Abstract
Neonatal sepsis is a major cause of morbidity and mortality in preterm infants. Clinical diagnosis is difficult and no reliable diagnostic test exists. Interleukin-6 (IL-6) is a central mediator of the sepsis syndrome. In this study we examined the diagnostic value of plasma IL-6 in preterm infants thought to be septic.
Normal plasma IL-6 levels were established in cord bloods of sixty preterm infants at a range of gestational ages. 50 infants suspected of congenital (n = 14) or acquired (n=36) infection were then studied. Samples were taken at the time of blood culture. IL-6 levels were determined by ELISA. The study group had a mean (SD) gestational age of 29.8 (3.6) weeks, and birth weight of 1361 (735)g.
Results: Dependent on clinical course 36 babies were considered septic (20 blood culture positive, 16 blood culture negative) and 14 non-septic. IL-6 levels were significantly (p < 0.001) elevated in both blood culture positive and culture negative sepsis. For sepsis, plasma IL-6 >0.235ng/ml had a sensitivity of 33%, specificity of 89%, +ve predictive value 60%, -ve predictive value 73%, figures for blood culture positive sepsis were 35%, 86%, 35%, and 86% respectively.
Conclusions: Plasma IL-6 levels have been shown to be significantly elevated in septic preterm infants. However predictive values of this test are insufficient to warrant the replacement of existing diagnostic tests.
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Edgar, J., Wilson, D., McMillan, S. et al. INTERLEUKIN-6 LEVELS IN NEONATAL SEPSIS. Pediatr Res 32, 623 (1992). https://doi.org/10.1203/00006450-199211000-00113
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DOI: https://doi.org/10.1203/00006450-199211000-00113