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Critical Care

, 19:P55 | Cite as

Diagnostic accuracy and clinical relevance of an inflammatory biomarker panel in early sepsis in adult critical care patients

  • P Bauer
  • R Kashyap
  • S League
  • J Park
  • D Block
  • N Baumann
  • A Algeciras-Schimnich
  • S Jenkins
  • C Smith
  • O Gajic
  • R Abraham
Open Access
Poster presentation

Keywords

Diagnostic Accuracy Procalcitonin Sepsis Group Critical Care Patient Cellular Marker 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Introduction

Low awareness, late recognition and delayed treatment of sepsis are still common. CD64 is a marker of the innate immune response upregulated in sepsis. The primary goal of this prospective, double-blind study was to compare the diagnostic accuracy of neutrophil CD64 and other cellular markers, along with C-reactive protein (CRP) and procalcitonin (PCT) levels, in early sepsis.

Methods

Adult ICU patients, between 2012 and 2014 were eligible. The eight-color flow cytometric biomarker panel included CD64, CD163, HLA DR, CD15 and others. Diagnostic test results were compared with infection as the reference standard and sepsis as the target condition, using receiver operating characteristic curve analyses. Multivariable logistic regression was used to assess the relationship of sets of markers with the probability of sepsis, adjusting for other patient characteristics.

Results

A total of 219 patients were enrolled, 120 with sepsis, 99 served as controls. APACHE IV (median 70 vs. 57), SOFA (8 vs. 7), ICU (2 vs. 1) and hospital length of stay (6 vs. 4) were higher in the sepsis group. Mortality was not different. After adjustment for APACHE IV, CRP and PCT, CD64 molecules/neutrophil measure remained a significant predictor of sepsis (OR = 1.852 for 1-unit increase on the log scale, 95% CI = 1.083 to 3.168, P = 0.02, AUC = 0.90). See Table 1.
Table 1

Area under the curve (AUC) for individual biomarkers

Measure

N

AUC

Cutoff for sepsis

Sensitivity (%)

Specificity (%)

C-reactive protein (mg/l)

208

0.86

43

76.9

76.9

CD64 molecules/neutrophil

196

0.83

1,040.5

76.4

76.7

Procalcitonin (ng/ml)

216

0.82

0.74

73.1

73.2

%CD64+ neutrophils

196

0.81

49.96

74.5

74.4

Conclusion

Neutrophil CD64 expression is an accurate predictor of early sepsis.

Copyright information

© Bauer et al.; licensee BioMed Central Ltd. 2015

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

Authors and Affiliations

  • P Bauer
    • 1
  • R Kashyap
    • 1
  • S League
    • 1
  • J Park
    • 1
  • D Block
    • 1
  • N Baumann
    • 1
  • A Algeciras-Schimnich
    • 1
  • S Jenkins
    • 1
  • C Smith
    • 1
  • O Gajic
    • 1
  • R Abraham
    • 1
  1. 1.Mayo ClinicRochesterUSA

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