Diagnostic and prognostic utility of neutrophil CD64 and monocyte HLA-DR in adult sepsis patients.

AIM: To evaluate the diagnostic and prognostic accuracy of nCD64, mHLA-DR and sepsis Index (SI), ratio of nCD64 and mHLA-DR, in patients with sepsis. METHODS: Prospective observational study was undertaken among 50 cases diagnosed with sepsis, 25 non-septic patients, and 25 healthy individuals as controls. Participants underwent flowcytometric estimation of nCD64 and mHLA-DR on the day of admission. RESULTS: The sepsis cohort had significantly higher nCD64 and lower mHLA-DR expression than both control groups (p-value: < 0.001). The sensitivity and specificity of nCD64 ABC (Antibodies Bound per Cell) for diagnosis of sepsis with a cut-off of 1152.16 was 94% and 74%, respectively. Similarly, for the Sepsis Index (cutoff-11.36), the sensitivity and specificity for the diagnosis of sepsis were 88% and 86%, respectively. The combination of sepsis index or CD64 (either positive) increased the sensitivity to 96%. Using the combination of all three markers (nCD64 ABC, mHLA-DR ABC, and SI), the sensitivity for diagnosis of sepsis approached 100%. Among flow cytometric variables, the sepsis index had a statistically significant association with hospital mortality on univariate analysis. However, overall, only the baseline SOFA score was independently associated with hospital mortality. CONCLUSION: nCD64 and sepsis index are good diagnostic markers in patients with sepsis.