Abstract
Very low birth weight (VLBW) infants with suspected late-onset infection requiring sepsis screening were enrolled in a prospective study to evaluate the diagnostic utilities of a comprehensive panel of key chemokines and cytokines, both individually and in combination, to identify diagnostic markers for early recognition of bacterial sepsis and necrotizing enterocolitis (NEC). Plasma chemokines interleukin (IL)-8, interferon-γ–inducible protein 10 (IP-10), monokine induced by interferon-γ (MIG), monocyte chemoattractant protein 1 (MCP-1), growth-related oncogene-α (GRO-α), and regulated upon activation of normal T cell expressed and secreted (RANTES) and cytokines IL-1β, IL-6, IL-10, IL-12p70, and tumor necrosis factor α (TNF-α) were measured at the onset of sepsis (0 h) and 24 h later. Of 155 suspected infection episodes, 44 were classified as infected. Concentrations of all studied inflammatory mediators (except IL-1β and RANTES) were significantly higher in the infected than in the noninfected group at 0 h, but the levels decreased precipitously by 24 h. IP-10 with a plasma cutoff concentration ≥1250 pg/mL could identify all septicemic and NEC cases and had the highest overall sensitivity (93%) and specificity (89%) at 0 h. We conclude that preterm infants have the ability to induce a robust chemokine and cytokine response during sepsis, and IP-10 is a sensitive early marker of infection.
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Abbreviations
- CRP:
-
C-reactive protein
- GRO-α:
-
growth-related oncogene-α
- IP-10:
-
interferon-γ–inducible protein 10
- MCP-1:
-
monocyte chemoattractant protein 1
- MIG:
-
monokine induced by interferon-γ
- NEC:
-
necrotizing enterocolitis
- RANTES:
-
regulated upon activation of normal T cell expressed and secreted
- ROC:
-
receiver operating characteristics
- VLBW:
-
very low birth weight
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This project was supported by a direct grant of research awarded by the Research Grant Council of the Government of Hong Kong SAR (project code 2041147) and by the H. M. Lui Memorial Fund (Providence Foundation Limited) (project code 6901814).
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Ng, P., Li, K., Chui, K. et al. IP-10 Is an Early Diagnostic Marker for Identification of Late-Onset Bacterial Infection in Preterm Infants. Pediatr Res 61, 93–98 (2007). https://doi.org/10.1203/01.pdr.0000250207.95723.96
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DOI: https://doi.org/10.1203/01.pdr.0000250207.95723.96
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