Am J Perinatol 2021; 38(S 01): e338-e346
DOI: 10.1055/s-0040-1710010
Original Article

Interleukin-6 as a Biomarker of Early-Onset Neonatal Sepsis

1  Programa de Medicina, Facultad de Salud, Universidad Surcolombiana, Neiva, Huila, Colombia
,
Paula X. Losada
1  Programa de Medicina, Facultad de Salud, Universidad Surcolombiana, Neiva, Huila, Colombia
,
Laura X. Fernández
2  Servicio de Pediatría, Hospital Universitario Hernando Moncaleano Perdomo, Neiva, Huila, Colombia
,
Emilce Beltrán
4  Servicio de Pediatría, Hospital Susana López de Valencia, Popayán, Cauca, Colombia
,
Isabel DeLaura
1  Programa de Medicina, Facultad de Salud, Universidad Surcolombiana, Neiva, Huila, Colombia
5  Fulbright US program, New York
6  Harvard College, Cambridge, Massachusetts
,
Carlos F. Narváez
1  Programa de Medicina, Facultad de Salud, Universidad Surcolombiana, Neiva, Huila, Colombia
,
Carlos Eduardo Fonseca-Becerra
1  Programa de Medicina, Facultad de Salud, Universidad Surcolombiana, Neiva, Huila, Colombia
2  Servicio de Pediatría, Hospital Universitario Hernando Moncaleano Perdomo, Neiva, Huila, Colombia
3  Unidad de Cuidado Intensivo Neonatal, Hospital Universitario Hernando Moncaleano Perdomo, Neiva, Huila, Colombia
› Author Affiliations

Abstract

Objective The aim of this study is to determine the utility of C reactive protein (CRP) and interleukin (IL)-6 in the diagnosis of neonatal sepsis (NS) in a neonatal intensive care unit (NICU) in the south of Colombia.

Study Design A nonmatched case–control study was conducted. Convenience sampling was performed. Data were obtained from clinical records. IL-6 levels were determined using enzyme-linked immunosorbent assay. Receiver operator characteristic (ROC) curve analysis and Youden's index were used to determine the optimal cutoffs for CRP and IL-6 levels in diagnosing NS, early-onset NS (EONS), and late-onset NS (LONS).

Results Data from 31 cases and 62 controls were included. History of chorioamnionitis (infinite odds ratio [OR] [3.07-infinity]), and the presence of meconium-stained amniotic fluid during birth (OR: 9.04 [1.35–112]) were identified as risk factors for NS. Differences in CRP (p < 0.0001) and IL-6 (p < 0.0485) levels were also found, more significantly for LONS and EONS patients, respectively. In the diagnosis of LONS using CRP levels, the area under the ROC curve (AUC) was 0.8371 (p < 0.0001). The optimal cutoff was 0.53 mg/dL. For EONS diagnosis using IL-6, the AUC was 0.6869 (p = 0.0315) and the optimal cutoff was 17.75 pg/mL.

Conclusion Differences between CRP and IL-6 levels were found between control and NS groups. Furthermore, CRP showed greater potential diagnostic utility in the LONS group, whereas IL-6 showed greater potential utility in the EONS group.

Key Points

  • NS is a major morbimortality cause worldwide

  • CRP and IL-6 levels may be useful NS biomarkers

  • No biomarker alone is enough for the diagnosis of NS

Supplementary Material



Publication History

Received: 26 October 2019

Accepted: 18 March 2020

Publication Date:
23 May 2020 (online)

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