Skip to main content

Advertisement

Log in

Expression of CD64 on neutrophils can be used to predict the severity of bloodstream infection before broad range 16S rRNA PCR

  • Published:
Folia Microbiologica Aims and scope Submit manuscript

Abstract

The aging population and increased incidence of severe bacterial infection can lead to sepsis. Interest to early identification of endangered patients and identification of pathogen do not always confirm the infection. To use biomarkers can help in early identification of infection and opportunity to start therapy timeously. All biomarkers were defined in 33 out of 96 patients. Thirty-two (97 %) patients had bacterial infection and 1 (3 %) patient had systemic inflammatory response syndrome (SIRS) without infection. PCR confirmed the infection in 27 cases and blood cultures in 8. Area under curve (AUC) for CD64 was 1.00, meanwhile other biomarkers showed 2-fold smaller AUC for positive infection. CD64 index was associated with bacterial infection (p < 0.001) and could be used to confirm assessment of SIRS severity (p = 0.037). As regards to our results, limited to only 33 patients, CD64 index served as a good parameter to predict bacterial infection and determine severity. The use of broad range 16S ribosomal RNA (rRNA) PCR proved to be an excellent tool to confirm bloodstream infection. The CD64 index had the highest AUC, which exceeded all the others, and could be used to predict the outcome of broad range 16S rRNA PCR from whole blood. However, C-reactive protein (CRP), procalcitonin (PCT) and sCD14 are much easier and faster to measure, but the values could be elevated in other clinical assessments.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  • Adib M, Bakhshiani Z, Navaei F, Saheb Fosoul F, Fouladi S, Kazemzadeh H (2012) Procalcitonin: a reliable marker for the diagnosis of neonatal sepsis. Iran J Basic Med Sci 15:777–782

    PubMed Central  CAS  PubMed  Google Scholar 

  • Azevedo JR, Torres OJ, Czeczko NG, Tuon FF, Nassif PA, Souza GD (2012) Procalcitonin as a prognostic biomarker of severe sepsis and septic shock. Rev Col Bras Cir 39:456–460

    Article  PubMed  Google Scholar 

  • Chiwakata CB, Manegold C, Bonicke L, Waase I, Julch C, Dietrich M (2001) Procalcitonin as a parameter of disease severity and risk of mortality in patients with Plasmodium falciparum malaria. J Infect Dis 183:1161–1164

    Article  CAS  PubMed  Google Scholar 

  • Cid J, Aguinaco R, Sánchez R, García-Pardo G, Llorente A (2010) Neutrophil CD64 expression as marker of bacterial infection: a systematic review and meta-analysis. J Infect 60:313–319

    Article  PubMed  Google Scholar 

  • Davis BH (2005) Improved diagnostic approaches to infection/sepsis detection. Expert Rev Mol Diagn 5:193–207

    Article  CAS  PubMed  Google Scholar 

  • Dellinger RP, Levy MM, Rhodes A, Annane D, Gerach H, Opal SM, Sevransky JE, Sprung CL, Douglas IS, Jaeschke R, Osborn TM, Nunnally ME, Townsend SR, Reinhart K, Kleinpell RM, Angu DC, Deutschman CS, Machado FR, Rubenfeld GD, Webb SA, Beale RJ, Vincent JL, Moreno R (2013) Surviving sepsis campaign: international guidelines for management of severe sepsis and septic shock: 2012. Intensive Care Med 39:165–228

    Article  CAS  PubMed  Google Scholar 

  • Ecker DJ, Sampath R, Li H, Massire C, Matthews HE, Toleno D, Hall TA, Blyn LB, Eshoo MW, Ranken R, Hofstadler SA, Tang YW (2010) New technology for rapid molecular diagnosis of bloodstream infections. Expert Rev Mol Diagn 10:399–415

