Tumor necrosis factor-alpha and interleukin-6 in early-onset neonatal sepsis
Abstract
Background Neonatal sepsis remains a major cause of mortality and morbidity in newborns. Early-onset neonatal sepsis occurs in infants under the age of 72 hours, while late-onset neonatal sepsis occurs in infants over the age of 72 hours and may be due to nosocomial infection. Diagnosing neonatal sepsis is a challenge, as its clinical symptoms are not clear. Corroborating tests include routine blood, C-reactive protein (CRP), serology, tumor necrosis factor-alpha (TNF-α), and interleukin-6 (IL-6) examinations.
Objective To compare the TNF-α and IL-6 levels in patients with proven and unproven early-onset neonatal sepsis (EONS)
Methods This case-control study was done in the Perinatology Unit, Abdul Moeloek Hospital, Lampung. Subjects were under the age of 72 hours with risk factors and clinical symptoms of sepsis. They underwent routine blood tests and blood cultures. Infants with positive cultures were considered to have proven sepsis (26 subjects) and infants with negative blood cultures were considered to have unproven sepsis (26 subjects). All subjects underwent serological examinations of TNF-α and IL-6.
Results There were no differences in the basic characteristics of subjects between the two groups. Levels of TNF-α in the sepsis group were significantly higher than in the unproven group [(28.30 vs. 10.96 pg/mL, respectively (P=0.001)]. Furthermore, Il-6 was significantly higher in the proven sepsis group than in the unproven sepsis group [(28.3 vs. 9.69 pg/mL, respectively) (P=0.006)].
Conclusion Levels of TNF-alpha and IL-6 are significantly higher in infants with proven than unproven early-onset neonatal sepsis.
References
2. Rerksuppaphol L, Rerksuppaphol S. Functional dyspepsia in children. J Med Health Sci. 2007;14:78-89.
3. Hyams JS, Davis P, Sylvester FA, Zester DK, Justinich CJ, Lerer T. Dyspepsia in children and adolescents: a prospective study. J Pediatr Gastroenterol Nutr. 2000;30:413-8.
4. De Giacomo, Valdambrini V, Lizzoli F, Gissi A, Palestra U, Tinelli C, et al. A population-based survey on gastrointestinal tract symptoms and Helicobacter pylori infection in children and adolescents. Helicobacter. 2002;7:356-63.
5. Youssef NN, Murphy TG, Langseder AL, Rosh JR. Quality of life for children with functional abdominal pain: a comparison study of patients’ and parents’ perceptions. Pediatrics. 2006;117:54-9.
6. Nayak SK. Probiotics and immunity: a fish perspective. Fish and Shellfish Immunology. 2010;29:2-14.
7. Salvatore S, Vandenplas Y. Prebiotics and probiotics in therapy and prevention of gastrointestinal disease in children. New York: Elsevier; 2010. p. 181-97.
8. Rasquin A. Lorenzo CD, Forbes D, Guiraldes E, Hyams JS, Staiano A, et al. Childhood functional gastrointestinal disorders: child/ adolescent. Gastroenterology. 20006; 130:1527-37.
9. Wong D, Baker CM. Pain in children: comparison of assessment scales. Pediatr Nurs. 1988;14:9-17.
10. Simren M, Barbara G, Flint HJ, Spiegel BM, Spiller RC, Vanner S, et al. Intestinal microbiota in functional bowel disorders: a Rome foundation report. Gut. 2013;62:159-76.
11. Floch MH, Madsen KK, Jenkins DJ, Guandalini S, Katz JA, Onderdonk A, et al. Recommendations for probiotic use. J Clin Gastroenterol. 2006;40:275-8.
12. Connor FL, Di Lorenzo C. Motility. In: Walker WA, Gouglet O, Kleinman RE, editors. Pediatric gastrointestinal disease. 4th ed. New York: BC Decker Inc; 2004. p. 55-66.
13. Design of Treatment Trials Committee, Irvine EJ, Whitehead WE, Chey WD, Matsueda K, Shaw M, et al. Design of treatment trials for functional gastrointestinal disorders. Gastroenterology. 2006;130:1538-51.
14. Gawronska A, Dziechciarz P, Horvath A, Szajewska H. A randomized double-blind placebo-controlled trial of Lactobacillus GG for abdominal pain disorders in children. Aliment Pharmacol Ther. 2007;25:177-84.
15. Francavilla R, Miniello V, Magista AM, De Canio A, Bucci N, Gagliardi F, et al. A randomized controlled trial of Lactobacillus GG in children with functional abdominal pain. Pediatrics. 2010;126:1445-52.
16. Bausserman M, Michail S. The use of Lactobacillus GG in irritable bowel syndrome in children: a double-blind randomized control trial. J Pediatr. 2005;147:197-201.
17. Pawar D, Garten L. Pain management in children. In: Kopf A, Patel NB, editors. Guide to pain management in low-resource settings. Glasgow: International Association for the Study of Pain; 2010. p.255-68.
18. Stone AA, Shiffman S, Schwartz JE, Broderick JE, Hufford MR. Patient non-compliance with paper diaries. BMJ. 2002;324:1193-4.
19. Kligler B, Cohrssen A. Probiotics. Am Fam Physician. 2008;78:1073-8.
20. Saps M, Di Lorenzo C. Probiotics for abdominal pain disorders in children-safe to use but are they helpful? Nat Clin Pract Gastroenterol Hepatol. 2007;4:430-1.
21. Nowroozi J, Mirzaii M, Norouzi M. Study of Lactobacillus as probiotic bacteria. Iranian J Pub Health. 2004;33:1-7.
Authors who publish with this journal agree to the following terms:
Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
Accepted 2016-03-30
Published 2016-05-12
