Publication:

Raised IL-6 and C-reactive protein in neonatal sepsis in Eastern India

Background Neonatal sepsis (NS) has significant morbidity and mortality rates and it is still difficult to diagnose on presentation. Early diagnosis and treatment decreases the mortality and morbidity of neonatal sepsis (NS). The study’s aim was to detect the levels of IL-6, CRP and hs-CRP in clinically suspected cases of neonatal sepsis and establish its association with the pathogenesis of the disease.

Methods The case control study consists of 70 neonates of whom 36 were clinically suspected case of sepsis admitted in NICU of paediatric department and were taken as cases and 34 were normal healthy neonates taken as control subjects. The cases as well as controls were within 28 days of age. Preterm and term neonates (<28 days of age) of both sexes showing signs of both early and late onset sepsis and also blood culture positive were included in the study. About 4 ml of venous blood was taken for measurement of hs CRP and IL 6. Serum hs-CRP levels was determined with a high-sensitivity nephelometric method while the serum level of IL 6 was measured by immunoassay Kits (Raybiotech, USA).

Results Serum IL 6 levels were increased in sepsis cases as compared to controls and were statistically significant (68.94±36.32 versus 8.26±3.82 pg/ml; P <0.0001). However, a high positive correlation was observed between ESR with serum IL 6 level (r=0.825; P = <0.001) among neonatal sepsis subjects while no correlation was seen in controls (r=0.279; P=0.098).

Conclusions It was observed that a significant rise in IL-6 or hs-CRP which may be suggested as specific marker for the identification of neonatal sepsis.  The combination of IL-6 or CRP or hs-CRP could therefore be vital for the diagnosis and would be better predictors of neonatal sepsis and may be crucial in the pathogenesis of the disease.