Flow Cytometry in the Detection of Neonatal Sepsis

Published on Feb 3, 2013in International Journal of Pediatrics
· DOI :10.1155/2013/763191
Volker N. Umlauf1
Estimated H-index: 1
(Boston Children's Hospital),
Stephan Dreschers7
Estimated H-index: 7
,
Thorsten W. Orlikowsky16
Estimated H-index: 16
Sources
Abstract
Neonatal sepsis remains a burden problem by showing minimal initial symptoms of subtle character, nonspecific manifestation, and diagnostic pitfalls. The clinical course can be fulminant and fatal if treatment is not commenced promptly. It is therefore crucial to establish early diagnosis and initiate adequate therapy. Besides clinical symptoms, the most reliable laboratory markers in establishing diagnosis is currently the combined measurement of CRP and a cytokine (IL-6 and IL-8). Due to their different kinetics, a diagnostic gap might occur and thus withholding antimicrobial therapy in clinical suspicion of infection is not acceptable. We therefore need parameters which unerringly differentiate between infants in need for antimicrobial therapy and those who are not. Flow cytometry promises to be a useful tool in this field, allowing the determination of different cellular, dissolved, and functional pathophysiological components of sepsis. Despite technical and methodical advances in flow cytometry, its use in clinical routine is still limited. Advantages and disadvantages of promising new parameters in diagnosis of sepsis performed by flow cytometry, particularly CD64, HLA-DR, and apoptosis, are reviewed here. The necessity of tests to be used as an “ideal” parameter is presented.
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Newest
#1Sushant Soni (UCMS: University College of Medical Sciences)H-Index: 4
#2Neelam WadhwaH-Index: 8
Last. Saroj SinghH-Index: 7
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Background: Enhanced neutrophil CD64 (nCD64) expression is likely to be useful in diagnosis of neonatal sepsis. This study evaluated the diagnostic efficacy of nCD64 expression as an early indicator of neonatal sepsis. Methods: Sixty neonates (culture positive, 24; negative, 36) with suspected sepsis and 30 controls were studied prospectively. CD64 expression was evaluated flow cytometrically on neutrophils and monocytes. Mean and median nCD64 expression, mean and median monocyte CD64/nCD64 (M/N...
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Rationale: Although the outcome of sepsis benefits from the prompt administration of appropriate antibiotics on correct diagnosis, the assessmentofinfectionincriticallyillpatientsisoftenachallengefor clinicians. Inthissetting,simple biomarkers, especiallywhenusedin combination, could prove useful. Objectives: To determine the usefulness of combination biomarkers to diagnose sepsis. Methods: Three hundred consecutive patients were enrolled to construct a biologic score that was next validated in ...
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#1Iris Streimish (Yale University)H-Index: 3
#2Matthew J. BizzarroH-Index: 29
Last. Vineet BhandariH-Index: 59
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We assessed neutrophil CD64 as a diagnostic marker for neonatal sepsis. For early-onset sepsis, the CD64 index with a cut-point value of 2.38 had sensitivity, specificity and a negative predictive values of 100%, 68%, and 100%, respectively. For late-onset sepsis, the respective values were 3.62, 75%, 77%, and 96%. Neutrophil CD64 index can be incorporated as a valuable marker for excluding neonatal sepsis.
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#1Efthalia HotouraH-Index: 5
#2Vasileios GiaprosH-Index: 16
Last. Styliani AndronikouH-Index: 19
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The aim of this study is to investigate prospectively specific immune system factors in preterm neonates with late-onset sepsis and infection-free controls. Matched preterm neonates (n = 82) were divided into three groups: suspected infection (n = 25), sepsis (n = 17), and infection-free controls (n = 40). Serial measurements were made of interleukin-6 (IL-6), IL-1β, tumor necrosis factor-α (TNF-α), lymphocyte subsets [CD3+, CD4+, CD8+, natural killer (NK) cells, and B cells], the immunoglobulin...
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#1Ying Fan (CQMU: Chongqing Medical University)H-Index: 1
Background Since the 1990s, finding the most efficient markers or combinations as predictors of early-onset neonatal sepsis has been the hot topic of studies. But there is no review of such biomarkers detected in umbilical blood at birth. By comparing clinical values of common inflammatory markers detected in cord blood shortly after birth, in this study we tried to find the most performing one or the most efficient combination that might be potentially used in birth room, as the earliest predic...
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#1Christian Gille (Boston Children's Hospital)H-Index: 17
#2Thorsten Orlikowsky (RWTH Aachen University)H-Index: 14
Last. Maya C. André (Boston Children's Hospital)H-Index: 17
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Abstract Trials of immune-modulating drugs in septic patients have mostly failed to demonstrate clinical efficacy. Thus, we sought to generate a surrogate model of myelomonocytic lineage differentiation that would potentially allow sepsis induction and preclinical testing of anti-inflammatory drugs. Comparing transplantation of cord blood–derived stem cells in neonatal NOD/SCID/IL2Rγ null (neonatal huNSG) mice with transplantation of adult peripheral mobilized stem cells into adult NSG (adult hu...
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#1Alan Leviton (Boston Children's Hospital)H-Index: 92
#2T. Michael O'Shea (Wake Forest University)H-Index: 57
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Aim: To compare the frequency of elevated concentrations of inflammation-related proteins in the blood of infants born before the 28th week of gestation who had documented bacteraemia and those who had presumed (antibiotic-treated but culture-negative) bacteraemia to those who had neither. Methods: The subjects of this study are the 868 infants born at 14 institutions for whom information about protein measurements on at least two of the three protocol days (days 1, 7, and 14) was available and ...
