Prospective Comparison of Neutrophil CD64, C-reactive protein and Procalcitonin in the identification of ICU sepsis-3

Lipeng Wang¹, Limei Yu¹, Weijuan Yu¹, Xiaohui Zhan², Xinying Lv¹, Maoli Yi¹, Jinying Wu¹, Chengming Sun¹, Lei Chen^{1, *}

¹Department of Laboratory Medicine, Yantai Yuhuangding Hospital, Yantai, China - ²Department of Intensive Care Unit, Yantai Yuhuangding Hospital, Yantai, China

Introduction: In the middle income country China, we performed a prospective study aimed at evaluating the individual and combined diagnostic accuracy of PCT, CRP and neutrophil CD64 expression for differential diagnosis of sepsis-3 in critically ill patients at the time of ICU admission.

Materials and methods: We analyzed the CRP and PCT concentrations from 66 patients with sepsis and 24 non-septic ICU controls according to sepsis-3. In addition, CD64 on neutrophils was measured using quantitative flow cytometry.

Results: The sensitivity values of CD64, CRP and PCT were 77.27% (95% CI, 65.00–86.32), 87.88% (95% CI, 76.96-94.25) and 65.15% (95% CI, 52.34–76.19), respectively, and the specificity values were 91.67% (95% CI, 71.53-98.54), 58.33% (95% CI, 36.94-77.20) and 87.50% (95% CI, 66.54-96.71), respectively. The efficiency of various combinations of tests was also evaluated; the combination of PCT and CD64 in parallel testing balanced the sensitivity (84.85%) and specificity (83.33%) well and had the maximum Youden index (0.682). 

Conclusion: Our data supported the potential of CD64, either alone or in combination with CRP/PCT, for routine clinical diagnosis of sepsis-3 in ICU populations in China.