Point-of-care neutrophil CD64 as a rule in diagnostic test for bacterial infections in the emergency department
Dublin Core
Title
Point-of-care neutrophil CD64 as a rule in diagnostic test for bacterial infections in the emergency department
Subject
nCD64, Bacterial infections, Viral infections, COVID-19, Infammation, Point of care immunology
Description
Introduction Bacterial infections are frequently seen in the emergency department (ED), but can be difcult to distinguish from viral infections and some non-infectious diseases. Common biomarkers such as c-reactive protein (CRP)
and white blood cell (WBC) counts fail to aid in the diferential diagnosis. Neutrophil CD64 (nCD64), an IgG receptor, is
suggested to be more specifc for bacterial infections. This study investigated if nCD64 can distinguish bacterial infections from other infectious and non-infectious diseases in the ED.
Methods All COVID-19 suspected patients who visited the ED and for which a defnitive diagnosis was made, were
included. Blood was analyzed using an automated fow cytometer within 2 h after presentation. Patients were divided
into a bacterial, viral, and non-infectious disease group. We determined the diagnostic value of nCD64 and compared
this to those of CRP and WBC counts.
Results Of the 291 patients presented at the ED, 182 patients were included with a defnitive diagnosis (bacterial
infection n =78; viral infection n =64; non-infectious disease n =40). ROC-curves were plotted, with AUCs of 0.71
[95%CI: 0.64–0.79], 0.77 [0.69–0.84] and 0.64 [0.55–0.73] for nCD64, WBC counts and CRP, respectively. In the bacterial group, nCD64 MFI was signifcantly higher compared to the other groups (p <0.01). A cut-of of 9.4AU MFI for
nCD64 corresponded with a positive predictive value of 1.00 (sensitivity of 0.27, a specifcity of 1.00, and an NPV of
0.64). Furthermore, a diagnostic algorithm was constructed which can serve as an example of what a future biomarker
prediction model could look like.
Conclusion For patients in the ED presenting with a suspected infection, nCD64 measured with automatic fow
cytometry, has a high specifcity and positive predictive value for diagnosing a bacterial infection. However, a low
nCD64 cannot rule out a bacterial infection. For future purposes, nCD64 should be combined with additional tests to
form an algorithm that adequately diagnoses infectious diseases.
and white blood cell (WBC) counts fail to aid in the diferential diagnosis. Neutrophil CD64 (nCD64), an IgG receptor, is
suggested to be more specifc for bacterial infections. This study investigated if nCD64 can distinguish bacterial infections from other infectious and non-infectious diseases in the ED.
Methods All COVID-19 suspected patients who visited the ED and for which a defnitive diagnosis was made, were
included. Blood was analyzed using an automated fow cytometer within 2 h after presentation. Patients were divided
into a bacterial, viral, and non-infectious disease group. We determined the diagnostic value of nCD64 and compared
this to those of CRP and WBC counts.
Results Of the 291 patients presented at the ED, 182 patients were included with a defnitive diagnosis (bacterial
infection n =78; viral infection n =64; non-infectious disease n =40). ROC-curves were plotted, with AUCs of 0.71
[95%CI: 0.64–0.79], 0.77 [0.69–0.84] and 0.64 [0.55–0.73] for nCD64, WBC counts and CRP, respectively. In the bacterial group, nCD64 MFI was signifcantly higher compared to the other groups (p <0.01). A cut-of of 9.4AU MFI for
nCD64 corresponded with a positive predictive value of 1.00 (sensitivity of 0.27, a specifcity of 1.00, and an NPV of
0.64). Furthermore, a diagnostic algorithm was constructed which can serve as an example of what a future biomarker
prediction model could look like.
Conclusion For patients in the ED presenting with a suspected infection, nCD64 measured with automatic fow
cytometry, has a high specifcity and positive predictive value for diagnosing a bacterial infection. However, a low
nCD64 cannot rule out a bacterial infection. For future purposes, nCD64 should be combined with additional tests to
form an algorithm that adequately diagnoses infectious diseases.
Creator
N. L. M. van de Ven, S. H. Bongers, R. Spijkerman, L. Koenderman, L. P. H. Leenen, F. Hietbrink and The COVPACH study group
Publisher
BMC Emergency Medicine
Date
(2023) 23:28
Contributor
Fajar bagus W
Format
PDF
Language
English
Type
Text
Files
Collection
Citation
N. L. M. van de Ven, S. H. Bongers, R. Spijkerman, L. Koenderman, L. P. H. Leenen, F. Hietbrink and The COVPACH study group, “Point-of-care neutrophil CD64 as a rule in diagnostic test for bacterial infections in the emergency department,” Repository Horizon University Indonesia, accessed November 21, 2024, https://repository.horizon.ac.id/items/show/4323.