Diagnostic Value of Cytokines and C-reactive Protein in the First 24 Hours of Neonatal Sepsis

Gary Laborada, Maria Rego, Ajey Jain, Michael Guliano, Joseph Stavola, Praveen Ballabh, Alfred N. Krauss, Peter A M Auld, Mirjana Nesin

Research output: Contribution to journalArticle

72 Citations (Scopus)

Abstract

The first objective of this article was to determine the diagnostic accuracy of tumor necrosis factor-α, interleukin-6 (IL-6), and interleukin-8 (IL-8) in differentiating infected from noninfected neonates during the first 24 hours of suspected sepsis and to compare them to the currently used laboratory parameters: C-reactive protein (CRP), immature-to-total neutrophil ratio, and leukocyte and platelet count. The secondary objective was to compare the cytokine levels in subpopulations of neonates. Seventy-five premature and 30 term infants were enrolled. Blood samples for the "currently used laboratory tests" and the cytokine levels were obtained at the first suspicion of sepsis ("0-hour") and 18 to 30 hours later ("24-hours"). Patients were classified as septic (48) or nonseptic (57). Thirty-two septic patients had positive blood cultures and 16 showed clinical signs of sepsis. Twenty septic patients had early-onset and 28 had late-onset sepsis. Sensitivity, specificity, and positive and negative predictive values (PPV and NPV) were calculated for each test. Receiver-operating characteristic curves were analyzed to determine the optimal thresholds. A combination of CRP > 10 pg/mL plus IL-6 > 18 pg/mL (sensitivity = 89%, specificity = 73%, PPV = 70%, NPV = 90%) was the best "0-hour" test, and CRP (sensitivity = 78%, specificity = 94%) was the best "24-hours" test. Lower IL-6 at 0-hour (p = 0.018) and IL-8 at 24 hours (p = 0.023) were detected among the patients infected with coagulase-negative staphylococci then with other bacteria. In conclusion, a combination of CRP + IL-6 provided additional diagnostic accuracy for differentiation between septic and nonseptic patients during the first 24 hours of suspected sepsis.

Original languageEnglish (US)
Pages (from-to)491-501
Number of pages11
JournalAmerican Journal of Perinatology
Volume20
Issue number8
DOIs
StatePublished - Nov 2003
Externally publishedYes

Fingerprint

C-Reactive Protein
Sepsis
Cytokines
Interleukin-6
Interleukin-8
Sensitivity and Specificity
Newborn Infant
Coagulase
Platelet Count
Staphylococcus
Leukocyte Count
ROC Curve
Neutrophils
Tumor Necrosis Factor-alpha
Neonatal Sepsis
Bacteria

Keywords

  • CRP
  • Cytokines
  • Diagnosis of neonatal sepsis
  • Markers of infection

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Obstetrics and Gynecology

Cite this

Diagnostic Value of Cytokines and C-reactive Protein in the First 24 Hours of Neonatal Sepsis. / Laborada, Gary; Rego, Maria; Jain, Ajey; Guliano, Michael; Stavola, Joseph; Ballabh, Praveen; Krauss, Alfred N.; Auld, Peter A M; Nesin, Mirjana.

In: American Journal of Perinatology, Vol. 20, No. 8, 11.2003, p. 491-501.

Research output: Contribution to journalArticle

Laborada, G, Rego, M, Jain, A, Guliano, M, Stavola, J, Ballabh, P, Krauss, AN, Auld, PAM & Nesin, M 2003, 'Diagnostic Value of Cytokines and C-reactive Protein in the First 24 Hours of Neonatal Sepsis', American Journal of Perinatology, vol. 20, no. 8, pp. 491-501. https://doi.org/10.1055/s-2003-45382
Laborada, Gary ; Rego, Maria ; Jain, Ajey ; Guliano, Michael ; Stavola, Joseph ; Ballabh, Praveen ; Krauss, Alfred N. ; Auld, Peter A M ; Nesin, Mirjana. / Diagnostic Value of Cytokines and C-reactive Protein in the First 24 Hours of Neonatal Sepsis. In: American Journal of Perinatology. 2003 ; Vol. 20, No. 8. pp. 491-501.
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AU - Stavola, Joseph

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