CD64 and Antibiotics in Human Sepsis

Monitoring CD64 on Neutrophils Regarding Effects of Antibiotics in Patients With SIRS Developing Sepsis

The purpose of the study is to find out whether CD64 expression on neutrophils measured by a new bedside test (LeukoDx) within 30 minutes is associated with effective antibiotic therapy in critically ill adult patients at risk of sepsis.

In the present study, in critically ill patients with suspected infection undergoing application of antibiotics, CD64 and inflammatory plasma markers will be determined on days 1 to 4.

CD64 expression on the surface of neutrophils will be determined by fluorescence activated cell sorter (FACS) and with a new bedside test (LeukoDx).

The purpose of the study is to clarify:

1. Is CD64 expression on neutrophils associated with effective antibiotic therapy in critically ill adult patients at risk of sepsis?
2. Is CD64 expression associated with distinct plasma parameters of inflammation?
3. Do the results of the gold standard CD64 determination by FACS correlate with those of a new bedside test (LeukoDx)?

Inclusion Criteria:

• age > 18 years
• critically ill adult patients
• sepsis
• SIRS
• initiation of antibiotic treatment
• patients < 48 hours after admission on ICU

Exclusion Criteria:

• multiple admissions on ICU, (>1 in last 2 weeks period)
• leukopenia < 1 G/l
• and thrombocytopenia
• rhG-CSF or IFN-gamma therapy up to 1 week before inclusion
• participation in another study receiving drugs or biological within the preceeding 30 days
• recent longterm corticosteroid treatment
• HIV
• patients after organ transplantation treated with immunomodulating drugs
• pregnant patients or after delivery
• life expectancy < 24 hours
• polytraumatized patients with reanimation on scene, or infest prognosis
• patients under high dose corticosteroids or chemotherapy