Interleukin-6: A Sensitive Parameter for the Early Diagnosis of Neonatal Bacterial Infection

PEDIATRICS ◽  
1994 ◽  
Vol 93 (1) ◽  
pp. 54-58 ◽  
Author(s):  
Christian Buck ◽  
Julia Bundschu ◽  
Peter Bartmann ◽  
Frank Pohlandt ◽  
Harald Gallati
Keyword(s):  
Blood Culture ◽  
Early Diagnosis ◽  
Bacterial Infection ◽  
Interleukin 6 ◽  
Early Recognition ◽  
Critical Role ◽  
Neonatal Infection ◽  
Clinical Sepsis ◽  
Sensitive Parameter ◽  
Culture Positive

Objective. Early recognition is important for the successful treatment and outcome of neonatal infections. As interleukin-6 (Il-6) plays a critical role in the induction of C-reactive protein (CRP) synthesis in the liver, it was hypothesized that this cytokine could be detected earlier in blood than the CRP during the course of bacterial infection. Design. In a prospective study of 298 newborns who were admitted to the nursery unit, CRP levels, blood cell count with differential, and Il-6 levels were determined at the time of admission and 24 hours after admission. Seventy-six newborns were excluded from the study because of incomplete or incorrect blood sampling. Results. The remaining 222 newborns were assigned to one of five groups: 11 newborns with blood culture-positive sepsis (sensitivity of Il-6 on admission 73%), 15 newborns with clinical sepsis (sensitivity of Il-6 on admission 87%), 41 newborns with infection (sensitivity of Il-6 on admission 68%), and 54 newborns without clinical and laboratory evidence of infection (specificity 78%). The remaining 101 newborns were defined as a mixed group because the diagnosis of neonatal infection could not clearly be made. Seventy-five percent of infected newborns had negative Il-6 levels 24 hours after admission. Of the 18 infected newborns with negative Il-6 levels on admission, 10 newborns had elevated CRP levels, suggesting that Il-6 was already negative because of the short half-life of Il-6. Sensitivity of Il-6 in CRP-negative newborns on admission was 100% in newborns with blood culture-positive and clinical sepsis. Il-6 was more sensitive than CRP in infected newborns on admission (73% vs 58%). Conclusion. Il-6 is a sensitive parameter for diagnosing neonatal bacterial infection. The combination of CRP and Il-6 seems to be the ideal tool for the early diagnosis of neonatal infection.

INTERLEUKIN-6: A SENSITIVE PARAMETER FOR THE EARLY DIAGNOSIS OF NEONATAL BACTERIAL INFECTION

Shock ◽  
1997 ◽  
Vol 7 (Supplement) ◽  
pp. 121
Author(s):  
F. Pohlandt ◽  
C. Buck ◽  
J. Bundschuh ◽  
H. Gallati ◽  
P. Bartmann
Keyword(s):  
Early Diagnosis ◽  
Bacterial Infection ◽  
Interleukin 6 ◽  
Sensitive Parameter

scholarly journals Serial Measurements of Interleukin 6 In The Early Diagnosis of Neonatal Infection

1999 ◽  
Vol 45 (6) ◽  
pp. 900-900
Author(s):  
M O Magudumana ◽  
D E Ballot ◽  
P A Cooper
Keyword(s):  
Early Diagnosis ◽  
Interleukin 6 ◽  
Neonatal Infection ◽  
Serial Measurements

scholarly journals Clinical profile of sepsis and choice of antimicrobials in babies admitted to special newborn care unit Kalaburagi

2021 ◽  
Author(s):  
Revanasiddappa Bhosgi ◽  
Kirankumar Harwalkar
Keyword(s):  
Blood Culture ◽  
Complete Blood Count ◽  
Early Recognition ◽  
Early Stage ◽  
Newborn Care ◽  
Neonatal Morbidity ◽  
Blood Parameters ◽  
Clinical Suspicion ◽  
High Index ◽  
Clinical Sepsis

Background: Sepsis is one of the common clinical conditions seen in neonates. Sepsis being major cause of neonatal morbidity and mortality in neonates, early recognition and treatment with antibiotics remains a mainstay of NICU protocols for neonatologists.Methods: It is a hospital based retrospective study conducted from July 2019 to February 2020 in GIMS, Kalaburagi. Neonates with suspicion of clinical sepsis were investigated for complete blood count (CBC), C-reactive protein (CRP) and blood culture (BC). Antibiotics were started based on CBC and CRP reports, or on high index of clinical suspicion. Based on common organisms isolated in previous 3 months statistics, antibiotics were decided. On confirmation by blood culture, antibiotics were changed as per blood culture report.Results: Out of 100 neonates, CRP was positive in  80 (70%) neonates, BC showed growth among 24 (24%) neonates. Although neonates had clinical sepsis, CRP was negative in 20 (10%), 76 (76%) did not show any kind of growth on BC. Mortality was seen in 04 (5%) neonates with only CRP positive, 02 (08%) neonates with only BC growth, 02 (10%) neonates with both CRP positive and BC growth, 02 (03%) neonates with CRP positive but no growth on BC. Clinical features were from subtle to severe.Conclusions: Although CRP and blood culture confirmation remains one of the main diagnostic parameter in sepsis, as mortality is seen among neonates with negative blood parameters, high  index of clinical suspicion is essential to treat sepsis at an early stage.

