Rev Esp Quimioter 2018; 31(6): 493-498

CD64 index as a marker of infection in patients with postoperative fever

NATALIA VICENTE LÓPEZ, RAFAEL FORÉS CACHÓN, REYES IRANZO VALERO, ANA LERMA VERDEJO, ELENA MÚÑEZ RUBIO, ANA ROYUELA VICENTE, ANTONIO RAMOS MARTÍNEZ

Objective. To evaluate the utility of the granulocyte CD64 index as a marker of infection in patients with postoperative fever.
Methods. Prospective observational study of a cohort of patients with postoperative fever (2nd-21st day after the intervention) collected during 14 months. Obtaining blood samples during the first 24 hours after the febrile peak to determine the CD64 index (ratio of fluorescence intensity, measured, in the granulocytes of the patient with respect to healthy controls), procalcitonin and C-reactive protein (CRP).
Results. During the study period, 50 patients were included, 28 patients (56%) with infection and 22 patients (44%) without evidence of infection. The PCR, procalcitonin and the CD64 index showed significantly higher values in the group of patients who suffered infection. The CD64 index showed a sensitivity of 88.9%, with a specificity of 65.2%. The positive predictive value (PPV) was 75% and the negative predictive value (NPV) was 83.3%, with an area under the curve (AUC) of 0.805 (95% CI 0.68-0.93). Procalcitonin presented a sensitivity of 53.9% and specificity of 86.4%, with NPV and PPV of 82.4% and 61.3% respectively, with AUC of 0.752 (95% CI 0.61-0.89). Regarding the PCR, it showed a sensitivity of 100%, with specificity of 4.4% with an area under the curve of 0.676 (95% CI 0.52-0.83).
Conclusions. The quantification of the CD64 index in patients who develop fever in the early postoperative period is useful to distinguish post-surgical inflammatory phenomena from episodes of established infection.

Rev Esp Quimioter 2018; 31(6): 493-498.  [Texto completo PDF]