Diagnostic accuracy and prognostic value of the CD64 index in very low birth weight neonates as a marker of early-onset sepsis

Objective: To assess the diagnostic and prognostic utility of CD64 expression as a marker of early-onset sepsis (EOS) in very low birth weight (VLBW) neonates. Methods: Neutrophil CD64 expression (CD64 index) was assessed in 129 VLBW neonates within 72 h after birth. The accuracy of the CD64 index in predicting EOS was determined by receiver operating characteristic curve analysis. The relationship between the expression of the CD64 index and neonatal outcomes was evaluated by multivariate analysis. Results: The highest performance of the CD64 index was achieved at 24 h after birth; accuracy, sensitivity, and negative predictive values were 0.85, 0.89, and 0.99, respectively, with a cut-off value of 2.4. The increased expression of CD64 index was significantly associated with subsequent infections (relative risk 1.54; 95% confidence interval 1.02-2.33). Conclusions: The CD64 index could be used as a reliable marker of EOS in VLBW neonates and it is an independent risk factor for late-onset infections.