    Article  CAS  PubMed  Google Scholar 

  • Endo S, Suzuki Y, Takahashi G, Shozushima T, Ishikura H, Murai A, Nishida T, Irie Y, Miura M, Iguchi H, Fukui Y, Tanaka K, Nojima T, Okamura Y (2012) Usefulness of presepsin in the diagnosis of sepsis in a multicenter prospective study. J Infect Chemother 18:891–897

    Article  CAS  PubMed  Google Scholar 

  • Fjaertoft G, Douhan Hakansson L, Pauksens K, Sisask G, Venge P (2007) Neutrophil CD64 (FcγRI) expression is a specific marker of bacterial infection: a study on the kinetics and the impact of major surgery. Scand J Infect Dis 39:525–535

    Article  CAS  PubMed  Google Scholar 

  • Gebert S, Siegel D, Wellinghausen N (2008) Rapid detection of pathogens in blood culture bottles by real-time PCR in conjunction with the pre-analytic tool MolYsis. J Infect 57:307–316

    Article  PubMed  Google Scholar 

  • Goulding NJ, Knight SM, Godolphin JL, Guyre PM (1992) Increase in neutrophil Fcγ receptor I expression following interferon gamma treatment in rheumatoid arthritis. Ann Rheum Dis 51:465–468

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  • Groselj-Grenc M, Ihan A, Derganc M (2008) Neutrophil and monocyte CD64 and CD163 expression in critically ill neonates and children with sepsis: comparison of fluorescence intensities and calculated indexes. Mediat Inflamm. doi:10.1155/2008/202646

  • Heiniger A, Binder M, Ellinger A, Botzenhart K, Unertl K, Doring G (2003) DNase pretreatment of master mix reagents improves the validity of universal 16S rRNA gene PCR results. J Clin Microbiol 41:1763–1765

    Article  Google Scholar 

  • Herrmann W, Ecker D, Quast S, Klieden M, Rose S, Marzi I (2000) Comparison of procalcitonin, sCD14 and interleukin-6 values in septic patients. Clin Chem Lab Med 38:41–46

    Article  CAS  PubMed  Google Scholar 

  • Hirakata Y, Yanagihara K, Kurihara S, Izumikawa K, Seki M, Miyazaki Y, Kohno S (2008) Comparison of usefulness of plasma procalcitonin and C-reactive protein measurements for estimation of severity in adults with community-acquired pneumonia. Diagn Microbiol Infect Dis 61:170–174

    Article  CAS  PubMed  Google Scholar 

  • Ip M, Rainer TH, Lee N, Chan C, Chau SS, Leung W, Leung MF, Tam TK, Antonio GE, Lui G, Lau TK, Hui DS, Fuchs D, Renneberg R, Chan PK (2007) Value of serum procalcitonin, neopterin and C-reactive protein in differentiating bacterial from viral etiologies in patients presenting with lower respiratory tract infections. Diagn Microbiol Infect Dis 59:131–136

    Article  CAS  PubMed  Google Scholar 

  • Jeschke MG, Finnerty CC, Kulp GA, Kraft R, Herndon DN (2013) Can we use C-reactive protein levels to predict severe infection or sepsis in severely burned patients? Int J Burn Trauma 3:137–143

    CAS  Google Scholar 

  • Jordana-Lluch E, Carolan HE, Giménez M, Sampath R, Ecker DJ, Quesada MD, Mòdol JM, Arméstar F, Blyn LB, Cummins LL, Ausina V, Martró E (2013) Rapid diagnosis of bloodstream infections with PCR followed by mass spectrometry. PLoS ONE 8:e62108

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  • Kocabas E, Sarıkçıoglu A, Aksaray N, Seydaoglu G, Seyhun Y, Yaman A (2007) Role of procalcitonin, C-reactive protein, interleukin-6, interleukin-8 and tumor necrosis factor-α in the diagnosis of neonatal sepsis. Turk J Pediatr 49:7–20

