Abstract
Salivary markers could serve as potential noninvasive markers in the diagnosis of neonatal infections. We aimed to investigate the diagnostic role of salivary and serum interleukin 10 (IL-10), C-reactive protein (CRP), mean platelet volume (MPV), and CRP/MPV ratio in the diagnosis of late-onset neonatal sepsis in full-term neonates. Seventy full-term neonates were enrolled in this prospective case-control study, 35 with late-onset neonatal sepsis, and 35 controls. Salivary IL-10, serum IL-10, and CRP concentrations were measured by enzyme-linked immunosorbent assay (ELISA). Complete blood (CBC) count was measured by an automated blood cell counter. The salivary IL-10, serum IL-10, CRP, MPV, and CRP/MPV ratio levels were much higher in neonates with late-onset sepsis than in control (220 ± 150 vs. 18 ± 9 pg/ml, P < 0.001), (316 ± 198 vs. 23.7 ± 14 pg/ml, P < 0.001), (78.2 ± 34 vs. 3.3 ± 1.7 mg/L, P < 0.001), (11.2 ± 0.9 vs. 8.6 ± 0.4 fL), and (7.08 ± 3.3 vs. 0.4 ± 0.2, P < 0.001), respectively. At the cutoff point of >31 pg/ml, salivary IL-10 showed 97.1% sensitivity and 94.3% specificity. Serum IL-10 at a cutoff value of ≥33.6 pg/ml had a sensitivity of 97.1% and specificity of 80%. MPV showed a sensitivity of 100% and specificity of 94.4% at a cutoff value ≥ 9.2 fL. CRP/MPV ratio showed a sensitivity of 100% and specificity of 97.1% at a cutoff value > 0.9. Salivary and serum IL-10 showed a positive correlation with CRP and CRP/MPV ratio in septic neonates. The current study shows for the first time that both salivary IL-10 and CRP/MPV showed statistically significant differences between neonates with late-onset sepsis and controls. Accordingly, salivary IL-10 could serve as a potential noninvasive biomarker for the diagnosis of late-onset sepsis in full-term neonates.
Highlights
Despite marked improvement in neonatal care, sepsis remains an important contributor to the neonatal morbidity and mortality worldwide [1, 2]
We evaluated the diagnostic value of salivary IL-10 as a noninvasive marker as well as serum IL-10, C-reactive protein (CRP), mean platelet volume (MPV), and CRP/MPV ratio in early diagnosis of late-onset neonatal sepsis in fullterm neonates
Our study investigates the value of CRP/MPV ratio in diagnosis of late-onset neonatal sepsis in full-term neonates
Summary
Despite marked improvement in neonatal care, sepsis remains an important contributor to the neonatal morbidity and mortality worldwide [1, 2]. Neonatal sepsis can be defined both clinically and/or microbiologically as a systemic inflammatory response to infection with the production and release of a wide range of inflammatory mediators. Detection of neonatal sepsis is still a very challenging task because of its nonspecific clinical presentation and difficulty to differentiate from noninfectious conditions [3, 4]. The gold standard to diagnose neonatal sepsis is blood culture which may be time-consuming and has limited sensitivity. Interleukin-10 (IL-10) is a key anti-inflammatory cytokine produced by many different kinds of immune cells and has a crucial role in preventing inflammatory and autoimmune pathologies [5,6,7]. The expression of anti-inflammatory cytokines including IL-10 is predominately occurring during the second phase of neonatal sepsis which reflects the upregulation of immunosuppressive mechanisms [8].
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