INTERLEUKIN-6 AND INTERLEUKIN-8 LEVELS IN NEONATAL SEPSIS

O. van Ditzhuyzen. X. Heches, D. Roi.

Centre Hospitalier Layné, 40000 Mont de Marsan, France

OBJECTIVE: The lack of specific clinical or laboratory findings in neonatal sepsis can be potentially life-threatening either due to delayed treatment or unnecessary antibiotic therapy. We have performed a prospective study to define the predictive value of Interleukin-6 (11-6) and Interleukin-8 (11-8) levels in a group of neonates at increased risk of sepsis.

METHODS: Inclusion criteria were defined by prolonged and/or premature rupture of membranes, fever during or within one week of labor, urinary tract infection in the 2 weeks prior to delivery. 11-6 and 11-8 levels were routinely available within 2 hours of cordocentesis (chiminoluminescence, IMMULITE, DPC France). Patients with C-Reactive-Protein (CRP) level above 5 mg/L were excluded and treated regardless of other findings.

RESULTS: Three hundred sixty out of 1250 consecutive births were monitored over a 15 months period according to maternal criteria of which 246 of whom newborn had a CRP less then 5 mg/L. A diagnosis of sepsis was made in 35 neonates at 48 hours as a result of the clinical and laboratory findings including 10 whose results were borderline, 211 neonates had no evidence of infection.

Statistical analysis yielded the following results for an 11-6 and 11-8 threshold >100 ng/mL.

	sensibility	specificity	positive predictive value	negative predictive value
11-6	57%	95%	69%	93%
11-8	40%	96%	61%	91%

CONCLUSION: Elevated levels of 11-6 and 11-8 levels reliably indicate early sepsis and could be a useful diagnostic tool readily available to most neonatal units