The clinical significance of CRP and IL-6 in early recognition of neonatal sepsis
DOI:
https://doi.org/10.55629/pakjpathol.v35i1.775Keywords:
neonatal sepsis, nCRP, IL-6Abstract
Objective: The aim of this study was to determine serum CRP and IL-6 levels in confirmed and clinically suspected groups of neonatal sepsis and these biochemical parameters are being compared with blood culture of neonates with clinical signs and symptoms of sepsis.
Material and Methods: The samples of 180 suspected cases of neonatal sepsis were sent to pathology department. Out of them 92 were proven positive for blood culture and were considered as confirmed septic group while rests were included in clinically suspected group. Blood culture was performed on BACT/ALERT® 3D. Serum CRP was performed by immunoturidimetric method on AU 680 Beckman Coulter and IL-6 measurement was done on Access 2.
Results: The serum CRP and IL-6 levels were higher in confirmed sepsis group and their levels were in correspondence to severity of infection. At cut off values of >10mg/L, CRP showed sensitivity of 94%, and specificity of 74% while at cut off of >35ng/L, IL-6 had sensitivity and specificity of 70% and 88% respectively.
Conclusion: The results of this study suggested that CRP was a highly sensitive marker and IL-6 was a more specific for detection of neonatal sepsis.
Keywords: neonatal sepsis, CRP, IL-6
References
Fleischmann SC, Goldfarb DM, Schlattmann P, Schlapbach LJ, Reinhart K, Kissoon N. The global burden of paediatric and neonatal sepsis: a systematic review. Lancet Respir Med. 2018; 6: 223-30. DOI:https://doi.org/10.1016/s2213-2600(18)30063-8
Tzialla C, Manzoni P, Achille C, Bollani L, Stronati M, Borghesi A. New diagnostic possibilities for neonatal sepsis. Am J Perinatol. 2018; 35(6): 575-7. DOI: https://doi.org/10.1055/s-0038-1639361
Sun D, Wang Q, Zhang X, Zhao X, Zhang H, Liu A. Clinical application of serum inflammatory factors combined with dynamic detection in the diagnosis and treatment of neonatal sepsis. Iran J Public Health. 2021; 50(2): 325-32.
DOI:https://doi.org/10.18502%2Fijph.v50i2.5347
Miller JM, Binnicker MJ, Campbell S, Carroll KC, Chapin KC, Gilligan PH, et al. A Guide to utilization of the microbiology laboratory for diagnosis of infectious diseases: 2018 Update by the Infectious Diseases Society of America and the American Society for Microbiology. Clin Infect Dis. 2018; 67(6): e1-e94. DOI: https://doi.org/10.1093/cid/ciy381
Scheer CS, Fuchs C, Gründling M, Vollmer M, Bast J, Bohnert JA, et al. Impact of antibiotic administration on blood culture positivity at the beginning of sepsis: A prospective clinical cohort study. Clin Microbiol Infect. 2019; 25(3): 326-31. DOI: https://doi.org/10.1016/j.cmi.2018.05.016
Ershad M, Mostafa A, Cruz DM, Vearrier D. Neonatal sepsis. Curr Emerg Hosp Med Rep. 2019; 7(3): 83-90. DOI: https://doi.org/10.1007/s40138-019-00188-z
Opal SM, Wittebole X. Biomarkers of infection and sepsis. Crit Care Clin. 2020; 36(1): 11–22. DOI: https://doi.org/10.1016/j.ccc.2019.08.002
Eschborn S, Weitkamp JH. Procalcitonin versus C-reactive protein: Review of kinetics and performance for diagnosis of neonatal sepsis. J Perinatol. 2019; 39(7): 893-903. DOI: https://doi.org/10.1038/s41372-019-0363-4
Xu XJ, Luo ZB, Xia T, Song H, Yang SL, Xu WQ, et al. Comparison of interleukin-6, interleukin-10, procalcitonin and C-reactive protein in identifying high-risk febrile illness in pediatric cancer patients: A prospective observational study. Cytokine. 2019; 116: 1-6. DOI: https://doi.org/10.1016/j.cyto.2019.01.004
