Microbiological study of cases of early neonatal sepsis and evaluation of the role of C-reactive protein, interleukin-6 and interleukin-8 as diagnostic biomarkers of such cases

Neonatal sepsis is responsible for significant morbidity and mortality. Its early diagnosis is very important but very difficult. This study aimed to evaluate the value of C reactive protein (CRP), interleukin 6 (IL-6) and interleukin 8 (IL-8) as early diagnostic biomarkers for early neonatal sepsis (ENOS). Forty neonates with prenatal risk for neonatal sepsis with their mother were taken in this study (group I). Ten healthy neonates and their healthy mothers were taken as the control group (group II) in Tanta University Hospital in the period of March to December, 2016. White blood count (WBC), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), interleukin-6 (IL-6) and interleukin-8 (IL-8) were evaluated in cord blood of neonates and in mother’s sera. Also, cultures were done for neonates to confirm neonatal sepsis. The results of this study showed that the gestational age was shorter in the study group than the control group. Staphylococcus aureus represent 55% of the organisms isolated from cases of early neonatal sepsis. WBC, ESR, CRP, IL-6 and IL-8 were significantly higher in the study group than the control group. In the study group, 50% had positive cultures, while there were only 10% in thr control group with P value of 0.001. The sensitivity, specificity, positive predictive value (PPV) and negative predictive values (NPV) for CRP were 88.6, 84.7, 86.9 and 90.4%, for IL-6, they were 92.4, 97.6, 90.4 and 86.6%, for IL-8, they were 90.8, 88.9, 92.4 and 91.7%, respectively. The best sensitivity and NPV was for IL-6. Cord blood CRP alone has little utility in EONS diagnosis. IL-6 and IL-8 has great superiority than CRP when combined with other hematological markers. IL-6 was better diagnostic biomarker for ENOS than IL-8 and CRP.