EVALUATION OF CD64 DETECTION ON NEUTROPHILS AND TLR-2 ON MONOCYTES BY FLOWCYTOMETRY AS MARKERS FOR EARLY DIAGNOSIS OF NEONATAL SEPSIS

Neonatal sepsis remains one of the main causes of neonatal mortality.Early diagnosis and treatment of neonatal sepsis may help to decrease neonatal mortality. However,blood culture results are not available for 48 hours. A reliable marker or set of markers is required for prompt identification of neonatal sepsis.CD64 expression on neutrophilsisup regulated within six hours after their activation. Quantitation of the neutrophil CD64 is a candidate for evaluation as a sensitive and specific indicator. Another proposed marker is TLR-2 whose expression on monocytes/phagocytes increases at the initial presentation of sepsis. Aim of the study: To evaluate detection of CD64 on neutrophil and TLR-2 on monocytes by flowcytometry as early markers for diagnosis of neonatal sepsis. Methods:This study included 50 neonates selected from the NICU, Ain Shams University pediatric Hospital: 25 neonates suspected clinically as neonatal sepsis patients, and 25apparently healthy neonates served as a control group. Blood cultures were done to confirm the diagnosis in the patient’s group. Detection of CD64 and TLR-2 on surfaces of neutrophils and monocytes respectively was done by flowcytometry in blood samples of both groups. Results: A significant increase in CD64 expression was found in patients than in control groups.The combination of CRP and TLR-2 showed sensitivity (100%), specificity (50%), positive predictive values (75%), and negative predictive values (100%). Conclusion: A combination of two markers has better performance in the diagnosis of neonatal sepsis. However blood culture remains irreplaceable to confirm the diagnosis and perform antimicrobial susceptibility.