Bhandari et al used the neutrophil CD64 index and absolute neutrophil count (ANC) to evaluate a neonate for sepsis. Identifying a neonate at low risk for sepsis can help to reduce unnecessary antibiotic therapy. The authors are from Yale University.


Patient selection: pre-term neonates with possible sepsis



(1) neutrophil CD64 index (using the Leuko64 kit, Trillium Diagnostics, as outlined on page 130)

(2) absolute neutrophil count (ANC, total white blood cell count multiplied by percent neutrophils in the differential count of the peripheral blood)


Exclusion of sepsis was done by using both the CD64 index and ANC level. A high negative predictive value for sepsis was associated with:

(1) a CD64 index < 2.30 and

(2) an ANC <= 7,000 per µL (based on the data in Table 2)



• A low ANC may occur in sepsis but was not documented in the current study.

• The CD64 index compares the reading of a patient's neutrophils versus a control.


A patient was considered to be at risk for culture-proven sepsis if the CD64 index was >= 4.02.


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