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#1Ferah Genel (Boston Children's Hospital)H-Index: 18
#2Füsun Atlihan (Boston Children's Hospital)H-Index: 10
Last. Ozlem Cengel Yurdun (Boston Children's Hospital)H-Index: 1
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Background This study was undertaken to assess the value of neutrophils CD11b, CD64, and CD62L for the early diagnosis of neonatal infection.
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#1Young Kwang Choo (Kangwon National University)H-Index: 1
#2Hyun-Seok Cho (Kangwon National University)H-Index: 3
Last. Hyeon-Soo Lee (Kangwon National University)H-Index: 4
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Purpose Early identification of neonatal sepsis is a global issue because of limitations in diagnostic procedures. The objective of this study was to compare the diagnostic accuracy of neutrophil CD64 and C-reactive protein (CRP) as a single test for the early detection of neonatal sepsis.
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#1Laura L. Raynor (UVA: University of Virginia)H-Index: 2
#2Jeffrey J. Saucerman (UVA: University of Virginia)H-Index: 29
Last. Karen D. Fairchild (UVA: University of Virginia)H-Index: 32
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Infants in the neonatal intensive care unit (NICU) are highly susceptible to late-onset sepsis, with rates as high as 25% among preterm very-low-birth-weight infants. This is an important public health problem because mortality and morbidity are substantial (1), and survivors are at increased risk for neurodevelopmental impairment (2). The standard paradigm for diagnosing and treating late-onset sepsis is to perform a blood culture and initiate empiric two-antibiotic therapy after an infant disp...
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Background. Sepsis is a critical medical condition that requires additional diagnostic considerations. Recently, focus has shifted to the diagnosis of sepsis using new markers to overcome the limitations of traditional laboratory diagnostic modalities. Neutrophil CD11b (nCD11b) and monocyteCD14 (mCD14) cell surface antigens have been shown to be useful in such diagnostic consideration. Aim. To investigate the diagnostic, monitoring, prognostic, and predictive roles of nCD11b and mCD14 as sepsis ...
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#1Brandon K. Ashley (RU: Rutgers University)H-Index: 3
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Sepsis is responsible for the highest economic and mortality burden in critical care settings around the world, prompting the World Health Organization in 2018 to designate it as a global health priority. Despite its high universal prevalence and mortality rate, a disproportionately low amount of sponsored research funding is directed toward diagnosis and treatment of sepsis, when early treatment has been shown to significantly improve survival. Additionally, current technologies and methods are...
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#1Brandon K. Ashley (RU: Rutgers University)H-Index: 3
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Hybrid material surfaces on microparticles are emerging as vehicles for many biomedical multiplexing applications. Functionalization of these hybrid surface microparticles to biomolecules presents unique challenges related to optimization of surface chemistries including uniformity, repeatability, and sample sparring. Hybrid interfaces between microlevel surfaces and individual biomolecules will provide different microenvironments impacting the surface functionalization optimization and efficien...
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#2Rania M. Abdel Halim (Ain Shams University)H-Index: 4
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Background. Neonatal septicemia is a critical medical situation; current conventional laboratory methods still have many limitations and diagnostic obstacles. For this purpose, last decades have witnessed a challenge between the battery of sepsis biomarkers including many leukocyte surface antigens, not only for early diagnostic purposes but also for better follow-up and good management of sepsis patients. Aim. To evaluate the diagnostic, prognostic, and monitoring performance of both neutrophil...
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#1Heba E. Hashem (Ain Shams University)H-Index: 7
#2Sherin A. El Masry (Ain Shams University)H-Index: 2
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Background Neonatal sepsis (NS) is a very critical medical situation associated with high morbidities and mortalities. There is an utmost need for a new tool helping in early diagnosis and proper management of sepsis neonates. Neutrophil CD64 (nCD64) shows a very promising value in this concerning issue. Aim Evaluate the diagnostic, monitoring, and prognostic performances of nCD64 and highly sensitive CRP (hs-CRP) in NS as well as the possible best panel of biomarkers that can achieve the most d...
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#4Christophe Garcia (UIUC: University of Illinois at Urbana–Champaign)H-Index: 196
: Sepsis, a life-threatening organ dysfunction caused by a dysregulated host response, leads the U.S in both mortality rate and cost of treatment. Sepsis treatment protocols currently rely on broad and non-specific parameters like heart and respiration rate, and temperature; however, studies show that biomarkers Interlukin-6 (IL-6) and Procalcitonin (PCT) correlate to sepsis progression and response to treatment. Prior work also suggests that using multi-parameter predictive analytics with bioma...
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Multiplexing allows quantifying multiple analytes in a single step, providing advantages over individual testing through shorter processing time, lower sample volume, and reduced cost per test. Currently, flow cytometry is the gold standard for biomedical multiplexing, but requires technical training, extensive data processing, and expensive operational and capital costs. To solve this challenge, we designed digital barcoded particles and a microfluidic architecture for multiplexed analyte quant...
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The CD64 receptor has been described as an interesting bacterial infection biomarker. Its expression has not been studied in previously healthy children admitted to pediatric critical care unit (PICU). Our objective was firstly to describe the CD64 expression and secondly study its diagnostic accuracy to discriminate bacterial versus viral infection in this children. We made a prospective double-blind observational study (March 2016–February 2018). A flow cytometry (FC) was done from peripheral ...
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