1388 Assessment of a Series of Markers as Diagnostic Tools of Early-Onset Neonatal Sepsis

Abstract

Aim: The aim of the research was to evaluate the usefulness of Toll-like receptors 2(TLR-2) and 4(TLR-4), interleukine-6(IL-6), tumor necrosis factor-alpha(TNF- α) and C-reactive protein(CRP) in diagnosis of early neonatal sepsis on preterm babies with premature rupture of membranes.Material and Methods:A prospective study has carried out between jan.2007-jan.2008 at Neonatology Department of the Cluj District University Hospital.Diagnosis of sepsis was done according to International Sepsis Definitions Criteria. Study group involved 21 newborns with symptoms suggestive of systemic infection, requiring sepsis evaluation, antibiotic treatment and control group represented by healthy newborns. We determined in the first day of life TLR-2, TLR-4, IL-6, TNF-α and CRP and in the third day the same without TLR. We used latex agglutination test for CRP, Elisa technique for TNF-α and IL-6 and flow cytometry for TLR. Data were analyzed using Statistica 6.0.Results: Sepsis group presented in the 1st day: TNF-α (pg/ml)= 14,7[5,0-24,3]; IL6 (pg/ ml)=153,7[82,3-225,1]; CRP (mg%)= 0,83[0,54- 1,12]; and the expression(%) of TLR2 = 42,5 [29,5- 55,4]; and TLR4 = 2,2[1,26-3,15]. TNF- α was correlate significantly and negative with TLR2. TLR2 was correlated significantly and positive with TLR4. In the 3-rd day the values were: TNF-α (pg/ml)= 10,1[5,1-15,1]; IL6(pg/ml)=46,5[16,3-76,7]; CRP (mg%)= 1,2[0,6-1,81]. Control group presented: TLR2(%) = 5,69 (p= 0,00006) and TLR4(%) = 0,67(p = 0,037).Conclusions: IL-6 and TNF-α can be considered markers of early-onset neonatal sepsis. TLR-2 and TLR-4 could be promising markers for neonatal sepsis. CRP revealed not to be a useful marker in diagnosis of early-onset sepsis.