DIAGNOSTIC VALUE OF SIMULTANEOUS MEASUREMENT OF PROCALCITONIN, INTERLEUKIN-6 AND HS CRP IN PREDICTION OF EARLY-ONSET NEONATAL SEPSIS

Neonatal sepsis is a major cause of morbidities and mortalities mostly remarkable in the third world nations .We aimed to assess the value of simultaneous measurement of procalcitonin (PCT) and interleukin-6 (IL-6) in association with high sensitive- C reactive protein in prediction of early neonatal sepsis.We performed a follow- up study on 95 neonates who were below 12 hours (h) of age, had clinical signs of sepsis or maternal risk factors for sepsis. Neonates were assigned to 4 groups including “proven early-onset sepsis”, “clinical early-onset sepsis”, “negative infectious status”, and “uncertain infectious status”. Blood samples were obtained within the first 12 h of birth repeated between 24 hours and 36 hours of age for determination of serum levels of PCT, IL-6, high sensitivie- C Reactive Protein (hs-CRP), and white blood cell (WBC) count.On admission, neonates with sepsis had a higher WBC count, IL-6, PCT, and hs-CRP levels compared with those neonates without sepsis. This remained significant even after 12-24 hours of admission. Also, patients with clinical evidences of sepsis had a higher serum level of PCT and IL-6 within 12-24 hours after admission compared to the patients with uncertain sepsis. In final The combination of IL-6, hs-CRP, and PCT seems to be predictive in diagnosis of early onset neonatal sepsis.

Download Full-text

Diagnostic role of interleukin-6 and quantitative C-reactive protein in suspected early onset neonatal sepsis

World Journal of Advanced Research and Reviews ◽

10.30574/wjarr.2020.8.1.0369 ◽

2020 ◽

Vol 8 (1) ◽

pp. 263-270

Author(s):

Priti Chowdhary ◽

Ritesh Ranjan ◽

Anita Pandey

Keyword(s):

Blood Culture ◽

Interleukin 6 ◽

Neonatal Sepsis ◽

Early Onset ◽

Signs And Symptoms ◽

Care Hospital ◽

Age Group ◽

C Reactive Protein ◽

Reactive Protein ◽

Early Onset Sepsis

Introduction: Neonatal sepsis is a major cause of morbidity and mortality most remarkable in the third world nations. Early diagnosis and subsequent therapy for the infected infants may play a vital role in lowering such mortality and morbidity rates. Aim: To study the clinical profile of neonatal sepsis in a tertiary care hospital and to correlate the findings with quantitative C-reactive protein (CRP) and Interleukin-6 (IL-6). Settings and Design: A total of 296 neonates admitted in neonatal intensive care unit (NICU) with clinical signs and symptoms suggestive of sepsis were studied. Based on their age the study population was divided into early onset sepsis (EOS): age group less 72 hours and late onset sepsis (LOS): age group more than 72 hours. Also healthy neonates who had no signs and symptoms of sepsis were taken as control for the study. Material and Methods: Blood culture was carried out using BacT/ Alert-3D automated system. Quantitative CRP by nephelometry and IL-6 by ELISA was done in all culture positive cases and controls. Correlation of detection of cases of sepsis by quantitative CRP and IL-6 with blood culture was carried out. Statistical analysis: Statistical parameters such as sensitivity, specificity, predictive values, accuracy and significance levels were calculated Results: In EOS the sensitivity and negative predictive value (NPV) of IL-6 was 62.32% and 33.33% respectively as compared to sensitivity of 27.5% and NPV of 26.47% of CRP. Conclusions: IL-6 is a good marker for early onset sepsis than CRP detecting a greater number of sepsis cases.

Download Full-text

Procalcitonin and Neonatal Sepsis: Is This the Biomarker We Are Looking For?

Neonatal Network The Journal of Neonatal Nursing ◽

10.1891/0730-0832.36.6.380 ◽

2017 ◽

Vol 36 (6) ◽

pp. 380-384 ◽

Cited By ~ 3

Author(s):

Susan Givens Bell

Keyword(s):

Neonatal Sepsis ◽

Early Onset ◽

Diagnostic Marker ◽

C Reactive Protein ◽

Neonatal Deaths ◽

Live Births ◽

Neonatal Disease ◽

Protein Levels ◽

Reactive Protein ◽

Early Onset Sepsis

AbstractResearchers estimate the incidence of early onset sepsis as 0.77–1/1,000 live births. It remains as one of the leading causes of neonatal deaths. Clinicians and researchers continue to search for biomarkers for specific neonatal disease processes. Clinicians frequently trend C-reactive protein levels during evaluation for neonatal sepsis. Recently, researchers have begun to explore procalcitonin as a potentially useful diagnostic marker for neonatal sepsis.

