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Paper Information

Journal:   MEDICAL JOURNAL OF MASHHAD UNIVERSITY OF MEDICAL SCIENCES   FALL 2006 , Volume 49 , Number 93; Page(s) 253 To 260.
 
Paper: 

EVALUATION OF QUANTITIVE IL6 IN THE DIAGNOSIS OF NEONATAL SEPSIS

 
 
Author(s):  MAMOURI GH.A.*, BOSKABADI H., TAVAKOL AFSHARI J., NASERI F., SHAKERI M.T.
 
* NEONATOLOGY DEPARTMENT, GHAEM HOSPITAL, MASHHAD
 
Abstract: 

Introduction: Infection in the neonate presents a diagnostic dilemma as the clinical presentation is non- specific and final culture results are usually not available until at least 48-72h after sampling. Early confirmation of definitive infection with use of cytokine levels would cause significant reduction in health care costs by shortening the duration of treatment and hospitalization. The objective of the present study was to evaluate interleukin 6 (IL6) level in the early diagnosis of neonatal sepsis.
Material and Methods: This single blind clinical trial was done in NICU of Ghaem Hospital in 2003 - 2004. Subject included 60 neonates evaluated for suspected sepsis. All infants had IL6, CBC, B/C, CRP done at evaluation presentation. Infants were categorized into groups according to the likehood of infection on the basis of clinical presentation, blood culture results, i.e., group 1(sepsis), group 2 (clinical sepsis) and group 3 (control). IL6 was compared between two groups by the T-test of mann - whitney; logistic regression was done to establish the best predictors of infection; and sensitivity, specificity, positive and negative predictive values were determined.
Results: The IL6 Level was significantly raised in those infants with sepsis (184 pg/ml, p value= 0.000) and clinical sepsis (102 pg/ml p value= 0.001) when compared to those infants without infection (5 pg/ml).
Conclusion: An IL6 Value
³11 pg/ml gave a NPV=96/7%, PPV=100%, specify=100%, sensitivity=96/8%. A CRP> 6pg/ml gave a sensitivity and specificity of 75% and 68% respectively. It is concluded that an IL6value done at the time of presentation of sign and symptoms, suggestive of infection, is useful in the early diagnosis of neonatal sepsis. In particular, an IL6 < 11 and CRP < 6 pg/ml may allow antibiotics to be withheld in a number of infants evaluated for sepsis.

 
Keyword(s): NEONATE, INTERLEUKIN 6, SEPSIS, INFECTION
 
References: 
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