Diagnostic role of IL-6 in Neonatal sepsis
Keywords:
Sepsis, IL-6, CRP, Neonatal
Abstract
Background: Neonatal sepsis is a serious life-threatening condition with high mortality. The early and accurate diagnosis of sepsis is one of main challenge for prevention of mortality due to sepsis in NICUs. A great effort to reduce the neonatal mortality rate is put into looking for new reliable biomarkers. Among various biomarkers, IL-6 could be promising and reliable biomarker for early diagnosis of neonatal sepsis.Objective: To evaluate the diagnostic value of IL-6 in Neonatal Sepsis.Design: Prospective, observational study.Methodology: By ELISA method the level of serum IL-6 were assessed in 41 neonates with suspected sepsis and 42 healthy neonates with no clinical and laboratory data of infection.Result: The AUC for IL-6 and CRP were 0.87, 0.80 respectively. The cut off value for IL-6 was 181pg/ml at which the sensitivity, specificity, PPV and NPV were 80.1%, 85.7%, 84.6%, 81.8% respectively. The cut off value for CRP is 3.78 mg/dl at which the sensitivity, specificity, PPV and NPV are 61%, 90.5%, 86.2%, 70.3% respectively. In culture positive patients sensitivity of IL-6 and CRP was 90% and 80%, respectively. In culture negative patients sensitivity of IL-6 and CRP was 71.4% and 42.8%, respectively. In EOS sensitivity of IL-6 and CRP was 86.3% and 50%, respectively. In LOS sensitivity of IL-6 and CRP was 73.6% and 72.6%, respectively.Conclusion: IL-6 is a novel biomarker with high sensitivity and good specificity for sepsis. This has better diagnostic value than CRP, especially in Blood culture negative and EOS.References
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22. Ng PC, Cheng SH, Chui KM, et al. Diagnosis of late onset neonatal sepsis with cytokines, adhesion molecule, and C-reactive protein in preterm very low birthweight infants. Arch Dis Child Fetal Neonatal Ed 1997;77(3):F221-7.
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2. Stoll B, Kliegman and Beharman. Infections in neonates: Etiology of fetal &neonatal infection: Kliegman RM, Behrman RE, Jenson HB and Stanton BF (eds). In Nelson text book of pediatrics, 2008; 18th ed;794-811.
3. Mishra UK, Jacobs SE, Doyle LW and Garland SM. Newer approaches to the diagnosis of early onset neonatal sepsis. Arch Dis Child Fetal Neonatal Ed, 2006; 91:F208–12.
4. Rodwell RL, Leslie AL and Tudehope DI. Early diagnosis of neonatal sepsis using a hematologic scoring system. J Pediatr, 1988; 112(5):761-7.
5. Singh M, Narang A, Bhakoo ON. Predictive perinatal score in diagnosis of neonatal sepsis. J Trop Pediatr. 1974;11:597-60.
6. Takkar VP, Bhakoo ON, Narang A. Scoring system for the prediction of early neonatal infections. Indian Pediatr. 1974;11:597-60.
7. Birju AS and James FP. Neonatal sepsis. An old problem with new insights. Virulence, 2014; 5(1): 170–178.
8. Ahrens P, Kattner E and Köhler B. Mutations of genes involved in the innate immune system as predictors of sepsis in very low birth weight infants.Pediatr Res, 2004; 55(4):652-6.
9. Kumar Y, Qunibi M and Neal TJ .Time topositivity of neonatal blood cultures. Arch Dis Child Fetal Neonatal Ed, 2001; 85(3): F182-6.
10. Hsu KK, Pelton SI and Shapiro DS. Detection of group B streptococcal bacteremia in simulated intrapartum antimicrobial prophylaxis. Diagn Microbiol Infect Dis, 2003; 45(1):23-7.
11. Chacko B and Sohi I. Early onset neonatal sepsis. Indian Journal of Pediatrics, 2005; 72(1): 23-26.
12. Kumhar G . Ramachandran V.G , Gupta P. Bacteriological Analysis of Blood Culture Isolates from Neonates in a Tertiary Care Hospital in India.J Health PopulNutr 2002:20(4):343-347.
13. Dzwonek AB, Neth OW and Thiebaut R. The role of mannose-binding lectin in susceptibility to infection in preterm neonates. Pediatr Res, 2008;63(6):680-5.
14. BanacBanac B, Dergan CM, Wraber B, Hojiker S. Interleukin 6 and Procalcitonin in early diagnosis of sever bacterial infection in critically ill neonates. Pflugers Arch Eur Physiol 2000;440:72-74.
15. Mehr S, Doyle LW. Cytokines as markers of bacterial sepsis in newborn infants: a review. Pediatr Infect Dis J 2000;19(9):879-87.
16. Ng PC, Li K, Leung TF, et al. Early prediction of sepsisinduced disseminated intravascular coagulation with interleukin-10, interleukin-6, and RANTES in preterm infants. Clin Chem 2006; 52(6):1181-9.
17. Stoll BJ. Infection in neonatal infants. In: Kliegman R, Behrman R, Jenson H, et al (eds). Nelson Textbook of Pediaterics. Philadelphia: Saunders. 2007; Pp: 794-811.
18. Kingsmore SF, Kennedy N, Halliday HL, et al. Identification of diagnostic biomarkers for infection in premature neonates. Mol Cell Proteomics 2008;7(10):1863-75.
19. Lam HS, Ng PC. Biochemical markers of neonatal sepsis. Pathology 2008;40(2):141-8.
20. Santana Reyes C, García-Muñoz F, Reyes D, et al. Role of cytokines (interleukin-1beta, 6, 8, tumour necrosis factor-alpha, and soluble receptor of interleukin-2) and C-reactive protein in the diagnosis of neonatal sepsis. Acta Paediatr 2003; 92(2):221-7.
21. Martin H, Olander B, Norman M. Reactive hyperemia and interleukin 6, interleukin 8, and tumor necrosis factor-alpha in the diagnosis of early-onset neonatal sepsis. Pediatrics 2001; 108(4):E61.
22. Ng PC, Cheng SH, Chui KM, et al. Diagnosis of late onset neonatal sepsis with cytokines, adhesion molecule, and C-reactive protein in preterm very low birthweight infants. Arch Dis Child Fetal Neonatal Ed 1997;77(3):F221-7.
23. Berner R, Niemeyer CM, Leititis JU, et al. Plasma levels and gene expression of granulocyte colony stimulating factor, tumor necrosis factor-alpha, interleukin (IL)-1beta, IL-6, IL-8, and soluble intercellular adhesion molecule-1 in neonatal early onset sepsis. Pediatr Res 1998;44(4):469-77.
24. Messer J, Eyer D, Donato L, et al. Evaluation of interleukin-6 and soluble receptors of tumor necrosis factor for early diagnosis of neonatal infection. J Pediatr 1996;129(4):574-80.
25. Lobat S,MD; Abbasali K,PhD; Arezou M,MD; Ali A,MD and Ghalamreza R,MD. The Role of IL-6 for Predicting Neonatal Sepsis: A Systemic Review and Meta-Analysis. Iran J Pediatr Dec2011;Vol 21(No 4), pp:411-417.
26. Buck C, Bundschu J, Gallati H, Bartmann P, Pohlandt F Pediatrics. 1994Jan;93(1):54-8, Interleukin-6: a sensitive parameter for the early diagnosis of neonatal bacterial infection.
27. Kuster, N Yiho. Immunological basis of neonatal sepsis. Clinical Neonatology. 2000 Vol. No.3.
Published
2016-02-13
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