Validity of interleukin-18 plus CRP measurement in the early diagnosis of sepsis neonatorum

ABSTRACT

Over the last decade a variety of laboratory tests have been developed to enhance the early and accurate diagnosis of sepsis neonatorum. However, non of these tests has been found to be absolutely reliable in detecting all septic neonates. To test the validity of circulating interleukin-18 [cIL-18] plus serum C-reactive protein [CRP] for the diagnosis of sepsis neonatorum, in term infants admitted to the neonatal intensive care unit [NICU] of Zagazig University Hospitals, during year 2005. Twenty - four neonates with positive blood cultures were selected from 60 neonates with clinically suspected sepsis. Their ages ranged from 0.3 to 25 days [X +/- SD 14.2 +/- 7.1]. In addition, 14 gestational age [GA]-, chronologic age - and sex - matched healthy neonates served as a control group. Results: Forty percent of neonates with clinically suspected sepsis proved to have positive blood cultures, E. coli being the most significant isolate [62.5%]. Rise of serum CRP and cIL-18 is highly significantly associated with culture-proven neonatal sepsis. Meanwhile, other tests were nonsignificant associates. Using ROC curve analysis, cIL-18 displayed a sensitivity and a specificity of 91.7% and 85.7%, and CRP displayed a sensitivity and a specificity of 72% and 100%, respectively. When both tests were used, combined, the reported sensitivity and specificity accounted for 100%, for each. The combined use of cIL-18 and serum CRP is valuable in the early and accurate diagnosis of sepsis neonatorum