    PubMed  Google Scholar 

  • Koeze J, Hendrix MG, van den Bergh FA, Brouwer RM, Zijlstra JG (2011) In critically ill patients the procalcitonin level can be misleading. Crit Care 15:422

    Article  PubMed Central  PubMed  Google Scholar 

  • Kuhn C, Disque C, Muhl H, Orszag P, Stiesch M, Haverich A (2011) Evaluation of commercial universal rRNA gene PCR plus sequencing tests for identification of bacteria and fungi associated with infectious endocarditis. J Clin Microbiol 49:2919–2923

    Article  PubMed Central  PubMed  Google Scholar 

  • Kurihara T, Yanagida A, Yokoi H, Koyata A, Matsuya T, Ogawa J, Okamura Y, Miyamoto D (2008) Evaluation of cardiac assays on a benchtop chemiluminescent enzyme immunoassay analyzer, PATHFAST. Anal Biochem 375:144–146

    Article  CAS  PubMed  Google Scholar 

  • Landmann R, Reber AM, Sansano S, Zimmerli W (1996) Function of soluble CD14 in serum from patients with septic shock. J Infect Dis 173:661–668

    Article  CAS  PubMed  Google Scholar 

  • Levy MM, Fink MP, Marshall JC, Abraham E, Angus D, Cook D, Cohen J, Opal SM, Vincent JL, Ramsay G, SCCM/ESICM/ACCP/ATS/SIS (2003) 2001 SCCM/ESICM/ACCP/ATS/SIS International Sepsis Definitions Conference. Crit Care Med 31:1250–1256

    Article  PubMed  Google Scholar 

  • Mancini N, Carletti S, Ghidoli N, Cichero P, Burioni R, Clementi M (2010) The era of molecular and other non-culture-based methods in diagnosis of sepsis. Clin Microbiol Rev 23:235–251

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  • Ng PC, Li G, Chui KM, Chu WC, Li K, Wong RP, Chik KW, Wong E, Fok TF (2004) Neutrophil CD64 is a sensitive diagnostic marker for early-onset neonatal infection. Pediatr Res 56:796–803

    Article  CAS  PubMed  Google Scholar 

  • Oppegaard O, Skodvin B, Halse AK, Langeland N (2013) CD64 as a potential biomarker in septic arthritis. BMC Infect Dis 19:278–285

    Article  Google Scholar 

  • Palmiere C, Mussap M, Bardy D, Cibecchini F, Mangin P (2013) Diagnostic value of soluble CD14 subtype (sCD14-ST) presepsin for the postmortem diagnosis of sepsis-related fatalities. Int J Legal Med 127:799–808

    Article  PubMed  Google Scholar 

  • Prashant A, Vishwanath P, Kulkarni P, Sathya Narayana P, Gowdara V, Nataraj SM, Nagaraj R (2013) Comparative assessment of cytokines and other inflammatory markers for the early diagnosis of neonatal sepsis—a case control study. PLoS ONE 8:e68426

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  • Qureshi SS, Lewis SM, Gant VA, Treacher D, Davis BH, Brown KA (2001) Increased distribution and expression of CD64 on blood polymorphonuclear cells from patients with systemic inflammatory response syndrome (SIRS). Clin Exp Immunol 125:258–265

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  • Reinhart K, Bauer M, Riedemann NC, Hartog CS (2012) New approaches to sepsis: molecular diagnostics and biomarkers. Clin Microbiol Rev 25:609–634

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  • Schuetz P, Maurer P, Punjabi V, Desai A, Amin DN, Gluck E (2013) Procalcitonin decrease over 72 hours in US critical care units predicts fatal outcome in sepsis patients. Crit Care 17:R115

    Article  PubMed Central  PubMed  Google Scholar 

  • Shozushima T, Takahashi G, Matsumoto N, Kojika M, Okamura Y, Endo S (2011) Usefulness of presepsin (sCD14-ST) measurements as a marker for the diagnosis and severity of sepsis that satisfied diagnostic criteria of systemic inflammatory response syndrome. J Infect Chemother 17:764–769

