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Neutrophil CD64 Index as a superior biomarker for early diagnosis of infection in febrile patients in the hematology department

  • Shu-Dao Xiong EMAIL logo , Lian-Fang Pu , Hui-Ping Wang , Lin-Hui Hu , Yang-Yang Ding , Man-Man Li , Dong-Dong Yang , Cui Zhang , Jing-Xin Xie and Zhi-Min Zhai
Published/Copyright: June 23, 2016
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Clinical Chemistry and Laboratory Medicine (CCLM)
From the journal Clinical Chemistry and Laboratory Medicine (CCLM) Volume 55 Issue 1

Abstract

Background:

In the hematology department, the availability of biomarkers for early detection of infection is difficult to obtain. The present study aimed to compare the diagnostic values of neutrophil CD64 Index, procalcitonin (PCT), interleukin-6 (IL-6) and C-reactive protein (CRP) and to determine whether the combined analysis of these biomarkers offer stronger predictive power in the diagnosis for the infection of febrile patients.

Methods:

Neutrophil CD64 Index, PCT, IL-6 and CRP levels were determined in 356 febrile patients in the hematology ward from May 2013 to May 2015. Sensitivity, specificity, positive and negative likelihood ratios, positive and negative predictive values, receiver operating characteristic (ROC) areas under the curve (AUC), and logistic regression analysis were determined to evaluate the diagnostic values of these biomarkers.

Results:

The levels of the four biomarkers were higher in the infection patients (p<0.001), and the PCT and IL-6 were higher in the patients with positive microbial blood culture (p<0.01). The neutrophil CD64 Index, PCT, IL-6, CRP had AUCs of 0.95, 0.83, 0.75 and 0.73, respectively. The best cut-off value of the neutrophil CD64 Index to detect infections was 5.06, with high specificity (87.5%) and sensitivity (88.4%). Furthermore, neutrophil CD64 Index, PCT and IL-6 offered the best combination of diagnosis with sensitivity of 93.9% and an AUC of 0.95. In addition, the neutrophil CD64 Index may have a special value to assist the physician to diagnose infection in the neutropenic patients with fever.

Conclusions:

The neutrophil CD64 Index is useful for early identification of infections in febrile patients in the hematology department. The combined analysis of the CD64 Index, PCT and IL-6 could further improve its sensitivity.

Keywords: combination diagnosis; C-reactive protein (CRP); fever; hematology; infection; interleukin-6 (IL-6); neutrophil CD64 Index; procalcitonin (PCT)
Corresponding author: Shu-Dao Xiong, MD, PhD, Department of Hematology/Hematological Lab, The Second Hospital, Anhui Medical University, No.678, Furong Road, Hefei, 230601, Anhui Province, P.R. China, Phone: +86-0551-63869344
aShu-Dao Xiong and Lian-Fang Pu contributed equally to this work and should be considered as co-first authors.

Acknowledgments

We would like to thank Dr. Michael Cabanero (Princess Margaret Cancer Centre, Toronto) for his great assistance in the language revision.

  1. Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.

  2. Research funding: This work was partly supported by National Science Foundation of China (81272259). We thank all the medical and nursing staff of our hematology department for their valuable cooperation.

  3. Employment or leadership: None declared.

  4. Honorarium: None declared.

  5. Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.

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Received: 2016-2-13
Accepted: 2016-5-13
Published Online: 2016-6-23
Published in Print: 2017-1-1

©2017 Walter de Gruyter GmbH, Berlin/Boston

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  2. Editorial
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  4. Review
  5. Assessment of vitamin D status – a changing landscape
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  9. Genetics and Molecular Diagnostics
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  32. Acknowledgment
  33. Letters to the Editor
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https://doi.org/10.1515/cclm-2016-0118
Keywords for this article
combination diagnosis; C-reactive protein (CRP); fever; hematology; infection; interleukin-6 (IL-6); neutrophil CD64 Index; procalcitonin (PCT)

Articles in the same Issue

  1. Frontmatter
  2. Editorial
  3. Describing children’s changes using clinical chemistry analytes
  4. Review
  5. Assessment of vitamin D status – a changing landscape
  6. Opinion Papers
  7. Order of blood draw: Opinion Paper by the European Federation for Clinical Chemistry and Laboratory Medicine (EFLM) Working Group for the Preanalytical Phase (WG-PRE)
  8. The principles of Health Technology Assessment in laboratory medicine
  9. Genetics and Molecular Diagnostics
  10. Functional polymorphism of lncRNA MALAT1 contributes to pulmonary arterial hypertension susceptibility in Chinese people
  11. General Clinical Chemistry and Laboratory Medicine
  12. Influence of pneumatic tube system transport on routinely assessed and spectrophotometric cerebrospinal fluid parameters
  13. Estimation of hematocrit in filter paper dried bloodspots by potassium measurement: advantage of use of perimeter ring samples over circular center sub-punch samples
  14. Evaluation of the first fully automated immunoassay method for the measurement of stimulating TSH receptor autoantibodies in Graves’ disease
  15. Comparison of four immunoassays to measure serum ferritin concentrations and iron deficiency prevalence among non-pregnant Cambodian women and Congolese children
  16. Activity and expression of dipeptidyl peptidase IV on peripheral blood mononuclear cells in patients with early steroid and disease modifying antirheumatic drugs naïve rheumatoid arthritis
  17. Hematology and Coagulation
  18. Neutrophil CD64 Index as a superior biomarker for early diagnosis of infection in febrile patients in the hematology department
  19. Dilute Russell’s viper venom time reagents in lupus anticoagulant testing: a well-considered choice
  20. Reference Values and Biological Variations
  21. Pediatric reference intervals for alkaline phosphatase
  22. Cancer Diagnostics
  23. Transcript expression and genetic variability analysis of caspases in breast carcinomas suggests CASP9 as the most interesting target
  24. CDH1 (E-cadherin) expression independently affects clinical outcome in acute myeloid leukemia with normal cytogenetics
  25. Cardiovascular Diseases
  26. Association of monocyte to HDL cholesterol level with contrast induced nephropathy in STEMI patients treated with primary PCI
  27. Low concentrations of adropin are associated with endothelial dysfunction as assessed by flow-mediated dilatation in patients with metabolic syndrome
  28. Preoperative serum potassium predicts the clinical outcome after non-cardiac surgery
  29. Diabetes
  30. A simple colorimetric assay for measuring fructosamine 3 kinase activity
  31. Acknowledgment
  32. Acknowledgment
  33. Letters to the Editor
  34. Normalisation issues in glucose measurements using phlebotomy tubes with liquid additives
  35. Utility of dilution tests in investigating interference in the free thyroxine assay
  36. Plasminogen activator inhibitor-1 as a marker of cardiovascular response in professional mountain ultra-marathon runners
  37. Pitfalls of LSD screening assays: comparison of KIMS and CEDIA immunoassays with LC-MS
  38. A two site comparison of two point-of-care activated clotting time systems
  39. Detection of the common South-East Asian β0-thalassemia mutations in samples with borderline HbA2 levels
  40. Biclonal plasma cell myeloma with the simultaneous appearance of both secretory lambda and nonsecretory kappa monoclonal light chains
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