Department of Pediatrics, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
J Trop Pediatr. 2011 Apr;57(2):145-51. doi: 10.1093/tropej/fmr021.
Early diagnosis of serious bacterial infection (SBI) in young infants is a difficult problem by clinical symptoms and signs. The goal of this study is to evaluate the predictive value of plasma IP-10 levels for early diagnosis of SBI in young infants <4 months of age.
We enrolled pediatric patients who were <4 months of age with a clinical suspicion to have SBI admitted in neonatal intensive care unit or complete nursing unit of Pediatric Department of Kaohsiung Medical University Hospital. Blood was drawn for measurement of complete blood counts, C-reactive protein (CRP) and plasma IP-10 levels and microbiological cultures were obtained at the time of admission.
There were 60 patients enrolled in this study. The SBI group (n = 21) have higher plasma IP-10 levels than those infants without SBI (n = 39) [median 104.8 (range 0-1457.1) versus 0 (range 0-129.3) pg ml(-1), P = 0.0161 after adjusting age]. A plasma IP-10 level >48.2 pg ml(-1) had the best diagnostic accuracy for indicating SBI {sensitivity 81.0% [95% confidence interval (CI) 71.1-90.1%]; specificity 94.9% [95% CI 65.4-87.0%]; positive likelihood ratio 15.9, negative likelihood ratio 0.2}.
In infants who were <4 months of age with suspicion of SBI, IP-10 assay might be a good predictor. Key words: chemokine, IP-10, serious bacterial infection, young infant, C-reactive protein.
通过临床症状和体征，早期诊断婴儿重症细菌感染（SBI）是一个难题。本研究旨在评估血浆 IP-10 水平对<4 个月龄婴儿 SBI 的早期诊断价值。
我们纳入了<4 个月龄且疑似患有 SBI 的儿科患者，这些患者入住高雄医学大学附设中和纪念医院新生儿加护病房或小儿科完整护理病房。入院时抽取血液进行全血细胞计数、C 反应蛋白（CRP）和血浆 IP-10 水平检测，并进行微生物培养。
本研究共纳入 60 例患者。SBI 组（n = 21）的血浆 IP-10 水平高于无 SBI 组（n = 39）[中位数 104.8（范围 0-1457.1）比 0（范围 0-129.3）pg/ml，P = 0.0161，校正年龄后]。血浆 IP-10 水平>48.2pg/ml 对指示 SBI 具有最佳的诊断准确性[敏感度 81.0%（95%CI 71.1-90.1%）；特异性 94.9%（95%CI 65.4-87.0%）；阳性似然比 15.9，阴性似然比 0.2]。
对于怀疑患有 SBI 的<4 个月龄婴儿，IP-10 检测可能是一种很好的预测指标。关键词：趋化因子；IP-10；重症细菌感染；婴儿；C 反应蛋白。
