Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2016 Feb;84(2):175-80.
doi: 10.1016/j.diagmicrobio.2015.10.003. Epub 2015 Oct 9.

Diagnostic accuracy and clinical relevance of an inflammatory biomarker panel for sepsis in adult critically ill patients

Philippe R Bauer  1 , Rahul Kashyap  2 , Stacy C League  3 , John G Park  4 , Darci R Block  5 , Nikola A Baumann  6 , Alicia Algeciras-Schimnich  7 , Sarah M Jenkins  8 , Carin Y Smith  9 , Ognjen Gajic  10 , Roshini S Abraham  11
Affiliations

Diagnostic accuracy and clinical relevance of an inflammatory biomarker panel for sepsis in adult critically ill patients

Philippe R Bauer et al. Diagn Microbiol Infect Dis. 2016 Feb.

Abstract

The objective of this study was to assess the diagnostic accuracy of C-reactive protein (CRP), procalcitonin (PCT), and cellular immune markers levels in sepsis. This was a prospective observational study in adult intensive care unit (ICU) patients, between 2012 and 2014. The 8-color flow cytometric biomarker panel included CD64, CD163, and HLA-DR. Index test results were compared with sepsis, using receiver operating characteristic curve analyses. Multivariate logistic regression assessed the relationship of sets of markers with the probability of sepsis. Of 219 enrolled patients, 120 had sepsis. C-statistic was the highest for CRP (0.86) followed by neutrophil CD64 expression (0.83), procalcitonin (0.82), and Acute Physiology and Chronic Health Evaluation (APACHE) IV (0.72). After adjustment for APACHE IV, the combination of CRP, PCT, and neutrophil CD64 measure remained a significant predictor of sepsis with an excellent AUC (0.90). In a targeted ICU population at increased risk of sepsis, CRP, PCT, and neutrophil CD64 combined improve the diagnostic accuracy of sepsis.

Keywords: C-reactive protein; CD64; Procalcitonin; Sensitivity and specificity; Sepsis; Study of diagnostic accuracy.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Flow diagram for screening and eligibility (sepsis was defined by 2 or more SIRS criteria and suspected or present source of infection and included sepsis, severe sepsis and septic shock criteria)
Figure 2
Figure 2
Neutrophil CD64 expression [log scale] and sepsis. Note the reference line at the cutoff (1040.5 molecules/neutrophil)
See this image and copyright information in PMC

References

    1. Martin GS, Mannino DM, Eaton S, Moss M. The epidemiology of sepsis in the United States from 1979 through 2000. N Engl J Med. 2003;348:1546–1554. - PubMed
    1. Vincent JL, Rello J, Marshall J, et al. EPIC II Group of Investigators International study of the prevalence and outcomes of infection in intensive care units. JAMA. 2009;302:2323–2329. - PubMed
    1. Kaukonen KM, Bailey M, Suzuki S, Pilcher D, Bellomo R. Mortality Related to Severe Sepsis and Septic Shock Among Critically Ill Patients in Australia and New Zealand, 2000-2012. JAMA. 2014;311:1308–1316. - PubMed
    1. Reinhart K, Daniels R, Kissoon N, O'Brien J, Machado FR, Jimenez E, GSA Executive Board and WSD Executive Board The burden of sepsis-a call to action in support of World Sepsis Day 2013. J Crit Care. 2013;28:526–528. - PubMed
    1. Simon L, Gauvin F, Amre DK, Saint-Louis P, Lacroix J. Serum procalcitonin and C-reactive protein levels as markers of bacterial infection: a systematic review and meta-analysis. Clin Infect Dis. 2004;39:206–217. - PubMed

Publication types

MeSH terms