Journal of Clinical Medicine Research, ISSN 1918-3003 print, 1918-3011 online, Open Access
Article copyright, the authors; Journal compilation copyright, J Clin Med Res and Elmer Press Inc
Journal website http://www.jocmr.org

Original Article

Volume 12, Number 3, March 2020, pages 157-164


Evaluation of the Activity of Neutrophils and Monocytes in Diabetic Patients With Sepsis, Can Surface Antigens HLA-DR and CD64 Be Useful as Prognostic Factors?

Figure

Figure 1.
Figure 1. Cytometry flow analysis in a control patient (a), a patient with diabetes and sepsis that survived (b), and a patient that deceased (c), showing the expression of HLA-DR and CD64 on monocytes and neutrophils on day 7.

Tables

Table 1. Type of Infection
 
InfectionNumber of patients
Respiratory14 (27.45%)
Urinary tract14 (27.45%)
Osteomyelitis3 (5.88%)
Soft tissues12 (23.52%)
Abdomen8 (15.68%)

 

Table 2. Analysis of Predictors of Mortality Between Survivor and Non-Survivor Diabetics With Sepsis
 
CharacteristicsSurvivorsNon-survivorsP value
WBC: white blood cells; NLR: neutrophils to lymphocytes ratio; CD64M0: CD64 antigen on monocytes on day 0; CD64M3: CD64 antigen on monocytes on day 3; CD64M7: CD64 antigen on monocytes on day 7; CD64O0: CD64 antigen on neutrophils on day 0; CD64O3: CD64 antigen on neutrophils on day 3; CD64O7: CD64 antigen on neutrophils on day 7; HLA-DRM0: HLA-DR antigen on monocytes on day 0; HLA-DRM3: HLA-DR antigen on monocytes on day 3; HLA-DRM7: HLA-DR antigen on monocytes on day 7; HLA-DRO0: HLA-DR antigen on neutrophils on day 0; HLA-DRO3: HLA-DR antigen on neutrophils on day 3; HLA-DRO7: HLA-DR antigen on neutrophils on day 7; HLA-DR/CD64M0: HLA-DR/CD64 co-expression on monocytes on day 0; HLA-DR/CD64M3: HLA-DR/CD64 co-expression on monocytes on day 3; HLA-DR/CD64M7: HLA-DR/CD64 co-expression on monocytes on day 7; HLA-DR/CD64O0: HLA-DR/CD64 co-expression on neutrophils on day 0; HLA-DR/CD64O3: HLA-DR/CD64 co-expression on neutrophils on day 3; HLA-DR/CD64O7: HLA-DR/CD64 co-expression on neutrophils on day 7; phagoM0: percentage of phagocytosis in monocytes on day 0; phagoM7: percentage of phagocytosis in monocytes on day 7; phagoO0: percentage of phagocytosis in neutrophils on day 0; phagoO7: percentage of phagocytosis in neutrophils on day 7.
Age71.03 ± 12.26577.55 ± 9.0150.068
WBC15,438.25 ± 7,040.36313,799.86 ± 6,172.5140.663
NLR9.838 ± 10.868312.552 ± 11.03570.292
SAPS II score30.08 ± 10.15934.64 ± 10.0030.136
CRP20.640 ± 13.098614.990 ± 10.48690.304
HbA1c8.593 ± 2.64257.37 ± 1.170.308
CD64M019.38 ± 9.8215.62 ± 5.220.262
CD64M312.88 ± 5.4310.95 ± 2.830.267
CD64M714.40 ± 5.039.44 ± 4.420.023
CD64O011.58 ± 8.989.94 ± 3.990.900
CD64O37.83 ± 4.0116.09 ± 1.490.290
CD64O711.03 ± 5.786.79 ± 4.240.062
HLA-DRM05.59 ± 2.745.09 ± 1.890.757
HLA-DRM34.54 ± 1.684.09 ± 0.960.679
HLA-DRM76.60 ± 2.324.73 ± 1.390.026
HLA-DRO05.23 ± 2.904.83 ± 2.160.464
HLA-DRO32.93 ± 0.823.22 ± 0.940.387
HLA-DRO77.19 ± 3.415.68 ± 2.910.189
HLA-DR/CD64M05.36 ± 2.664.85 ± 1.890.706
HLA-DR/CD64M34.35 ± 1.623.92 ± 0.970.747
HLA-DR/CD64M76.49 ± 2.264.38 ± 1.310.010
HLA-DR/CD64O03.36 ± 1.873.36 ± 2.000.973
HLA-DR/CD64O32.56 ± 1.422.24 ± 0.850.245
HLA-DR/CD64O74.21 ± 2.072.90 ± 0.820.143
PhagoM072.12 ± 19.0673.99 ± 19.060.672
PhagoM770.30 ± 15.9665.14 ± 23.940.709
PhagoO087.85 ± 11.6688.39 ± 11.250.909
PhagoO788.52 ± 10.5073.38 ± 26.960.083

