scholarly journals Utility of neutrophil CD64 in distinguishing bacterial infection from inflammation in severe alcoholic hepatitis fulfilling SIRS criteria

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Gaurav Pandey ◽  
Harshit Singh ◽  
Saurabh Chaturvedi ◽  
Manjunath Hatti ◽  
Alok Kumar ◽  
...  
Keyword(s):  
Bacterial Infection ◽  
Sensitivity And Specificity ◽  
Alcoholic Hepatitis ◽  
Total Leukocyte Count ◽  
Cd64 Expression ◽  
Neutrophil Lymphocyte Ratio ◽  
Reactive Protein ◽  
Neutrophil Cd64 ◽  
Severe Alcoholic Hepatitis ◽  
Infection And Inflammation

AbstractTo assess utility of neutrophilCD64 (nCD64) expression in differentiating bacterial infection from inflammation in patients with severe alcoholic hepatitis (SAH) fulfilling systemic inflammatory response syndrome criteria. Patients with SAH and infection (n = 58), SAH without infection (n = 70), and healthy controls (n = 20) were included. Neutrophil CD64 expression by flowcytometry, serum Procalcitonin (ELISA) and C-reactive protein (Nephelometry) and neutrophil–lymphocyte ratio (NLR) were studied. Percentage of neutrophils with CD64 expression (nCD64%) was significantly higher in patients with SAH and infection than in those without infection and controls [76.2% (56.9–86.5) vs. 16% (12.6–23.1) vs. 7.05% (1.4–9.5), p < 0.05], as was their mean fluorescence intensity [MFI; 1431 (229–1828) vs. 853 (20–968) vs. 99.5 (54.7–140.7), p < 0.05]. Using a cut-off of 27%, the sensitivity and specificity of nCD64% to diagnose bacterial infection was 94% and 81%, respectively, with area under curve (AUC) of 0.95. At a cut-off value of 0.261 ng/ml, the sensitivity and specificity of serum procalcitonin was 83% and 72%, respectively, with AUC of 0.86. Serum CRP, total leukocyte count, NLR had AUCs of 0.78, 0.63 and 0.64, respectively. Quantitative measurement of nCD64 can better distinguish systemic bacterial infection and inflammation in SAH as compared to traditional biomarkers.

scholarly journals Sa1503 – Neutrophil-Lymphocyte Ratio: A New Approach to Evaluate the Response to Corticosteroids in Patients with Severe Alcoholic Hepatitis

2019 ◽  
Vol 156 (6) ◽  
pp. S-1226-S-1227
Author(s):  
Yazan Abu Omar ◽  
Rohit Agrawal ◽  
Tejinder Randhawa ◽  
Muhammad B. Majeed ◽  
Yuchen Wang ◽  
...  
Keyword(s):  
Alcoholic Hepatitis ◽  
New Approach ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Severe Alcoholic Hepatitis

scholarly journals Ratio of total leukocyte count to C-reactive protein: does it help to differentiate infectious fever from engraftment fever in patients undergoing autologous hematopoietic stem cell transplant?

2020 ◽  
Vol 9 (2) ◽  
pp. 40-46
Author(s):  
Sachin Punatar ◽  
Lingaraj Nayak ◽  
Avinash Bonda ◽  
Anant Gokarn ◽  
Aniket Mohite ◽  
...  
Keyword(s):  
Sensitivity And Specificity ◽  
Roc Curve ◽  
Total Leukocyte Count ◽  
Cell Transplant ◽  
C Reactive Protein ◽  
Total Blood ◽  
Hematopoietic Stem ◽  
Reactive Protein ◽  
Blood Culture Positivity ◽  
Auc Value

