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Neutrophil CD64 index as a good biomarker for early diagnosis of bacterial infection in pregnant women during the flu season
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  • Lifei Yu,
  • Panpan Cen,
  • Linjian Zhang,
  • Jianfei Ke,
  • Xiangfei Xu,
  • Jiexia Ding,
  • Jie Jin,
  • Jianhang Leng,
  • yunsong yu
Lifei Yu
Affiliated Hangzhou First People's Hospital Zhejiang University School of Medicine
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Panpan Cen
Affiliated Hangzhou First People's Hospital Zhejiang University School of Medicine
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Linjian Zhang
Affiliated Hangzhou First People's Hospital Zhejiang University School of Medicine
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Jianfei Ke
Affiliated Hangzhou First People's Hospital Zhejiang University School of Medicine
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Xiangfei Xu
Affiliated Hangzhou First People's Hospital Zhejiang University School of Medicine
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Jiexia Ding
Affiliated Hangzhou First People's Hospital Zhejiang University School of Medicine
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Jie Jin
Affiliated Hangzhou First People's Hospital Zhejiang University School of Medicine
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Jianhang Leng
Affiliated Hangzhou First People's Hospital Zhejiang University School of Medicine
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yunsong yu
Zhejiang University School of Medicine Sir Run Run Shaw Hospital

Corresponding Author:yvys119@zju.edu.cn

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Abstract

Backgroud Pregnant women are at high risk of developing febrile illness during the flu season. Early identification of a viral or bacterial infection is crucial in the management of febrile pregnant patients. Neutrophil CD64 (nCD64) has been shown to have more important diagnostic value in sepsis than traditional inflammatory indicators. Methods The pregnant women enrolled were divided into three groups according to disease: influenza A infection, bacterial infection and healthy controls. Peripheral blood CD64, leukocyte, C-reactive protein (CRP), procalcitonin (PCT) and human Th1/Th2-related cytokines levels were routinely measured. The correlation between and diagnostic value of the nCD64 index and other biomarkers were evaluated using Spearman’s correlation test and receiver operating characteristic (ROC) curve analysis. Results Pregnant women with bacterial infection had significantly elevated levels of leukocytes (8.4 vs. 5.95, 10^9/L; P=0.004), CRP (89.70 vs. 50.05, mg/ml; P=0.031), PCT (0.13 vs. 0.04, ng/ml; P=0.010), and TNF-α (0.46 vs. 0.38, pg/ml; P=0.012) and an elevated nCD64 index (12.16 vs. 0.81; P<0.001) compared to those with influenza A infection. The area under the curve (AUC) of the nCD64 index to discriminate bacterial infection among pregnant women (area = 0.9183, P < 0.0001) was the largest. The sensitivity and specificity of the nCD64 index at an optimal cut-off value of 3.16 were 84% and 100%, respectively, with a negative predictive value (NPV) of 94%. Conclusions Our study demonstrates the clinical value of the nCD64 index in distinguishing between bacterial infection and influenza A in pregnant women during the flu season.
07 Apr 2023Submitted to Influenza and other respiratory viruses
10 Apr 2023Submission Checks Completed
10 Apr 2023Assigned to Editor
17 Apr 2023Reviewer(s) Assigned
15 Jun 2023Review(s) Completed, Editorial Evaluation Pending
19 Jun 2023Editorial Decision: Revise Major
15 Jul 20231st Revision Received
21 Jul 2023Submission Checks Completed
21 Jul 2023Assigned to Editor
01 Aug 2023Reviewer(s) Assigned
07 Aug 2023Review(s) Completed, Editorial Evaluation Pending
11 Aug 2023Editorial Decision: Accept