 

Table 3. Analysis of Characteristics in Septic Diabetic Patients With Excellent, Moderate and Inadequate Blood Glucose Control
 
CharacteristicsHbA1c ≤ 7, HbA1c ≤ 53 mmol/mol7 < HbA1c ≤ 8.5, 53 < HbA1c ≤ 69, 40 mmol/molHbA1c > 8.5, HbA1c > 69.40 mmol/molP value
NSGP values: HbA1c ≤ 7, 7 < HbA1c ≤ 8.5, HbA1c > 8.5, respectively; IFCC values in mmol/mol: HbA1c ≤ 53, 53 < HbA1c ≤ 69.40, HbA1c > 69.40, respectively. NSGP: National Glycohemoglobin Standardization Program; IFCC: The International Federation of Clinical Chemistry and Laboratory Medicine; WBC: white blood cells; NLR: neutrophils to lymphocytes ratio; CD64M0: CD64 antigen on monocytes on day 0; CD64M3: CD64 antigen on monocytes on day 3; CD64M7: CD64 antigen on monocytes on day 7; CD64O0: CD64 antigen on neutrophils on day 0; CD64O3: CD64 antigen on neutrophils on day 3; CD64O7: CD64 antigen on neutrophils on day7; HLA-DRM0: HLA-DR antigen on monocytes on day 0; HLA-DRM3: HLA-DR antigen on monocytes on day3; HLA-DRM7: HLA-DR antigen on monocytes on day 7; HLA-DRO0: HLA-DR antigen on neutrophils on day 0; HLA-DRO3: HLA-DR antigen on neutrophils on day 3; HLA-DRO7: HLA-DR antigen on neutrophils on day7; HLA-DR/CD64M0: HLA-DR/CD64 co-expression on monocytes on day 0; HLA-DR/CD64M3: HLA-DR/CD64 co-expression on monocytes on day 3; HLA-DR/CD64M7: HLA-DR/CD64 co-expression on monocytes on day 7; HLA-DR/CD64O0: HLA-DR/CD64 co-expression on neutrophils on day 0; HLA-DR/CD64O3: HLA-DR/CD64 co-expression on neutrophils on day3; HLA-DR/CD64O7: HLA-DR/CD64 co-expression on neutrophils on day 7; phagoM0: percentage of phagocytosis in monocytes on day 0; phagoM7: percentage of phagocytosis in monocytes on day 7; phagoO0: percentage of phagocytosis in neutrophils on day 0; phagoO7: percentage of phagocytosis in neutrophils on day 7. aP < 0.05 vs. grI. bP < 0.05 vs. grII.
Age74 ± 9.1374.32 ± 1067.57 ± 16.120.463
WBC14,702.86 ± 7,795.9415,713.64 ± 6294.4615,485 ± 6,223.940.983
NLR12.16 ± 16.4811.19 ± 9.517.89 ± 4.590.628
SAPS II score31.79 ± 10.6730.64 ± 8.9831.21 ± 12.430.970
CRP18.20 ± 13.5016.99 ± 12.0825.92 ± 11.670.130
HbA1c6.42 ± 0.517.72 ± 0.3811.25 ± 2.930.000
CD64M022.21 ± 11.8818.38 ± 7.9815.71 ± 6.980.270
CD64M312.98 ± 5.6012.39 ± 4.8512.20 ± 5.440.775
CD64M713.80 ± 6.1613.62 ± 4.6913.62 ± 5.490.860
CD64O014.02 ± 11.8512.01 ± 6.857.59 ± 3.69a, b0.038
CD64O37.18 ± 3.507.96 ± 3.997.09 ± 3.840.810
CD64O711.53 ± 6.7011.01 ± 5.028.52 ± 5.880.251
HLA-DRM05.89 ± 3.086.09 ± 2.594.34 ± 1.480.052
HLA-DRM34.56 ± 1.604.87 ± 1.773.85 ± 1.040.215
HLA-DRM76.80 ± 3.236.17 ± 1.886.16 ± 2.030.878
HLA-DRO04.93 ± 2.175.85 ± 3.484.43 ± 1.650.243
HLA-DRO33.45 ± 1.172.87 ± 0.712.80 ± 0.490.275
HLA-DRO76.15 ± 4.297.54 ± 2.846.82 ± 3.260.325
HLA-DR/CD64M05.67 ± 3.015.84 ± 2.524.13 ± 1.39b0.050
HLA-DR/CD64M34.40 ± 1.574.67 ± 1.693.66 ± 1.060.193
HLA-DR/CD64M76.52 ± 3.115.95 ± 1.806.22 ± 2.200.850
HLA-DR/CD64O03.61 ± 1.603.56 ± 2.362.93 ± 1.210.291
HLA-DR/CD64O32.46 ± 0.822.79 ± 1.852.16 ± 0.610.383
HLA-DR/CD64O73.91 ± 2.604.09 ± 1.634.00 ± 2.040.494
PhagoM073.97 ± 19.6372.94 ± 15.8969.48 ± 19.230.670
PhagoM774.57 ± 12.3869.31 ± 15.9065.55 ± 21.960.671
PhagoO088.72 ± 11.2486.76 ± 12.7888.65 ± 10.420.927
PhagoO792.55 ± 4.8584.36 ± 12.7383.75 ± 21.290.293