Procalcitonin as Predictor of Bacterial Infection in Meconium Aspiration Syndrome

2017 ◽  
Vol 35 (08) ◽  
pp. 769-773 ◽  
Author(s):  
Mahendiran K. ◽  
M. Faridi ◽  
N. Singh ◽  
Prerna Batra
Keyword(s):  
Blood Culture ◽  
Bacterial Infection ◽  
Neonatal Infection ◽  
Meconium Aspiration Syndrome ◽  
Primary Objective ◽  
Total Leukocyte Count ◽  
Meconium Aspiration ◽  
Group 2 ◽  
Sepsis Screen ◽  
Group 1

Background There is a lack of definite consensus on indications for initiating antibiotics in neonates with meconium aspiration syndrome (MAS), instigating researchers to search for a biomarker that can help differentiate MAS from MAS with bacterial infection. Objective Our primary objective was to compare serum procalcitonin (PCT) levels in full-term vigorous neonates having MAS with or without bacterial infection. Materials and Methods Seventy term vigorous neonates with diagnosis of MAS were enrolled. Blood samples were taken for sepsis screen, C-reactive protein (CRP), PCT, and blood culture at 6 ± 2 hours of respiratory distress. Neonates were categorized into group 1 (MAS without bacterial infection) and group 2 (MAS with bacterial infection) based on blood culture. The duration of our study was 18 months. Results Mean ± standard deviation PCT level was 2.52 ± 3.99 in group 1 and 2.71 ± 4.22 in group 2, which was comparable. At cutoff of 0.1 ng/mL, PCT had a sensitivity of 90% and specificity of 8% in detecting bacterial infection. Mean total leukocyte count, absolute neutrophil count, immature to total leucocyte ratio, microerythrocyte sedimentation rate, and CRP were comparable. Conclusion Though PCT is an early and reliable marker of neonatal infection, the levels were increased in neonates with MAS irrespective of the presence of bacterial infection.

scholarly journals Interleukin-6: A Sensitive Parameter for the Early Detection of Neonatal Sepsis

2009 ◽  
Vol 1 (1) ◽  
pp. 1 ◽  
Author(s):  
M Khaled Noor ◽  
M Shahidullah ◽  
Hamidur Rahman ◽  
Mahbub Mutanabbi
Keyword(s):  
Blood Culture ◽  
Interleukin 6 ◽  
Neonatal Sepsis ◽  
Venous Blood ◽  
Neonatal Infection ◽  
Health Care Facilities ◽  
Hematological Parameter ◽  
Control Group ◽  
Mortality And Morbidity ◽  
Early Marker

<p><strong>Background: </strong>Neonatal sepsis is a major cause of neonatal mortality and morbidity throughout the world. Though blood culture is the gold standard and has higher sensitivity and specificity over the hematological value and cytokine, it is not available in our community health situation and also in most of health care facilities. It is also time consuming. Therefore hematological value and interleukin-6 can be evaluated for the early diagnosis of neonatal bacterial infection.</p> <p><strong>Objective: </strong>This study was conducted to see the usefulness of IL-6 as an early marker of neonatal sepsis and also to compare the sensitivity in comparison with CRP, hematological value and blood culture.</p> <p><strong>Study Design: </strong>It was a quasy experimental study.</p> <p><strong>Setting: </strong>This study was carried out in the neonatal unit of pediatric department, BSMMU during the period of September, 2005 to February, 2006.</p> <p><strong>Method: </strong>Forty five suspected septic cases were enrolled in the study and thirty healthy newborn were taken for comparison. Venous blood sample from peripheral vein was collected on the 1st day of symptoms and/or 1st day of admission and was sent for IL-6 estimation within half an hour and estimation of IL-6 was done by using immunolyte DPC USA which employed automated chemiluminescent immunoassays.</p> <p><strong>Results: </strong>Out of forty five cases of suspected-neonatal sepsis, IL-6 were positive in twenty five cases. In culture proven sepsis 100% cases had raised IL-6. In control group only five babies had raised IL-6. Three cases were culture positive, of which all were also positive for IL-6 (100%). Among the cases twenty six were CRP positive, of which twenty were also positive for IL-6 (76.92%).</p> <p><strong>Conclusion: </strong>In the present study IL-6 was found to be an early marker of neonatal infection. Sensitivity was more than CRP and other hematological parameter in the first twenty four hours.</p> <p><strong>Key words: </strong>Interleukin-6, Neonatal Sepsis.</p><p>DOI: 10.3329/bsmmuj.v1i1.3687</p> <p><em>BSMMU J </em>2008; 1(1): 1-5</p>

Evaluation of interleukin-6 and soluble receptors of tumor necrosis factor for early diagnosis of neonatal infection