Download Full-text

C-Reactive Protein, Interleukin-6, and Procalcitonin in the Immediate Postnatal Period: Influence of Illness Severity, Risk Status, Antenatal and Perinatal Complications, and Infection

Clinical Chemistry ◽

10.1373/49.1.60 ◽

2003 ◽

Vol 49 (1) ◽

pp. 60-68 ◽

Cited By ~ 127

Author(s):

Claudio Chiesa ◽

Gabriella Pellegrini ◽

Alessandra Panero ◽

John F Osborn ◽

Fabrizio Signore ◽

...

Keyword(s):

Interleukin 6 ◽

Neonatal Sepsis ◽

Early Onset ◽

Neonatal Infection ◽

Diagnostic Value ◽

Illness Severity ◽

Perinatal Complications ◽

C Reactive Protein ◽

Risk Status ◽

Reactive Protein

Abstract Background: Studies of the diagnostic accuracy of most laboratory tests for early-onset neonatal sepsis have yielded variable results. We investigated whether some of this variation might be attributable to differences in population baseline severity and risk status as well as to specific ante- and perinatal variables, independent of the presence of neonatal infection. Methods: The Score for Neonatal Acute Physiology (SNAP) was used to define illness severity, with SNAP Perinatal Extension (SNAP-PE) used to define the combined physiologic and perinatal mortality risk. A total of 134 ill newborns (19 with early-onset infection and 115 with no infection) were available for simultaneous analysis of the association of SNAP, SNAP-PE, and maternal and perinatal variables with C-reactive protein (CRP), interleukin-6 (IL-6), and procalcitonin (PCT) concentrations at birth and at 24 and 48 h of life. Results: Early-onset neonatal infection was associated with significant increases in CRP, IL-6, and PCT concentrations at all three time points, independent of illness severity. However, among babies without infection, higher SNAP and SNAP-PE scores were associated with higher IL-6 concentrations at birth. Certain maternal or perinatal variables altered IL-6 and PCT values in the infected as well as in the uninfected neonates. However, if different cutoff points were used at any of the three neonatal ages, PCT sensitivity and specificity were greater than those of CRP or IL-6. Conclusions: Illness severity and risk status are unlikely to interfere with the use of CRP and PCT for detection of early-onset neonatal sepsis. In contrast, the diagnostic value of IL-6 at birth may be altered by physiologic severity and risk indexes. The reliability of CRP, IL-6, and PCT for the diagnosis of early-onset neonatal infection requires specific cutoff values for each evaluation time point over the first 48 h of life.

Download Full-text

C-reactive protein and the neonatal early-onset sepsis calculator for the diagnosis of neonatal sepsis

European Journal of Clinical Microbiology & Infectious Diseases ◽

10.1007/s10096-021-04156-y ◽

2021 ◽

Author(s):

Nati Friedman ◽

Sivan Yochpaz ◽

Semyon Zirkin ◽

Jacky Herzlich ◽

Ronella Marom

Keyword(s):

Neonatal Sepsis ◽

Early Onset ◽

C Reactive Protein ◽

Reactive Protein ◽

Early Onset Sepsis ◽

Sepsis Calculator

Download Full-text

The serum level of C-reactive protein in neonatal sepsis

Srpski arhiv za celokupno lekarstvo ◽

10.2298/sarh0806253v ◽

2008 ◽

Vol 136 (5-6) ◽

pp. 253-257 ◽

Cited By ~ 3

Author(s):

Brankica Vasiljevic ◽

Olga Antonovic ◽

Svjetlana Maglajlic-Djukic ◽

Miroslava Gojnic

Keyword(s):

Gestational Age ◽

Neonatal Sepsis ◽

Late Onset ◽

Hematological Parameters ◽

Clinical Signs ◽

Preterm Neonates ◽

C Reactive Protein ◽

Reactive Protein ◽

Early Onset Sepsis ◽

Serum Crp

INTRODUCTION C-reactive protein (CRP) is the most common diagnostic marker of infection. OBJECTIVE Objectives of this study were to determine the serum CRP level in neonates with sepsis and establish the influence of gestational age (GA) on the CRP level in the first few weeks after birth. METHOD Diagnosis of neonatal sepsis was established by the presence of clinical signs of sepsis, isolation of the causative agent of sepsis and abnormal hematological parameters. All neonates were divided into two groups: early onset sepsis (EOS) and late onset sepsis (LOS). According to GA all neonates were divided into three groups: <32 GA, 32-36 GA and ?37 GA. Serum CRP was measured 0-72 h after the onset of signs and symptoms of infection. RESULTS This study included all neonates with sepsis at our Institute during 2003. EOS was diagnosed in 130 neonates (mean age was 33 weeks; range 27-41 weeks) and 33 infants (mean age 29 weeks; range 27-38 weeks). We defined a relevant CRP response as a concentration of >10 mg/l for term and near term neonates and >5 mg/l for preterm neonates. The maximum concentrations of CRP were reached 48 hr after the first symptoms of neonatal sepsis. CONCLUSION CRP levels are proportional with increasing GA and body weight in EOS. The effects of gestational age do not influence CRP levels in LOS. Maturation changes in the immune system are the most likely explanation for this and partly the organisms responsible for an infection may be different at different gestational ages and also in EOS and LOS. There is no correlation with serum CRP levels and with the severity of the disease and bad prognosis in EOS.

