Accuracy of plasma interleukin-6 and C-reactive protein as markers of sepsis in preterm neonates with respiratory distress syndrome

Aim: To evaluate the diagnostic accuracy of plasma interleukin-6 (IL-6) and serum CRP in detecting blood culture proven sepsis in preterm neonates with respiratory distress syndrome (RDS).Patients and Methods: 140 preterm neonates, 62 with RDS and 78 without RDS, who developed clinical signs of sepsis were prospectively studied. Plasma IL-6 and serum CRP levels were measured. The ROC curves, the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and likelihood ratios (LR) were calculated for IL-6 (> 20 pg/mL and > 80 pg/mL) and CRP (> 10 mg/L).Results: Positive blood cultures were found in 64 neonates (37 with RDS and 27 without RDS). Neonates with RDS had higher IL-6 (p 20 pg/mL was 0,93, 0,65 and 2,68, respectively, in neonates without RDS, and 0,92, 0,16 and 1,09, respectively, in neonates with RDS. The sensitivity, specificity and LR of CRP > 10mg/L were 0,86, 0,71 and 2,97, respectively, in neonates without RDS and 0,73, 0,68 and 2,28, respectively, in neonates with RDS.Conclusions: In neonates without RDS both the IL-6 and CRP are equally accurate markers in diagnosing sepsis, whereas in those with RDS the diagnostic value of IL-6 is limited