Marker Of Neonatal Infection Research Articles

Investigation of Changes in Nucleated Red Blood Cells in Neonatal Infection

Background: Early diagnosis is paramount to the treatment of neonatal infections. Nucleated red blood cells (NRBCs) are immature erythrocytes that increase in number due to stress and hypoxia. This study was conducted to determine NRBC count in the peripheral blood and examine its significance as a marker of neonatal infection. Methods: This case-control study was conducted on 154 infants (78 infants with infection as the case group and 76 infants without infection as the control group) admitted to Ghaem and Emam Reza hospitals, Mashhad, Iran. After a complete physical examination, a series of tests, including blood culture, complete blood count, C-reactive protein test, and peripheral blood smear, were performed on the infants; their NRBCs per 100 white blood cells (WBCs) were also counted. Results: The mean NRBC counts in the infants with and without infection were 30 and 3 per 100 WBCs, respectively (P<0.001). In cases with an NRBC count of more than 10, sensitivity and specificity were reported as 45% and 83%, respectively, and the positive and negative predictive values were 29% and 91%, respectively. The infants’ NRBC count was directly correlated with their mortality. Conclusion: NRBC count in the peripheral blood smear helps with the diagnosis of neonatal infection and can be used in conjunction with other laboratory tests as a simple and convenient method.

Temporal Relationship between Serum Levels of Interleukin-6 and C-Reactive Protein in Therapeutic Hypothermia for Neonatal Hypoxic-Ischemic Encephalopathy.

Objective C-reactive protein (CRP) is a useful marker of neonatal infection. Recent studies have shown that neonatal therapeutic hypothermia delays an elevation of CRP in infants with hypoxic-ischemic encephalopathy (HIE). This study investigated the time difference of peak levels of serum CRP and other inflammatory responses during therapeutic hypothermia. Study design We prospectively studied the serial serum data of CRP, interleukin-6 (IL-6), procalcitonin (PCT), and complete blood counts during the first week of life in HIE infants receiving therapeutic hypothermia. Results We identified 22 infants who received therapeutic hypothermia between August 2013 and July 2015. No infants developed clinically overt infections. The peak of serum levels of IL-6, PCT, and CRP were postnatal days 1, 2, and 4, respectively. White blood cells, neutrophils, and platelet counts gradually decreased from days 1 to 7. Early postnatal serum levels of IL-6 correlated with CRP on day 4 (IL-6 on day 2; r = 0.78, p < 0.001). Conclusion The peak value of CRP on day 4 might reflect the early production and secretion of IL-6 rather than an actual infection. Serial measurement of IL-6 might help avoid invasive sepsis workup and unnecessary change of antibiotics in infants.

Relation between interleukin-6 in the cervicovaginal fluid and subclinical chorioamnionitis in patients with preterm premature rupture of membranes

Abstract Objective To evaluate the accuracy of the interleukin-6 (IL-6) in the cervicovaginal fluid to diagnose subclinical chorioamnionitis and neonatal infection in patients with preterm premature rupture of membranes (PPROM). Methods One hundred and twenty (120) pregnant women > 34 weeks, and Results The sensitivity & specificity of Interleukin-6 test to diagnose neonatal infection were 82.8% & 89.3%; respectively, while the Interleukin-6 test sensitivity & specificity to diagnose chorioamnionitis were 90.7% & 91.0%; respectively. The positive predictive value (PPV) & negative predictive value (NPV) of Interleukin-6 test to diagnose neonatal infection were 86.9% & 85.9%; respectively, while the Interleukin-6 test PPV & NPV to diagnose chorioamnionitis were 87.5% & 93.4%; respectively. The accuracy of Interleukin-6 test to diagnose neonatal infection was 86.3%, while the accuracy of Interleukin-6 test to diagnose chorioamnionitis was 90.9%. Conclusions Detection of Interleukin-6 in the cervicovaginal secretion is a sensitive, non-invasive prenatal marker for neonatal infection and subclinical chorioamnionitis in patients with PPROM.