Download Full-text

assessment of The Role of Interleukin 6, C-Reactive Protein and high sensitive C-Reactive Protein in the diagnosis of early onset neonatal sepsis (A clinical and laboratory approach).

Zagazig University Medical Journal ◽

10.21608/zumj.2020.31650.1867 ◽

2020 ◽

Vol 0 (0) ◽

pp. 0-0

Author(s):

Yasser abdel hamid ◽

Ahmed Abdel Moniem ◽

Naglaa Khalifa ◽

usama Elsafy

Keyword(s):

Interleukin 6 ◽

Neonatal Sepsis ◽

Early Onset ◽

C Reactive Protein ◽

Reactive Protein

Download Full-text

NEONATAL SEPSIS AND IDENTIFICATION OF RISK FACTORS: STUDY IN AVBRH HOSPITAL SAWANGI

International Journal of Medical and Biomedical Studies ◽

10.32553/ijmbs.v3i6.1215 ◽

2019 ◽

Vol 3 (6) ◽

Author(s):

Pramod P. Singhavi

Keyword(s):

Risk Factors ◽

Neonatal Sepsis ◽

Early Onset ◽

Late Onset ◽

Signs And Symptoms ◽

Premature Rupture ◽

Maternal Risk ◽

Late Onset Sepsis ◽

Early Onset Sepsis ◽

Meconium Stained Amniotic Fluid

Introduction: India has the highest incidence of clinical sepsis i.e.17,000/ 1,00,000 live births. In Neonatal sepsis septicaemia, pneumonia, meningitis, osteomyelitis, arthritis and urinary tract infections can be included. Mortality in the neonatal period each year account for 41% (3.6 million) of all deaths in children under 5 years and most of these deaths occur in low income countries and about one million of these deaths are due to infectious causes including neonatal sepsis, meningitis, and pneumonia. In early onset neonatal sepsis (EOS) Clinical features are non-specific and are inefficient for identifying neonates with early-onset sepsis. Culture results take up to 48 hours and may give false-positive or low-yield results because of the antenatal antibiotic exposure. Reviews of risk factors has been used globally to guide the development of management guidelines for neonatal sepsis, and it is similarly recommended that such evidence be used to inform guideline development for management of neonatal sepsis. Material and Methods: This study was carried out using institution based cross section study . The total number neonates admitted in the hospital in given study period was 644, of which 234 were diagnosed for neonatal sepsis by the treating pediatrician based on the signs and symptoms during admission. The data was collected: Sociodemographic characteristics; maternal information; and neonatal information for neonatal sepsis like neonatal age on admission, sex, gestational age, birth weight, crying immediately at birth, and resuscitation at birth. Results: Out of 644 neonates admitted 234 (36.34%) were diagnosed for neonatal sepsis by the paediatrician based on the signs and symptoms during admission. Of the 234 neonates, 189 (80.77%) infants were in the age range of 0 to 7 days (Early onset sepsis) while 45 (19.23%) were aged between 8 and 28 days (Late onset sepsis). Male to female ratio in our study was 53.8% and 46% respectively. Out of total 126 male neonates 91(72.2%) were having early onset sepsis while 35 (27.8%) were late onset type. Out of total 108 female neonates 89(82.4%) were having early onset sepsis while 19 (17.6%) were late onset type. Maternal risk factors were identified in 103(57.2%) of early onset sepsis cases while in late onset sepsis cases were 11(20.4%). Foul smelling liquor in early onset sepsis and in late onset sepsis was 10(5.56%) and 2 (3.70%) respectively. In early onset sepsis cases maternal UTI, Meconium stained amniotic fluid, Multipara and Premature rupture of membrane was seen in 21(11.67%), 19 (10.56%), 20(11.11%) and 33 (18.33%) cases respectively. In late onset sepsis cases maternal UTI, Meconium stained amniotic fluid, Multipara and Premature rupture of membrane was seen in 2 (3.70%), 1(1.85%), 3 (5.56%) and 3 (5.56%) cases respectively. Conclusion: Maternal risk identification may help in the early identification and empirical antibiotic treatment in neonatal sepsis and thus mortality and morbidity can be reduced.

Download Full-text