Meta-analysis of diagnostic accuracy of neutrophil CD64 for neonatal sepsis

Background: The aim of this study was to systematically evaluate the diagnostic performance of nCD64 for neonatal sepsis. Methods: Computer retrieval was conducted for the databases of PubMed, Embase, and Springer databases up to March 18, 2015 to select the relevant studies on nCD64 and neonatal sepsis. Sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), and 95 % confidence intervals (CI) for diagnostic efficiency of nCD64 were pooled. In addition, the summary receiver operating characteristic (SROC) curve was also conducted based on the sensitivity and specificity. Results: Seventeen studies including 3478 participants were included in this meta-analysis. The overall pooled sensitivity, specificity, PLR, NLR and DOR were 0.77 (95 % CI: 0.74-0.79), 0.74 (95 % CI: 0.72-0.75), 3.58 (95 % CI: 2.85-4.49), 0.29 (95 % CI: 0.22-0.37) and 15.18 (95 % CI: 9.75-23.62), respectively. In addition, the area under the SROC curve (AUC) was 0.8666, and no threshold effect was found based on the Spearman correlation analysis (P = 0.616). Besides, subgroup analysis showed higher sensitivity, specificity and AUC in term infants and proven infection group than those in preterm infants and clinical infection group, respectively. Conclusions: The n CD64 expression alone is not a satisfactory marker for diagnosing neonatal sepsis with relatively low sensitivity, specificity, PLR and NLR, in spite of relatively high SROC area. Therefore, the n CD64 expression used in diagnosis of neonatal sepsis should be treated with caution.