Context: Neonatal sepsis is a clinical syndrome of bacteraemia characterized by systemic signs and symptoms of infection in the first month of life. Blood culture is the mainstay of diagnosis but it has a long turnaround time and a delay in instituting therapy affects outcome. Taking this into perspective, the present study was undertaken to find out the importance of two inflammatory markers in the rapid diagnosis of neonatal sepsis.

Aim: To compare the utility of Interleukin-6 and Tumour necrosis factor-α with automated blood culture in rapid diagnosis of neonatal sepsis.

Settings and Design: A prospective cross-sectional study of one year (from September 2017 to August 2018) was carried out in Neonatal Intensive Care Unit of this institute.

Methods and Material: Sixty neonates with clinically suspected sepsis were included. Blood cultures were processed in BACTEC 9120 system. Enzyme Linked Immunosorbent Assay was performed for IL-6 and TNF-α. Values were compared to blood culture positivity.

Statistical Analysis: Sensitivity, Specificity, Mean, Student unpaired T test, Chi square test and p- values

Results: In this study, sensitivity and negative predictive value of both IL-6 and TNF-α was 100%. Statistically IL-6 was shown to be a better marker than TNF-α in the rapid diagnosis of neonatal sepsis, both in early- and late-onset. IL-6 and TNF-α jointly showed a high sensitivity and were comparable in specificity to blood culture, as compared to any of these two markers alone.

Conclusions: This study highlights the importance of IL-6 and TNF-α estimation for rapid diagnosis of neonatal sepsis, enabling effective management and better prognosis.

Keywords: Neonatal sepsis; Interleukin-6; Tumour necrosis factor-α.

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Nirjhar Chatterjee

Assistant Professor, Department of Microbiology, TNMC & Nair Hospital Mumbai