Khaled Amro, Jurgen Dinger.
Early detection of bacterial sepsis in newborns.
Pak J Med Res Jan ;50(4):133-6.

Background: Neonatal infections are the most common cause of morbidity and mortality in infancy. Objectives: To determine the usefulness of interleukin-6 and blood culture in the diagnosis of suspected bacterial infections in neonatal intensive care unit. Subjects and Methods: This retrospective case record analysis was conducted over two years 2009-2010. Data was collected using patient’s records from the pediatric and neonatal care unit of the hospital. The ages of the new born ranged from 28 to 42 weeks of gestation. Blood samples were collected at the time of admission, before the initiation of the first dose of antibiotic. Tests included; complete blood count, blood culture, and interleukin-6 (IL-6), C-reactive protein estimation. The results of blood culture and inflammatory markers, i.e. interleukin-6 (IL-6) and C-reactive protein were analysed. Results: A total of 73 blood samples were taken from neonates who were clinically suspected to be having sepsis. Twenty two samples revealed positive blood cultures for bacteria. The level of interleukin in first hour was very high (>1000 pg/ml) in 17 samples while its median value was 100 pg/ml. Normal or minimal elevation of C-reactive protein was seen in these cases. Low level of (<350 pg/ml) was seen in 5 newborns and C-reactive protein in these cases was around 12 mg/l. Conclusions: High IL-6 levels show some correlation with positive bacterial blood culture and it can help in supplementing the diagnosis of neonatal sepsis. Policy message: For an early diagnosis of neonatal sepsis, IL-6 levels may be used to treat these cases especially in settings where blood culture facilities are remote.

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