Elsevier

The Journal of Pediatrics

Volume 132, Issue 2, February 1998, Pages 295-299
The Journal of Pediatrics

Interleukin-6 concentrations in neonates evaluated for sepsis,☆☆,,★★

https://doi.org/10.1016/S0022-3476(98)70448-2Get rights and content

Abstract

Objectives: This study was performed to determine serum concentrations of interleukin-6 (IL-6) during bacterial infections in the first week of life and to evaluate the usefulness of IL-6 as a diagnostic test for perinatal bacterial infections, alone and in combination with C-reactive protein (CRP). Study design: Blood was obtained from 241 newborn children on admission to the neonatal intensive care unit and at 3 to 4 days after admission. Both samples were analyzed for IL-6, CRP, and white blood cell count with differential. Results: Twenty-four newborns were classified as having an infection. Increased serum IL-6 levels were detected in infected compared with noninfected newborns on admission (p < 0.0001). Detection of IL-6 (≥20 pg/ml) alone yielded a sensitivity of 78%, a specificity of 71%, a positive predictive value of 40%, and a negative predictive value of 93%. A combined parameter of IL-6 (≥50 pg/ml) and CRP (≥10 mg/L) yielded a sensitivity of 96%, a specificity of 74%, a positive predictive value of 49%, and a negative predictive value of 99%. Conclusions: Used in combination with CRP, IL-6 seems to be a valuable parameter in the early diagnosis of neonatal infections. (J Pediatr 1998;132:295-9)

Section snippets

Patients

The study included 241 neonates consecutively admitted to the neonatal intensive care unit at the University Hospital of Trondheim during an 11-month period in 1993. Clinical and laboratory records were reviewed and coded without knowledge of the patient's serum IL-6 concentrations. Clinical symptoms were divided into six categories: (1) pallor and icterus; (2) lethargy, apnea, bradycardia, irritability and seizures; (3) tachypnea and dyspnea; (4) hypotension, tachycardia, and compromised

Characteristics of the Study Population

Twenty-four neonates had an infection and were included in group 1. Six of these neonates were classified as having sepsis, nine had clinical sepsis, and nine had pneumonia. The positive blood cultures of the six neonates with sepsis demonstrated Staphylococcus aureus (n = 2), Hemophilus influenzae (n = 1), coagulase-negative staphylococci (n = 2), and group B streptococci (n = 1). One patient had polymicrobial sepsis (Enterococcus species in addition to S. aureus). Eighteen neonates had

Discussion

This study has shown that IL-6 concentrations are significantly elevated in neonates with bacterial infections during the first week of life compared with those of noninfected neonates. These results are in accordance with findings reported in other clinical studies.17, 18, 19, 20 Furthermore, we found a characteristic relationship between IL-6 and CRP in neonates with infection or probable infection. First, high IL-6 values and low CRP values on admission were followed by increasing CRP

Acknowledgements

We thank research nurse R. S. Salvesen for organizing the data collection; the laboratory assistants at The University Hospital of Trondheim, Children's Department, especially K. Nygaard and L. Nygaard Nilsen, for blood sample collection and preparation; laboratory assistant M. Soerensen, University of Trondheim, Institute of Cancer Research and Molecular Biology, for running the IL-6 analyses; Dr. H. Johnsen, University of Trondheim, Department of Clinical Chemistry, for assistance with

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From Children's Department, University Hospital of Trondheim and Institute of Cancer Research and Molecular Biology, University of Trondheim, University Medical Center, Trondheim, Norway.

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Supported by The Research Council in Norway, The Norwegian National Health Association and The Neonatal Fund at the University Hospital of Trondheim.

Reprint requests: Henrik Doellner, Children's Department, University Hospital of Trondheim, N-7006 Trondheim, Norway.

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0022-3476/98/$5.00 + 0  9/21/81349

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