Quantitative measurement of monocyte HLA-DR expression in the identification of early-onset neonatal infection.

Biology of the neonate Pub Date : 2006-01-01 Epub Date: 2005-09-12 DOI:10.1159/000088288
Pak Cheung Ng, Geng Li, Kit Man Chui, Winnie Chiu Wing Chu, Karen Li, Raymond Pui On Wong, Tai Fai Fok
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引用次数: 42

Abstract

Background: This study aimed to evaluate the diagnostic utilities of monocyte HLA-DR as an infection marker in the identification of early-onset clinical infection and pneumonia in newborn infants.

Methods: Term newborns in whom infection was suspected when they were <72 h of age were eligible for enrollment in the study. C-reactive protein (CRP), monocyte HLA-DR and neutrophil CD64 expressions were quantitatively measured at the time of sepsis evaluation (0 h) and 24 h afterwards by flow cytometry and standard laboratory method.

Results: A total of 288 infants with suspected sepsis were investigated, and 93 were found to be clinically infected. There were no significant differences in monocyte HLA-DR expression between the infected, non-infected and control groups at 0 h (median (interquartile range): 13,986 (10,994-18,544), 14,234 (12,045-17,474) and 18,441 (14,250-21,537) antibody phycoerythrin (PE) molecules bound/cell), and between infected and non-infected infants at 24 h (median (interquartile range): 17,772 (12,933-25,167) and 19,406 (14,885-24,225) antibody PE molecules bound/cell). The areas under the receiver operating characteristics (ROC) curves for HLA-DR, CD64 and CRP were 0.52-0.54, 0.88-0.94 and 0.75-0.77, respectively. We were unable to determine an optimal cutoff value for HLA-DR, as the diagnostic utilities of any cutoff point on the ROC curves were unable to satisfy the criteria (i.e. sensitivity and specificity >or=80%) for consideration as an useful diagnostic marker of infection.

Conclusions: Our findings did not support the use of monocyte HLA-DR alone or in combination with other infection markers in the diagnosis of early-onset clinical infection and pneumonia in term newborns.

单核细胞HLA-DR表达在早期新生儿感染鉴定中的定量测定。
背景:本研究旨在评估单核细胞HLA-DR作为一种感染标志物在新生儿早发性临床感染和肺炎诊断中的应用价值。结果:共调查疑似脓毒症患儿288例,其中临床感染93例。感染、非感染和对照组之间单核细胞HLA-DR表达在0小时(中位数(四分位数范围):13,986(10,994-18,544)、14,234(12,045-17,474)和18,441(14,250-21,537)抗体藻红蛋白(PE)分子结合/细胞)以及感染和非感染婴儿之间24小时(中位数(四分位数范围):17,772(12,933-25,167)和19,406(14,885-24,225)抗体PE分子结合/细胞)无显著差异。HLA-DR、CD64、CRP的受试者工作特征曲线下面积分别为0.52 ~ 0.54、0.88 ~ 0.94、0.75 ~ 0.77。我们无法确定HLA-DR的最佳截断值,因为ROC曲线上任何截断点的诊断效用都不能满足标准(即灵敏度和特异性>或=80%),不能作为有用的感染诊断标志物。结论:我们的研究结果不支持单独使用单核细胞HLA-DR或与其他感染标志物联合用于足月新生儿早发性临床感染和肺炎的诊断。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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