Could CD64 expression be used as a predictor of positive culture results in children with febrile neutropenia?
Rev Bras Hematol Hemoter
; 37(6): 395-9, 2015.
Article
em En
| MEDLINE
| ID: mdl-26670402
BACKGROUND: Early recognition of infectious processes in neutropenic patients is hampered by the fact that these processes may have dissimilar and non-specific clinical presentations. CD64 is a neutrophil surface marker that is not expressed in non-sensitized neutrophils. When the neutrophil is exposed to tumor necrosis factor-alpha it is activated and is measured via the CD64 index. METHODS: This paper evaluated the relationship between the index value of CD64 on the first day of febrile neutropenia and a positive blood culture. The correlations with white blood count, C-reactive protein and erythrocyte sedimentation rate were also evaluated. This case-control, prospective, diagnostic study included 64 episodes of neutropenia. Case group (n=14) comprised positive blood cultures, and the control group (n=50), negative blood cultures. RESULTS: The median rates of CD64 were 2.1 (σ±3.9) in the case group and 1.76 (σ±5.02) in the control group. There was no correlation between the value of the CD64 index and blood cultures. The CD64 index was also not correlated with C-reactive protein positivity. Furthermore, the CD64 index was not able to predict blood culture positivity. The sensitivity was 64.3%, the specificity was 42%, the positive predictive value was 23.7% and the negative predictive value was 80%. For C-reactive protein, the sensitivity, specificity, positive predictive value, and negative predictive value were 71.4%, 32%, 22.7%, and 80%, respectively. CONCLUSION: The CD64 index is not suitable for predicting the positivity of blood cultures in this specific population of patients with febrile neutropenia.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Tipo de estudo:
Prognostic_studies
/
Risk_factors_studies
Idioma:
En
Revista:
Rev Bras Hematol Hemoter
Ano de publicação:
2015
Tipo de documento:
Article
País de publicação:
Brasil