1996 ◽  
Vol 129 (4) ◽  
pp. 574-580 ◽  
Author(s):  
Jean Messer ◽  
Didier Eyer ◽  
Lionel Donato ◽  
Harald Gallati ◽  
Jacqueline Matis ◽  
...  
Keyword(s):  
Tumor Necrosis Factor ◽  
Early Diagnosis ◽  
Interleukin 6 ◽  
Tumor Necrosis ◽  
Neonatal Infection ◽  
Soluble Receptors ◽  
Necrosis Factor

scholarly journals Yale observation scale for bacterial infection in febrile children

2020 ◽  
Vol 7 (2) ◽  
pp. 424
Author(s):  
Shiwani Mangla ◽  
Hemant Jain
Keyword(s):  
Blood Culture ◽  
Bacterial Infection ◽  
Roc Curve ◽  
Early Recognition ◽  
Predictive Ability ◽  
Cost Effective ◽  
P Value ◽  
Observation Scale ◽  
Causes Of Mortality ◽  
Yale Observation Scale

Background: Sepsis is one of the leading causes of mortality in children under 5 years by UNICEF statistics which is difficult to diagnose because of nonspecific initial clinical presentation and potential for rapid deterioration. In this regard use of Yale Observation Scale assists in early recognition of serious bacterial infection than other laboratory investigation as it is simple, quick, easy to apply and cost-effective bed side scale.Methods: All eligible young febrile infants and children were consecutively enrolled in the study. Axillary temperatures of the cases were documented. Yale observation scoring was done. Blood sample were sent for culture and sensitivity. Colonies were identified morphologically by Gram stain and biochemically. The collected data was analyzed using ROC curve for finding cut off scores of Yale Observation Scale for prediction of severe bacterial illness and final outcome. Statistical analysis was performed using the Statistical Packages for Social Sciences (SPSS) version 14 for MS Window.Results: Bacteremia was found in 23(15.3%) out of total 150 young febrile children enrolled in the present study. It shows that in lower YOS score blood culture was sterile and in higher YOS score blood culture was positive for bacteremia, which is statistically significant with p value (<0.05). As per ROC curve analyses the best cut off value of YOS for prediction of bacteremia was 17.5 with sensitivity 91.3%, specificity 81.9%, PPV 47.7% and NPV of 98.1%.Conclusions: YOS of  >17.5 has a good predictive ability for prediction of bacteraemia in young febrile children.

ANTIMICROBIAL SUSCEPTIBILITY IN CULTURE POSITIVE ENTERIC FEVER

2019 ◽  
Vol 3 (7) ◽  
Author(s):  
Dr. Manish Kulshrestha ◽  
Dr. Anjali Kulshrestha
Keyword(s):  
Bone Marrow ◽  
Blood Culture ◽  
Nalidixic Acid ◽  
Antimicrobial Susceptibility ◽  
Salmonella Enterica ◽  
Enteric Fever ◽  
Multidrug Resistant ◽  
Bone Marrow Culture ◽  
Diffusion Method ◽  
Culture Positive

INTRODUCTION: Enteric fever includes typhoid and paratyphoid fever. Peak incidence is seen in children 5–15 years of age; but in regions where the disease is highly endemic, as in India, children younger than 5 years of age may have the highest infection rates. There are about 22 million new typhoid cases occur each year. Young children in poor, resource limited areas, who make up the majority of the new cases and there is a mortality figures of 215,000 deaths annually. A sharp decline in the rates of complications and mortality due to typhoid fever is observed as a result of introduction of effective antibiotic therapy since 1950s. MDR-ST became endemic in many areas of Asia, including India soon after multidrug-resistant strains of Salmonella enterica serotype typhi (MDR-ST) that were resistant to all the three first-line drugs then in use, namely chloramphenicol, amoxycillin and co-trimoxazole emerged in early 1990s. MATERIAL AND METHODS: Only blood culture or bone marrow culture positive cases were included. The patients with culture isolated enteric fever were included in the study. Antimicrobial susceptibility testing was carried out by disk diffusion method using antibiotic discs. The analysis of the antimicrobial susceptibility was carried out as per CLSI interpretative guidelines. RESULTS: A total of 82 culture positive cases were included in the present study. 80 culture isolates were from blood culture and 2 from the bone marrow culture. Salmonella entericasubspecies enterica serovartyphi (S typhi) was isolated from 67 (81.70%) patients while Salmonella enterica subspecies entericaserovarparatyphi (S paratyphi A) was isolated from 13 (15.85%) cases and 2 (2.44%) were Salmonella enterica subspecies entericaserovarschottmuelleri (S paratyphi B). Of the 82 cases 65(79.3%) isolates were resistant to ciprofloxacin, 17 (20.7%) were resistant to nalidixic acid, one (1.2%) case each was resistant to Cefotaxime and ceftriaxone, 2 (2.4%) were resistant to chloramphenicol, 10 (12.2%) were resistant and to cotrimoxazole 3 (3.7%) were resistant. CONCLUSION: In a culture positive cases 65(79.3%) isolates were resistant to ciprofloxacin and 17 (20.7%) were resistant to nalidixic acid. Multidrug resistant isolates were 65(79.3%).

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