IJAR - Indian Journal of Applied Research

Dr. Purnima Mondal; Dr. Sudipta Kumar Maity; Prof.(Dr.) Jaydeb Ray

Volume : X, Issue : VIII, August - 2020

Role of interleukin-6 and interleukin-10 in early diagnosis of neonatal sepsis,a prospective study in a tertiary care hospital

Dr. Purnima Mondal, Dr. Sudipta Kumar Maity, Prof. Dr. Jaydeb Ray

Abstract :

Neonatal sepsis encompasses overwhelming infection without much localization (septicaemia) or infection localized to lungs (pneumonia) or meninges (meningitis).Early manifestations of neonatal sepsis are often subtle & non–specific. There is no rapid and reliable test for confirmation of etiological diagnosis. Treatment is generally started when clinical picture is supported by indirect early markers of neonatal infection. Many recent studies considered Procalcitonin to be a superior marker of neonatal sepsis compared to C–reactive protein (CRP) with the added advantage of differentiating bacterial & viral infection. Though IL–6 is a very early marker & major inducer of CRP , its level become normal even if infection continues, giving a false–negative result. But the simultaneous determination of IL–6 & CRP can obviate this problem, and sensitivity becomes 100%. Summary : The objective of this study is to establish clinico–pathological co–relation between neonatal sepsis & cytokines. Specific objectives of this study are to evaluate IL–6 & IL–10 as an early marker of neonatal sepsis and to compare the reliability of IL–6 & IL–10 with other marker of neonatal sepsis, viz.CRP (C reactive protein) in both probable and proven case of sepsis. Both inborn and outborn babies with & without signs and symptoms of neonatal sepsis were included in the study. IL–6 & IL–10 measurement done using immunoassay techniques in the Department of Biochemistry of Institute of Child Health, Kolkata. Blood cultures were positive in 10 cases out of total 63 neonates ( 16%, most common organism was Klebsiella sp). IL–10 & CRP concentrations are found significantly higher in the sepsis group compared to no–sepsis group. The sensitivity, specificity, positive predictive value, negative predictive value of serum IL–6,serum IL–10 & serum CRP was done using a cut–off value of 19pg/ml, 25pg/ml & 2mg/ml respectively. Combined IL–10 + CRP at lower cut off value has a better sensitivity (94.6%) compared to IL–6 + CRP (91.5%), whereas IL–6 + CRP has a better specificity (33.9%) than IL–10+ CRP (31.2%) . At higher cut off value IL–10+ CRP has better sensitivity and specificity than IL–6 + CRP. Routinely used sepsis markers like TLC, I/T ratio, ANC etc. were found to be inadequate to screen for sepsis on presentation in NICU. IL–10 & IL–6 may be a valid & early predictive marker of neonatal sepsis.