| Background: Neonatal sepsis is a life threatening disease with an incidence
of 3.5 to 8 cases per 1,000 live births; and mortality rate 16 to 30%.
Cytokines, produced by monocytes, macrophages, and endothelial cells in
response to infectious stimuli are important proinflammatory mediators in
the early phases of the sepsis syndrome. Elevated serum levels of
interleukin-6 (IL-6) had been found in both neonatal and adult sepsis.
However, for neonatal sepsis, little is known about a group of molecules
playing a central role in the innate immune system. Among them is the
neutrophil CD64 which is expressed on neutrophil surface in many
inflammatory conditions.
Objective: To study the neutrophil CD64 expression in neonates with early
onset sepsis and its relation to other laboratory markers as IL6, CRP, total
leucocytic count and platelet count.
Methods: This study comprised 30 neonates with a gestational age of 28 to
40 weeks with a picture of early onset neonatal sepsis within 48 hours of life
admitted to neonatal care unit, Suzan Mubarak Hospital, El-Minia
University, Egypt during the period from February, 2008 to January, 2009
and 20 healthy neonates age and sex matched as a control group. Neutrophil
surface expression of CD64 was quantified with flow cytometry. We
measured plasma IL6, C-reactive protein, complete blood count and blood
culture.
Results: Neutrophil CD64 expression was increased significantly in
neonates with neonatal sepsis than controls (p=0.001). Cases with history of
premature rupture of membranes (PROM) ?48 hours, with positive blood
culture or poor outcome had the highest levels of neutrophil CD64
expression (528±50.7, 558±58.4 and 560.9±43.9 relative fluorescence units
(RFU) respectively). A significant positive correlation was found between
CD64 levels and the levels of IL6 (r=0.71, p=0.001),C-reactive protein
(r=0.74, p=0.001) and total leucocytic count (r=0.76 ,p=0.01) and negative
correlation with gestational age (r=-0.92, p=0.001) and body weight (r=-
0.92, p=0.006), but there was no correlation between it and platelet count
(r=-0.32, p=0.08).
Conclusion: Neutrophil CD64 expression is increased in neonates with
early-onset neonatal sepsis and correlated well with other laboratory
markers of sepsis. |