Diagnostic role of interleukin-6 and quantitative C-reactive protein in suspected early onset neonatal sepsis

Introduction: Neonatal sepsis is a major cause of morbidity and mortality most remarkable in the third world nations. Early diagnosis and subsequent therapy for the infected infants may play a vital role in lowering such mortality and morbidity rates. Aim: To study the clinical profile of neonatal sepsis in a tertiary care hospital and to correlate the findings with quantitative C-reactive protein (CRP) and Interleukin-6 (IL-6). Settings and Design: A total of 296 neonates admitted in neonatal intensive care unit (NICU) with clinical signs and symptoms suggestive of sepsis were studied. Based on their age the study population was divided into early onset sepsis (EOS): age group less 72 hours and late onset sepsis (LOS): age group more than 72 hours. Also healthy neonates who had no signs and symptoms of sepsis were taken as control for the study. Material and Methods: Blood culture was carried out using BacT/ Alert-3D automated system. Quantitative CRP by nephelometry and IL-6 by ELISA was done in all culture positive cases and controls. Correlation of detection of cases of sepsis by quantitative CRP and IL-6 with blood culture was carried out. Statistical analysis: Statistical parameters such as sensitivity, specificity, predictive values, accuracy and significance levels were calculated Results: In EOS the sensitivity and negative predictive value (NPV) of IL-6 was 62.32% and 33.33% respectively as compared to sensitivity of 27.5% and NPV of 26.47% of CRP. Conclusions: IL-6 is a good marker for early onset sepsis than CRP detecting a greater number of sepsis cases.