Related Experiment Videos
Interleukin 6 in neonates with early and late onset infection
A Panero1, L Pacifico, N Rossi
1Institutes of Pediatrics, La Sapienza University of Rome, Italy.
Insights
Interleukin 6 (IL-6) levels help diagnose neonatal infections. Serial IL-6 measurements in the first 48 hours are crucial to avoid overdiagnosing early-onset infection in neonates.
Area of Science:
- Neonatal Medicine
- Immunology
- Biomarker Research
Background:
- Neonatal infections pose significant diagnostic challenges.
- Accurate and timely diagnosis is critical for effective treatment and improved outcomes in neonatal intensive care units (NICUs).
- Interleukin 6 (IL-6) is a key inflammatory cytokine implicated in infection responses.
Purpose of the Study:
- To evaluate the diagnostic utility of serum interleukin 6 (IL-6) concentrations for early (< or = 48 hours of life) and late-onset infections in neonates.
- To determine if serial IL-6 measurements improve diagnostic accuracy in the NICU setting.
Main Methods:
- Serum IL-6 levels were measured in five neonate groups on postnatal Days 1 and 2: confirmed early infection, clinical septicemia, uninfected symptomatic, uncertain findings, and healthy controls.
- IL-6 was also assessed in neonates who developed late-onset systemic infection during their hospital stay.
- Matched controls were used for late-onset infection analysis.
Main Results:
- On Day 1, IL-6 was elevated in all patient groups compared to healthy neonates, with no significant differences among patient groups.
- On Day 2, IL-6 remained elevated in confirmed early infection and clinical septicemia groups compared to uninfected, uncertain, and healthy groups.
- IL-6 levels were significantly higher in neonates with late-onset infection and decreased upon recovery.
Conclusions:
- Serum IL-6 concentrations show potential for detecting both early and late-onset infections in neonates.
- Serial IL-6 measurements within the first 48 hours of life are essential to prevent overdiagnosis of infection in the NICU.
Objective:
To assess the utility of determining interleukin 6 (IL-6) concentrations for diagnosing early (< or = 48 h of life) and late onset infection in a neonatal intensive care setting.
Methods:
We measured serum IL-6 values in five groups of neonates on both postnatal Days 1 and 2 (early sampling): Group 1, patients with clinical and microbiologic evidence of early onset infection; Group 2, patients with negative body fluid cultures but strong evidence of infection (clinical septicemia); Group 3, patients without clinical and microbiologic evidence of infection; Group 4, patients in whom infection could be neither confirmed nor excluded; and Group 5, healthy neonates with a normal postnatal course. We also measured IL-6 values in older neonates who during their hospital stay developed systemic infection (late sampling). Three controls matched for duration of hospital stay and birth date were chosen for each patient.
Results:
On postnatal Day 1 IL-6 values were elevated in all four patient groups compared with those in healthy neonates (P < 0.05 by analysis of variance (ANOVA)). There were no significant differences found among patient groups. On postnatal Day 2 IL-6 concentrations were persistently elevated in Groups 1 and 2 compared with values from those in Group 3, Group 4 and healthy controls (P < 0.01). At this time no significant differences in IL-6 values were found between uninfected symptomatic patients (Group 3), patients with uncertain findings (Group 4) and healthy controls. IL-6 concentrations were significantly higher in patients with late onset infection at presentation than in the patient controls (P < 0.0001) and returned to low values in those who recovered from infection.
Conclusions:
There are differences in the serum concentrations of IL-6 that can be helpful in detecting early and late onset infection in preterm and term neonates. During the first 48 h of life serial IL-6 determinations are necessary so as not to overdiagnose infection in a neonatal intensive care setting.