 

Table 4. Analysis of Characteristics Between Septic Patients With Diabetes Mellitus and Diabetic Patients Without Sepsis
 
CharacteristicsSeptic patients with diabetesDiabetic patientsP value
WBC: white blood cells; NLR: neutrophils to lymphocytes ratio; CD64MO: CD64 antigen on monocytes on day 0; CD64M3: CD64 antigen on monocytes on day 3; CD64M7: CD64 antigen on monocytes on day 7; CD64O0: CD64 antigen on neutrophils on day 0; CD64O3: CD64 antigen on neutrophils on day3; CD64O7: CD64 antigen on neutrophils on day7; HLA-DRM0: HLA-DR antigen on monocytes on day 0; HLA-DRM3: HLA-DR antigen on monocytes on day 3; HLA-DRM7: HLADR antigen on monocytes on day7; HLA-DRO0: HLA-DR antigen on neutrophils on day 0; HLA-DRO3: HLA-DR antigen on neutrophils on day 3; HLA-DRO7: HLA-DR antigen on neutrophils on day 7; HLA-DR/CD64M0: HLA-DR/CD64 co-expression on monocytes on day 0; HLA-DR/CD64M3: HLA-DR/CD64 co-expression on monocytes on day 3; HLA-DR/CD64M7: HLA-DR/CD64: co-expression on monocytes on day 7; HLADR/CD64O0: HLA-DR/CD64 co-expression on neutrophils on day 0; HLA-DR/CD64O3: HLA-DR/CD64 co-expression on neutrophils on day 3; HLA-DR/CD64O7: HLA-DR/CD64 co-expression on neutrophils on day 7; phagoM0: percentage of phagocytosis in monocytes on day 0; phagoM7: percentage of phagocytosis in monocytes on day 7; phagoO0: percentage of phagocytosis in neutrophils on day 0; phagoO7: percentage of phagocytosis in neutrophils on day 7.
Age72.43 ± 11.8757.88 ± 15.640.000
WBC15,084.76 ± 6,837.0667,491.54 ± 2,326.560.093
NLR10.42 ± 10.852.53 ± 1.30
SAPS II score31.06 ± 10.209.72 ± 5.40
CRP19.38 ± 12.65
HBA1c8.34 ± 2.467.75 ± 1.980.093
CD64M018.57 ± 9.1110.48 ± 2.820.000
CD64M312.53 ± 5.08
CD64M713.67 ± 5.21
CD64O011.22 ± 8.168.37 ± 2.530.083
CD64O37.51 ± 3.73
CD64O710.40 ± 5.75
HLA-DRM05.48 ± 2.576.86 ± 1.660.000
HLA-DRM34.46 ± 1.57
HLA-DRM76.33 ± 2.29
HLA-DRO05.14 ± 2.746.73 ± 8.240.666
HLA-DRO32.99 ± 0.84
HLA-DRO76.97 ± 3.35
HLA-DR/CD64M05.25 ± 2.516.61 ± 1.610.000
HLA-DR/CD64M34.28 ± 1.52
HLA-DR/CD64M76.18 ± 2.27
HLA-DR/CD64O03.36 ± 1.883.50 ± 4.810.000
HLA-DR/CD64O32.50 ± 1.34
HLA-DR/CD64O74.02 ± 1.98
PhagoM072.52 ± 17.5846.81 ± 13.140.000
PhagoM769.53 ± 17.15
PhagoO087.96 ± 11.4674.94 ± 11.670.000
PhagoO786.27 ± 14.77