Engraftment fever (EF) is a common complication of autologous HSCT (AHSCT). It is difficult to discern it from infectious fever (IF). We studied the significance of total blood leucocyte count (TLC) to C-reactive protein (CRP) ratio in differentiating EF from IF. 109 consecutive AHSCT patients were retrospectively analysed between March 2011 and August 2013. Breakthrough fever (BF) was defined as new-onset fever preceded by an afebrile period of at least 48 hours. The BF episodes were classified as IF or EF. Infectious fever was diagnosed in case of blood culture positivity, radiological signs of infection, or fever subsiding within 48 hours of changing the antibiotics. Engraftment fever was defined in cases associated with rising leucocyte counts without identifiable infective focus. EF responded well to steroid therapy. Daily TLC and CRP values were obtained from patients’ records. Optimal cut-off value of ratio on day of BF was obtained by plotting ROC curve. Sensitivity and specificity were calculated at this value. Among 109 cases, the breakthrough fever manifested in seventy patients. The median term for BF was day +9. Sixty-two patients had the EF. Median value of TLC/CRP ratio on the day of BF was significantly higher in patients with EF than with IF (0.139 vs 0.038, p=0.013). With ROC analysis, the AUC value was 0.78 (95%CI – 0.66-0.89, p<0.0001). The ROC curve provided the optimal TLC/CRP value of 0.056. Using a ratio >0.056 for EF, the sensitivity and specificity were 63% (95%CI 50-75%) and 100% (95%CI 63-100%) respectively. TLC/CRP ratio >0.056 is highly specific for EF. Prospective studies are warranted to confirm these findings.

Neutrophil CD64 Is an Improved Indicator of Infection or Sepsis in Emergency Department Patients

2006 ◽  
Vol 130 (5) ◽  
pp. 654-661 ◽  
Author(s):  
Bruce H. Davis ◽  
Stephen H. Olsen ◽  
Ejaz Ahmad ◽  
Nancy C. Bigelow
Keyword(s):  
Emergency Department ◽  
Sedimentation Rate ◽  
Diagnostic Tests ◽  
Diagnostic Performance ◽  
Tertiary Care ◽  
Clinical Score ◽  
C Reactive Protein ◽  
Cd64 Expression ◽  
Reactive Protein ◽  
Neutrophil Cd64

Abstract Context.—Sepsis, affecting millions of individuals annually with an associated high mortality rate, is among the top 10 causes of death. In addition, improvements in diagnostic tests for detecting and monitoring sepsis and infection have been limited in the last 25 years. Neutrophil CD64 expression has been proposed as an improved diagnostic test for the evaluation of infection and sepsis. Objective.—To evaluate the diagnostic performance of a quantitative flow cytometric assay for leukocyte CD64 expression in comparison with the standard tests for infection/sepsis in an ambulatory care setting. Design.—Prospective analysis of 100 blood samples from patients from an emergency department setting in a 965-bed tertiary care suburban community hospital was performed for neutrophil CD64 expression, C-reactive protein, erythrocyte sedimentation rate, and complete blood count. The laboratory findings were compared with a clinical score for the likelihood of infection/sepsis, which was obtained by a blinded retrospective chart review. Results.—The diagnostic performance, as gauged by the clinical score, varied with neutrophil CD64 (sensitivity 87.9%, specificity 71.2%, efficiency 76.8%) and outperformed C-reactive protein (sensitivity 88.2%, specificity 59.4%, efficiency 69.4%), absolute neutrophil count (sensitivity 60.0%, specificity 50.8%, efficiency 53.8%), myeloid left shift (sensitivity 68.2%, specificity 76.3%, efficiency 73.3%), and sedimentation rate (sensitivity 50.0%, specificity 65.5%, efficiency 61.0%). Conclusion.—Neutrophil CD64 expression quantitation provides improved diagnostic detection of infection/sepsis compared with the standard diagnostic tests used in current medical practice.

The sensitivity of neutrophil CD64 expression as a biomarker of bacterial infection is low in critically ill patients

2012 ◽  
Vol 38 (3) ◽  
pp. 445-452 ◽  
Author(s):  
Antoine Gros ◽  
Mikael Roussel ◽  
Elise Sauvadet ◽  
Arnaud Gacouin ◽  
Sophie Marqué ◽  
...  
Keyword(s):  
Bacterial Infection ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Cd64 Expression ◽  
Neutrophil Cd64
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