Study of Monocyte Subsets and Their Surface Expression of CD86 and Serum IL-17 Compared to Serum Procalcitonin as Markers of Early Neonatal Sepsis

Figures & data

Table 1 General and Laboratory Data of Studied Neonates

		Control Group	Patients Group	Test Value	P-value
		N=30	N=30
Sex	Female	15 (50.0%)	15 (50.0%)	0.000	1.000
	Male	15 (50.0%)	15 (50.0%)
Gestational age (weeks)	Mean ±SD	37.33±1.90	36.03±2.47	2.285	0.026
	Range	33–40	30–39
Weight/kg	Mean ±SD	2.78±0.52	2.42±0.51	2.726	0.008
	Range	1.9–3.8	1.1–3.5
WBC 1000/mm^3	Mean ±SD	9.59±3.29	10.42±5.58	−0.699	0.488
	Range	5.6–17.1	3–24
Hemoglobin g/dL	Mean ±SD	13.78±2.19	12.02±2.05	3.208	0.002
	Range	10–18.9	8.9–17
Platelet 1000/cm	Mean ±SD	212.43±85.75	195.90±105.28	0.667	0.507
	Range	17–379	40–596
CRP mg/L	Median (IQR)	5 (4–6)	30 (24–48)	−6.444	0.000
	Range	3–12	6–146

Abbreviations: WBC, white blood cells; CRP, C-reactive protein; SD, standard deviation; IQR, interquartile range.

Figure 1 Microorganism results of blood culture in the septic group.

Table 2 Percentage of Monocyte Subset and CD86 Positive Monocytes and Serum Levels of Procalcitonin and IL-17 in the Studied Groups

		Control Group	Patients Group	Test Value	P-value
		N=30	N=30
Monocytes (%)	Median (IQR)	6.4 (3.6–9.7)	7.1 (3.3–9.6)	−0.133	0.894
	Range	0.1–19.7	1.4–22.3
CD86^+ monocytes (%)	Median (IQR)	24 (14.9–30.7)	78.35 (44.1–91.4)	−6.003	0.000
	Range	5.1–45.5	26.5–100
CD86 MFI	Median (IQR)	2.4 (1.3–5.2)	1.65 (1.3–3.9)	−0.407	0.684
	Range	1–7.5	1.1–7.2
Classical monocytes (%)	Median (IQR)	80.6 (75.8–86.8)	81.2 (46.6–88.3)	−0.673	0.501
	Range	9–93.7	1.1–95.1
Intermediate monocytes (%)	Median (IQR)	4.5 (3–7.7)	10 (6–33.5)	−3.645	0.000
	Range	0.4–27.8	2.9–49.3
Nonclassical monocytes	Median (IQR)	0.25 (0–1)	4.3 (1.9–11)	−5.348	0.000
	Range	0–10.4	0.8–48.8
CD16 MFI	Median (IQR)	3.4 (2.5–5.7)	8.7 (5.2–15)	−4.318	0.000
	Range	1–24.7	2.7–45
Procalcitonin (pg/mL)	Median (IQR)	156 (143–166)	225.5 (190–303)	−5.924	0.000
	Range	0.2–201	143–738
IL-17 (ng/L)	Median (IQR)	101.5 (84–134)	421.5 (162–646)	−5.501	0.000
	Range	65–354	101–728

Abbreviations: MFI, mean fluorescence intensity; IL-17, interleukin 17; SD, standard deviation; IQR, interquartile range.

Table 3 Cutoff Values, Sensitivities, and Specificities for Serum IL-17 and Procalcitonin Level, Percentage of CD86 Positive Monocytes, CD16 MFI on CD16 Positive Monocytes and CRP in Early Detection of Early Neonatal Sepsis

Parameter	AUC	Cutoff Point	Sensitivity (%)	Specificity (%)	PPV (%)	NPV (%)
CD86^+ monocytes (%)	0.951	>36	90.0	90.0	90.0	90.0
CD16 MFI	0.824	>4.3	93.33	63.33	71.8	90.5
IL-17 (ng/L)	0.913	>145	86.67	90.00	89.7	87.1
Procalcitonin (pg/mL)	0.945	>170	96.67	86.67	87.9	96.3
CRP	0.980	>6	96.67	86.67	87.9	100.0

Abbreviations: MFI, mean fluorescence intensity; IL-17, interleukin 17; CRP, C-reactive protein; AUC, area under curve; PPV, positive predictive value; NPP, negative predictive value.

Figure 2 Flow cytometric results. (A) Monocyte gating on the CD45/side scatter, (B) CD14/CD16 expression on the gated monocytes. (C) CD14/CD16 expression on the gated monocytes. (D) Monocyte subclasses; CD14⁺⁺/CD16^– classical monocytes (L) and (M), CD14⁺⁺/CD16⁺ intermediate monocytes (O) and (P) and CD14⁺/CD16⁺ nonclassical monocytes (Q). (E) Histogram of CD86 expression on monocytes. (F) Histogram of CD16 expression on monocytes.