T lymphocyte immunophenotype as a diagnostic marker of late-onset neonatal sepsis
Given the high risks associated with neonatal sepsis, there is a need for a diagnostic marker that would predict the disease before the results of blood or cerebrospinal fluid cultures are available. We evaluated changes in the CD4+ T lymphocyte immunophenotype in neonates with late-onset sepsis to...
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Published in | Anales de pediatría (Barcelona, Spain : 2003) Vol. 67; no. 6; pp. 536 - 543 |
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Main Authors | , , , |
Format | Journal Article |
Language | Spanish |
Published |
Spain
01.12.2007
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Subjects | |
Online Access | Get full text |
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Summary: | Given the high risks associated with neonatal sepsis, there is a need for a diagnostic marker that would predict the disease before the results of blood or cerebrospinal fluid cultures are available. We evaluated changes in the CD4+ T lymphocyte immunophenotype in neonates with late-onset sepsis to try to improve the test combinations currently used (C reactive protein, immature:total neutrophil ratio, leukocytosis).
We performed a prospective cohort study in 24 neonates with late-onset sepsis and 48 non-infected controls with a gestational age of 37 weeks or less. CD4+ T lymphocyte subpopulations in peripheral blood samples were identified by labeling with monoclonal antibodies and quantified by flow cytometry. Diagnostic performance curves were constructed by logistic regression.
As a marker of late-onset neonatal sepsis, a percentage of CD4+/CD45RO+/CD45RA- T lymphocytes of >3.5% showed a sensitivity of 94.1%, specificity of 69.2%, positive predictive value of 80.0%, negative predictive value of 90.0%, and odds ratio of 36.0 (p<0.001). When we combined this marker with a C-reactive protein level of >10.0 mg/L, the specificity of this combination of tests increased to 94.7% and the positive predictive value to 85.7%.
A percentage of CD4+/CD45RO+/CD45RA- T lymphocytes of >3.5% is an effective indicator of late-onset neonatal sepsis in preterm infants. If this marker is combined with a C-reactive protein level of >10.0 mg/l, its diagnostic performance is improved. |
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Bibliography: | ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Feature-1 content type line 23 |
ISSN: | 1695-4033 1695-9531 |