    Article  CAS  PubMed  Google Scholar 

  • Simon L, Gauvin F, Amre DK, Saint-Louis P, Lacroix J (2004) Serum procalcitonin and C-reactive protein levels as markers of bacterial infection: a systematic review and meta-analysis. Clin Infect Dis 39:206–217

    Article  CAS  PubMed  Google Scholar 

  • Skvarc M, Stubljar D, Rogina P, Kaasch AJ (2013) Non-culture-based methods to diagnose bloodstream infection: Does it work? Eur J Microbiol Immunol 3:97–104

    Article  Google Scholar 

  • Spanuth E, Wilhelm J, Loppnow H, Ebelt H, Ivandic B, Werdan K (2012) Diagnostic and prognostic value of presepsin (soluble CD14 subtype) in emergency patients with early sepsis using the new assay PATHFAST presepsin. In: Renz H, Tauber R (eds) Advances in Clinical Chemistry and Laboratory Medicine. De Gruyer, Boston, pp 128–133

    Google Scholar 

  • Stubljar D, Rogina P, Skvarc M, Pavlovic A (2013) Diagnostic accuracy of sCD14 (presepsin) is comparable to procalcitonin (PCT) for the diagnosis of bacterial infections in critically ill patients. ECCMID 2013, Berlin. http://registration.akm.ch/einsicht_iframe.php?XNABSTRACT_ID=162896&XNSPRACHE_ID=2&XNKONGRESS_ID=180&XNMASKEN_ID=900. Accessed 4 September 2014.

  • Thorgersen EB, Pischke SE, Barratt-Due A, Fure H, Lindstad JK, Pharo A, Hellerud BC, Mollnes TE (2013) Systemic CD14 inhibition attenuates organ inflammation in porcine Escherichia coli sepsis. Infect Immun 81:3173–3181

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  • Ulla M, Pizzolato E, Lucchiari M, Loiacono M, Soardo F, Forno D, Morello F, Lupia E, Moiraghi C, Mengozzi G, Battista S (2013) Diagnostic and prognostic value of presepsin in the management of sepsis in the emergency department: a multicentre prospective study. Crit Care 17:R168

    Article  PubMed Central  PubMed  Google Scholar 

  • Wellinghausen N, Kochem AJ, Disqué C, Mühl H, Gebert S, Winter J, Matten J, Sakka SG (2009) Diagnosis of bacteremia in whole-blood samples by use of a commercial universal 16S rRNA gene-based PCR and sequence analysis. J Clin Microbiol 47:2759–2765

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  • Wong HR, Salisbury S, Xiao Q, Cvijanovich NZ, Hall M, Allen GL, Thomas NJ, Freishtat RJ, Anas N, Meyer K, Checchia PA, Lin R, Shanley TP, Bigham MT, Sen A, Nowak J, Quasney M, Henricksen JW, Chopra A, Banschbach S, Beckman E, Harmon K, Lahni P, Lindsell CJ (2012) The pediatric sepsis biomarker risk model. Crit Care 16:R174

    Article  PubMed Central  PubMed  Google Scholar 

  • Yaegashi Y, Shirakawa K, Sato N, Suzuki Y, Kojika M, Imai S, Takahashi G, Miyata M, Furusako S, Endo S (2005) Evaluation of a newly identified soluble CD14 subtype as a marker for sepsis. J Infect Chemother 11:234–238

    Article  CAS  PubMed  Google Scholar 

Download references

Conflict of interest

There was no conflict of interests.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to David Stubljar.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Stubljar, D., Skvarc, M. Expression of CD64 on neutrophils can be used to predict the severity of bloodstream infection before broad range 16S rRNA PCR. Folia Microbiol 60, 111–118 (2015). https://doi.org/10.1007/s12223-014-0346-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12223-014-0346-y

Keywords

Navigation