Tessema B, Lippmann N, Willenberg A, Knüpfer M, Sack U, König B. The diagnostic performance of interleukin-6 and C-reactive protein for early identification of neonatal sepsis. Diagnostics (Basel). 2020; 10(11): 978. DOI: https://doi.org/10.3390/diagnostics10110978
Kuzniewicz MW, Mukhopadhyay S, Li S, Walsh EM, Puopolo KM. Time to positivity of neonatal blood cultures for early-onset sepsis. Pediatr Infect Dis J. 2020; 39(7): 634-40. DOI:https://doi.org/10.1097/INF.0000000000002632
Küng E, Unterasinger L, Waldhör T, Berger A, Wisgrill L. Cut-off values of serum interleukin-6 for culture-confirmed sepsis in neonates. Pediatr Res. 2023; 93(7): 1969-74. DOI: https://doi.org/10.1038/s41390-022-02329-9
Eichberger J, Resch B. Reliability of interleukin-6 alone and in combination for diagnosis of early onset neonatal sepsis: Systematic review. Front Pediatr. 2022; 10: 840778. DOI: https://doi.org/10.3389/fped.2022.840778
Ebenebe CU, Hesse F, Blohm ME, Jung R, Kunzmann S, Singer D. Diagnostic accuracy of interleukin-6 for early-onset sepsis in preterm neonates. J Matern Fetal Neonatal Med. 2021; 34(2): 253-8. DOI: https://doi.org/10.1080/14767058.2019
Zeng G, Chen D, Zhou R, Zhao X, Ye C, Tao H, et al. Combination of C-reactive protein, procalcitonin, IL-6, IL-8, and IL-10 for early diagnosis of hyperinflammatory state and organ dysfunction in pediatric sepsis. J Clin Lab Anal. 2022; 36(7): e24505. DOI: https://doi.org/10.1002/jcla.24505
Ganesan P, Shanmugam P, Sattar SB, Shankar SL. Evaluation of IL-6, CRP and hs-CRP as early markers of neonatal sepsis. J Clin Diagn Res. 2016; 10(5): DC13-7. DOI: https://doi.org/10.7860/JCDR/2016/19214.7764
Chatterjee K, Mandal PK, Rahaman SR, Malathi R, Ray SK, Dutta A. Raised IL-6 and C-reactive protein in neonatal sepsis in Eastern India. Int J Contemp Pediatr. 2017 Sep;4(5):1590-4. DOI:https://doi.org/10.18203/2349-3291.ijcp20173124
Li X, Li T, Wang J, Feng Y, Ren C, Xu Z, Yang J, et al. Clinical value of C-reactive protein/ platelet ratio in neonatal sepsis: A Cross-Sectional Study. J Inflamm Res. 2021; 14: 5123-9. DOI: https://doi.org/10.2147/JIR.S334642
Burstein B, Beltempo M, Fontela PS. Role of C-reactive protein for late-onset neonatal sepsis. JAMA Pediatr. 2021;175(1):101–102. DOI:https://doi.org/10.1001/jamapediatrics.2020.2129
Khan F. C-reactive protein as a screening biomarker in neonatal sepsis. J Coll Physicians Surg Pak. 2019; 29(10): 951-53.
DOI: https://doi.org/10.29271/jcpsp.2019.10.951
Kaur S, Singh K. Early-onset neonatal sepsis: Role of C-reactive protein, micro-ESR, and gastric aspirate for polymorphs as screening markers. Int J Pediatr. 2021; 2021:1544553. DOI: https://doi.org/10.1155/2021/1544553
Chaudhuri PK, Ghosh A, Sinha V, Singh BK, Singh M, Lugova H, et al. The role of C-reactive protein estimation in determining the duration of antibiotic therapy in neonatal sepsis. Cureus. 2022 12; 14(10): e30211. DOI: https://doi.org/10.7759/cureus.30211
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Farheen Aslam
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Readers may “Share-copy and redistribute the material in any medium or format” and “Adapt-remix, transform, and build upon the material”. The readers must give appropriate credit to the source of the material and indicate if changes were made to the material. Readers may not use the material for commercial purpose. The readers may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.
