EVALUATION OF INTERLEUKIN-6 FOR EARLY DIAGNOSIS OF NEONATAL SEPSIS IN COMPARISON WITH CRP

Abstract

Introduction Early diagnosis of neonatal sepsis is essential for successful treatment. Blood culture is a gold standard for diagnosis but the final results are not available until 48-72 hours after culture. Interleukin-6 (IL-6) as a marker plays a critical role in the induction of C-reactive protein (CRP) synthesis in the liver. It has been hypothesized that this cytokine could be detected in blood earlier than CRP during the course of neonatal sepsis. Methods Blood samples were collected upon admission from 50 neonates with suspected sepsis, and 10 healthy neonates. The patients were assigned to two groups according to bacteriological and laboratory results. Group І consisted of 19 newborns with positive blood cultures and clinical signs of sepsis. Group ІІ included 31 neonates with negative blood cultures, but with two or three clinical signs of sepsis. The control group (group III) included 10 healthy neonates with no clinical or biological data of infection. Serum CRP was determined by using the nephelometry method and IL-6 was determined by ELISA method. Results Mean CRP level in the group with proven sepsis was 22.18 mg/l which was higher than in other groups (P=0.005). The sensitivity and specificity of CRP were 57% and 100%, respectively. Mean level of IL-6 was 117.49 pg/ml in group І, which was higher than in other groups (P=0.001), exhibiting a sensitivity of 78% and a specificity of 95%. Conclusions Based on our results, measurement of IL-6 is more useful than CRP for early diagnosis of neonatal sepsis, especially within the 24 hours before the onset of sepsis. We conclude that IL-6 measurement combined with CRP measurement can be the ideal tests for diagnosis of neonatal sepsis. Keywords Interleukin-6, C-reactive protein, Neonatal sepsis.