Assessment of The Role of Interleukin 6, C-Reactive Protein and high sensitive CReactive Protein in the Diagnosis of Early Onset Neonatal Sepsis (A clinical and Laboratory Approach.

Background: Bacterial sepsis is a life threatening crisis with high mortality and morbidity in neonates, Reliable marker is needed for the diagnosis of neonatal sepsis. C-reactive protein (CRP), IL-6 can be used as Reliable markers for the diagnosis of neonatal sepsis so that early treatment could be achieved. Aim of the work: to detect the levels of IL-6, CRP and HS-CRP in clinically suspected cases of neonatal sepsis and evaluation and analysis of these measurments as early markers of neonatal sepsis. Patients and methods: A prospective cohort study was carried on 60 neonates at neonatal intensive care unit of pediatric department and clinical pathology department at Zagazig university hospitals. Results: IL-6 at a cut off value of 187.5Pg/ml had sensitivity of 87.5% and specificity of 63.6% with a negative predictive value of 93.3%. HS-CRP at a cut off value of 3.3 Mg/L had a higher sensitivity but a lower specificity at 100% and 47.7% repectively. CRP showed higher specificity than HS-CRP and IL-6 with 61.7% with a negative predictive value of 90%. A combination of IL-6 and CRP showed improvement of sensitivity to 100% and a negative predictive value of 100% and is more cost effective than the combination of IL-6 and HS-CRP which showed similar sensitivity and negative predictive value but showed less specificity Conclusion: a combination of IL-6 and HS-CRP would be a sensitive test for early diagnosis of neonatal sepsis at a sensitivity of 100% and a similar NPV, on the other hand a combination of IL-6 and CRP is less sensitive but more specific. [ABSTRACT FROM AUTHOR]