Diagnostic
Diagnostic
yield of at admission estimation of serum IL-6 and high-sensitivity CRP for
Early-onset Neonatal Sepsis
1Hesham A. El-Ghaiaty, 2Ahmed F.
El-Hassanin, 3Said M. Morsy, 4Lobna A. Mobasher
1Department of Pediatrics, Faculty of Medicine, Benha
University, Egypt
2Department of Pediatrics, Faculty of Medicine,
Mansoura University, Egypt
3Department of Pediatrics, Faculty of Medicine, Zagazig
University, Egypt
4Department of Clinical Pathology, Aladan Hospital,
Kuwait
Abstract: Objectives: To
evaluate the ability of at admission estimation of serum high-sensitivity
C-reactive protein (hs-CRP) and interleukin (IL)-6 for discrimination between
neonates had early-onset sepsis (EOS) and those free of infection and to act as
early predictor for result of blood culture (BC).Patients & Methods:
The study included 87 neonates admitted to neonatal ICU (NICU) underwent
evaluation using the Score for Neonatal Acute Physiology Perinatal Extension II
(SNAPPE II) with higher scores indicated more severe infection. Neonates were
categorized into: Infected neonates had clinical manifestations of sepsis and
positive BC, Clinically infected neonates had clinical manifestations of sepsis
and negative BC and EOS-free neonates had negative BC and no clinical
manifestations. Two venous blood samples were obtained: The first at time of
NICU admission for ELISA estimation of hsCRP and IL-6 serum levels and the second
sample was obtained either at time of development of clinical signs of sepsis
or at of 72 hours in non-infected groups was used for BC and for complete blood
count. Results: Blood culture was positive in 43 neonates
(Infected), 19 neonates were clinically infected and 25 neonates were EOS-free.
Mean SNAPPE II score and serum hs-CRP levels were significantly lower in
EOS-free neonates compared to infected neonates with non-significant difference
between clinically infected neonates. Mean total WBC count and serum IL-6
levels were significantly lower in EOS-free compared to infected and in
clinically infected compared to infected neonates. Regression analysis for
studied parameters as predictors for sure neonatal EOS confirmed by positive BC
defined high total WBC count and high serum IL-6 as the most significant
predictors and as predictors for EOS among those had negative BC defined high
total WBC count, high serum IL-6, elevated serum hsCRP and birth weight in
decreasing order of significance. Conclusion: Combined at
admission estimation of serum hsCRP and IL-6 levels in conjunction with at
72-hr WBC count could differentiate between infected and non-infected neonates
and provide early prediction for positive BC so allowing early initiation of
therapy for infected neonates.
[Hesham A. El-Ghaiaty, Ahmed F.
El-Hassanin, Said M. Morsy, Lobna M. Mobasher. Diagnostic yield of at
admission estimation of serum IL-6 and high-sensitivity CRP for Early-onset
Neonatal SepsisJ Am Sci 2013;9(3):334-341]. (ISSN: 1545-1003). http://www.jofamericanscience.org. 47
Kew words: Early-onset neonatal infection, interleukin-6, high-sensitivity CRP, Total leucocytic count.
