A influŒncia do tempo de coleta sobre os nÌveis de interleucina-6 na sepse neonatal precoce The role of sample collection timing on interleukin-6 levels in early-onset neonatal sepsis

Objective: To assess different perinatal findings and sample collection timing in newborns with early-onset sepsis comparing those with low IL-6 levels to the ones with high levels. Methods: Eighty-five newborn infants, with clinical signs of sepsis and/or positive blood cultures, had plasma IL-6 collected in the initial evaluation for early-onset sepsis in the first 96 hours of life. They were classified in two groups according to their plasma IL-6 levels: higher, and equal to or lower than IL-6 median value for the whole septic group Results: Median IL-6 for the whole group was 89 pg/ml. High and low level groups were formed by 42 and 43 newborns respectively. There were no differences between the two groups regarding gestational ages, birth weights, cesarean-section proportion, Apgar scores, number of neonates with maternal risk factors for infection, number of maternal intrapartum antibiotic therapy, and number of positive blood cultures. Median plasma IL-6 in the high level group was 287 pg/ml, and in the low level group 46 pg/ml (p < 0.001). Median sample timing was 17.5 hours of life for the high level group and 36 hours of life for the low level group (p < 0.001). There was a significant negative correlation coefficient between IL-6 levels and sample collection timing. Conclusion: Sample collection timing is an important factor for detection of high plasma IL-6 level in newborn infants with earlyonset sepsis.

[1]  R. C. Silveira,et al.  Interleukin-6 and tumor necrosis factor-alpha levels in plasma and cerebrospinal fluid of term newborn infants with hypoxic-ischemic encephalopathy. , 2003, The Journal of pediatrics.

[2]  E. Doménech,et al.  Role of cytokines (interleukin‐1β, 6, 8, tumour necrosis factor‐α, and soluble receptor of interleukin‐2) and C‐reactive protein in the diagnosis of neonatal sepsis , 2003 .

[3]  O. Ramilo,et al.  Clinical chorioamnionitis, elevated cytokines, and brain injury in term infants. , 2002, Pediatrics.

[4]  P. Temming,et al.  Enhanced Interleukin-6 and Interleukin-8 Synthesis in Term and Preterm Infants , 2002, Pediatric Research.

[5]  L. Vatten,et al.  Early diagnostic markers for neonatal sepsis: comparing C-reactive protein, interleukin-6, soluble tumour necrosis factor receptors and soluble adhesion molecules. , 2001, Journal of clinical epidemiology.

[6]  L. Bentz,et al.  Association Between Funisitis and Elevated Interleukin‐6 in Cord Blood , 2001, Obstetrics and gynecology.

[7]  R. Romero,et al.  The relationship among inflammatory lesions of the umbilical cord (funisitis), umbilical cord plasma interleukin 6 concentration, amniotic fluid infection, and neonatal sepsis. , 2000, American journal of obstetrics and gynecology.

[8]  A. Leviton,et al.  Brain damage in preterm newborns: biological response modification as a strategy to reduce disabilities. , 2000, The Journal of pediatrics.

[9]  R. Procianoy,et al.  Evaluation of interleukin‐6, tumour necrosis factor‐α and interleukin‐1β for early diagnosis of neonatal sepsis , 1999 .

[10]  L. Pacifico,et al.  Interleukin 6 in neonates with early and late onset infection. , 1997, The Pediatric infectious disease journal.

[11]  P. Bartmann,et al.  INTERLEUKIN‐6: A SENSITIVE PARAMETER FOR THE EARLY DIAGNOSIS OF NEONATAL BACTERIAL INFECTION: 480 , 1997, Pediatrics.

[12]  Michael R. Anderson,et al.  Advances in the therapy for sepsis in children. , 1997, Pediatric clinics of North America.

[13]  U. Simeoni,et al.  Evaluation of interleukin-6 and soluble receptors of tumor necrosis factor for early diagnosis of neonatal infection. , 1996, The Journal of pediatrics.

[14]  S. Cohen,et al.  Cytokine function: a study in biologic diversity. , 1996, American journal of clinical pathology.

[15]  E. Bont,et al.  Diagnostic value of plasma levels of tumor necrosis factor α (TNFα) and interleukin‐6 (IL‐6) in newborns with sepsis , 1994, Acta paediatrica.

[16]  T. Hirano.  The biology of interleukin-6. , 1992, Chemical immunology.

[17]  J. Gerdes,et al.  Clinicopathologic approach to the diagnosis of neonatal sepsis. , 1991, Clinics in perinatology.

[18]  T. Kishimoto,et al.  The biology of interleukin-6. , 1989, Blood.

[19]  William Oh,et al.  Changes in pathogens causing early-onset sepsis in very-low-birth-weight infants , 2003 .

[20]  F. Signore,et al.  C-reactive protein, interleukin-6, and procalcitonin in the immediate postnatal period: influence of illness severity, risk status, antenatal and perinatal complications, and infection. , 2003, Clinical chemistry.