine

JF - Open Access Emergency Medicine

SN - 1179-1500

ER -