Interleukin-6 (il-6) and tumor necrosis factor alpha (tnf-α) for diagnosis of early-onset neonatal sepsis ♦ 1337

OBJECTIVE: To assess the contribution of IL-6 and TNF-α to an early diagnosis of early-onset neonatal sepsis. MATERIAL AND METHODS: A cohort of 117 newborn infants delivered during a one

year period had IL-6 and TNF-α (by enzyme-immunoassay),blood and CSF cultures, and leukocyte count collected on the initial evaluation of possible early-onset sepsis. They were divided in

four groups: I (n=13): positive blood and/or CSF cultures, II (n=36): probably infected with clinical sepsis but negative cultures, III (n=17): same as group II but mother received

peripartum antibiotic, IV (n=51): newborn infants that did not receive any antibiotic therapy. RESULTS: There were no differences among the four groups in respect to mean gestational ages

and birth weights. The IL-6 and TNF-α levels were significantly higher in groups I, II and III than in group IV(p<0.001). Median IL levels: I: 60 pg/ml(range:24-3000), II: 83

pg/ml(range:14-3000), III: 126 pg/ml(range:21-283), IV: 38 pg/ml(range:1-283). Median TNF-α levels: I: 33 pg/ml (range:12-380), II: 21 pg/ml (range:10-59), III: 21 pg/ml(range:10-2516), IV:

15 pg/ml (range: 7-50). The optimal cutoff point obtained with the receiver operating characteristics(ROC) curve was 32 pg/ml or more for IL-6(sensitivity=92%,specificity=43%,positive

predictive value=67%), and 12 pg/ml or more for TNF-α (sensitivity=88%,specificity=43%,positive predictive value=66%). Combining IL-6 cutoff value of 32 pg/ml or more and TNF-α of 12 pg/ml

or more provides a sensitivity of 98%. CONCLUSION: The combination of IL-6 and TNF-α appears to be a highly sensitive marker of sepsis in the immediate post-natal period. AUTHOR INFORMATION

AUTHORS AND AFFILIATIONS * DEPARTMENT OF PEDIATRICS,NEWBORN SECTION, UNIVERSIDADE FEDERAL DO RIO GRANDE DO SUL, PORTO ALEGRE, RS, Brazil RENATO S PROCIANOY & RITA S VIEIRA Authors *

RENATO S PROCIANOY View author publications You can also search for this author inPubMed Google Scholar * RITA S VIEIRA View author publications You can also search for this author inPubMed 

Google Scholar RIGHTS AND PERMISSIONS Reprints and permissions ABOUT THIS ARTICLE CITE THIS ARTICLE PROCIANOY, R., VIEIRA, R. INTERLEUKIN-6 (IL-6) AND TUMOR NECROSIS FACTOR ALPHA (TNF-α) FOR

DIAGNOSIS OF EARLY-ONSET NEONATAL SEPSIS ♦ 1337. _Pediatr Res_ 41 (Suppl 4), 225 (1997). https://doi.org/10.1203/00006450-199704001-01356 Download citation * Issue Date: 01 April 1997 *

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