Evaluation of procalcitonin, C-reactive protein and interleukin-6 level in neonatal sepsis

ABSTRACT

Bacterial sepsis is a major cause of morbidity and mortality in neonates. Diagnosis of neonatal sepsis may be difficult because clinical presentations are often nonspecific, bacterial cultures are time-consuming and other laboratory tests lack sensitivity and specificity. The aim of the present study was to evaluate the diagnostic use of procalcitonin, circulating cytokine [IL-6] and CRP in neonates with suspected sepsis. Blood was collected from 40 neonates admitted to neonatal intensive care units for suspicion of neonatal sepsis as well as 32 healthy controls. Sepsis group was subdivided into S1 [Proven sepsis n=16] and S2 [clinical sepsis n=24] according to the results of blood culture. Serum IL-6 was measured by Elisa, CRP was measured by nephlelometery and procalcitonin by Immunoluminometric assay. In sepsis group, level of CRP was significantly elevated compared to healthy controls P < 0.05. As regard to IL-6 level, it was significantly elevated in sepsis group compared to healthy control [P < 0.001], in addition it was increased in both patients subgroups S1, S2 with no statistically significant difference between both subgroups. Serum PCT concentration were significantly higher in sepsis group in comparison with the healthy control [P< 0.05]. PCT concentration were also significantly higher at initial suspicion and at 12-24 h and 36-48 h after the onset of symptoms in S1 than S2 subgroups. PCT seems to be a better marker of neonatal sepsis. Also, the combination of IL-6+CRP presented accuracy for differentiation between septic and non septic patients during the first 24 h of suspected sepsis