Interleukin-6: A Sensitive Parameter for the Early Detection of Neonatal Sepsis

Background: Neonatal sepsis is a major cause of neonatal mortality and morbidity throughout the world. Though blood culture is the gold standard and has higher sensitivity and specificity over the hematological value and cytokine, it is not available in our community health situation and also in most of health care facilities. It is also time consuming. Therefore hematological value and interleukin-6 can be evaluated for the early diagnosis of neonatal bacterial infection. Objective: This study was conducted to see the usefulness of IL-6 as an early marker of neonatal sepsis and also to compare the sensitivity in comparison with CRP, hematological value and blood culture. Study Design: It was a quasy experimental study. Setting: This study was carried out in the neonatal unit of pediatric department, BSMMU during the period of September, 2005 to February, 2006. Method: Forty five suspected septic cases were enrolled in the study and thirty healthy newborn were taken for comparison. Venous blood sample from peripheral vein was collected on the 1st day of symptoms and/or 1st day of admission and was sent for IL-6 estimation within half an hour and estimation of IL-6 was done by using immunolyte DPC USA which employed automated chemiluminescent immunoassays. Results: Out of forty five cases of suspected-neonatal sepsis, IL-6 were positive in twenty five cases. In culture proven sepsis 100% cases had raised IL-6. In control group only five babies had raised IL-6. Three cases were culture positive, of which all were also positive for IL-6 (100%). Among the cases twenty six were CRP positive, of which twenty were also positive for IL-6 (76.92%). Conclusion: In the present study IL-6 was found to be an early marker of neonatal infection. Sensitivity was more than CRP and other hematological parameter in the first twenty four hours. Key words: Interleukin-6, Neonatal Sepsis.DOI: 10.3329/bsmmuj.v1i1.3687 BSMMU J 2008; 1(1): 1-5

Mean Peroxidase Index as a Potential Marker for Neonatal Infection

Mean Peroxidase Index as a Potential Marker for Neonatal Infection

Immunologic markers in the neonatal period: diagnostic value and accuracy in infection

Diagnosis of early-onset neonatal infection has led to the development of several screening tests including C-reactive protein, a very commonly used marker, and cytokines (mainly interleukin-6 and -8), alone or in combination with C-reactive protein, based on the premise that their increases in response to infection may precede that of C-reactive protein. In recent years the search for diagnostic tests has turned to procalcitonin, a propeptide of calcitonin, which appears to be a promising marker of infection in newborn infants. Additionally, specific leukocyte cell surface antigens (mainly CD11b and CD64), detected by flow cytometry, are evaluated as markers of neonatal infection, since their expression on the cell membrane increases in substantial quantities after leukocyte activation by bacteria or their cellular products. This review aims to examine the role of these newly available immunologic indices and to assess their validity as diagnostic markers of infection during the neonatal period.

Procalcitonin (ProCT) as a Marker of Neonatal Infection. 142

Background: ProCT, new marker of bacterial infection, could be more useful than C Reactive Protein (CRP) in neonates suspected of infection but its evaluation has not been performed, especially in infants with RD.

Granulocyte colony-stimulating factor as a marker for bacterial infection in neonates

OBJECTIVE: To evaluate granulocyte colony-stimulating factor (G-CSF) as an early marker of bacterial or fungal infection in neonates. STUDY DESIGN: We measured G-CSF levels in infants of varying gestational and postnatal ages. We separated the infants into three groups: group 1, positive bacterial or fungal blood culture result; group 2, negative blood culture result but evidence of clinical sepsis; and group 3, negative blood culture result and no or weak evidence of sepsis. Comparison of mean G-CSF levels by group was accomplished by an analysis of variance. RESULTS: One hundred seventy-six evaluations for sepsis were done for 156 infants with gestational ages ranging from 24 to 43 weeks; 50% of these infants were less than 35 weeks of gestational age. The mean G-CSF levels of groups 1 and 2 were significantly higher than those of group 3. The mean G-CSF level of each group was 2278 pg/ml (group 1), 1873 pg/ml (group 2), and 280 pg/ml (group 3) ( p <0.001). On the basis of a cutoff level of 200 pg/ml, the sensitivity of the test was 95%, specificity 73%, positive predictive value 40%, and negative predictive value 99%. CONCLUSION: G-CSF levels represent a sensitive marker of infection in neonates of all gestational ages. (J P EDIATR 1996;128:765-9)