Abo El Magd Nagwa M, Abdel Salam Shimaa A, Aly Yasmin AF, Fahim Noha A
Department of Medical Microbiology & Immunology, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
Department of Pediatrics, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
Egypt J Immunol. 2018 Jun;25(2):87-95.
Neonatal sepsis remains a major cause of mortality and morbidity in neonates, Traditional methods for diagnosis like blood culture has a low sensitivity and delayed results in neonates. This study aimed to measure the level of interleukin-27 (IL-27) in sera of patients with neonatal sepsis to determine its potential role as a biomarker for diagnosis of bacterial sepsis. This prospective study included 90 neonates with suspected neonatal sepsis. Plasma levels of IL-27 were measured using an ELISA; blood culture, 16s r DNA and C-reactive protein (CRP) level were done to diagnose sepsis. The ROC curve analysis was performed to evaluate the predictive ability of IL 27 and CRP individually and in combination to identify bacterial sepsis in neonates. The Studied neonates were divided into 45 patients with neonatal sepsis and 45 uninfected systemic inflammatory response syndrome (SIRS) patients as controls. 30 neonates in the infected group were identified by positive blood culture results (66.6%) and 15 patients were identified by being positive for 16s r DNA (33.3%). For IL- 27, the ROC area under the curve (AUC) was 0.991 and a cut-off point of > 485.56 with sensitivity of 95.56% and a specificity of 100%. For CRP, the AUC value was 0.933 and a cut-off point of > 32 with sensitivity of 88.89% and a specificity of 82.22%. In conclusion, our results indicated that elevated IL-27 correlated well with bacterial sepsis among neonatal patients with bloodstream infections and may provide additional diagnostic value along with other available biomarkers.
新生儿败血症仍然是新生儿死亡和发病的主要原因，传统的诊断方法如血培养在新生儿中敏感性较低且结果延迟。本研究旨在测量新生儿败血症患者血清中白细胞介素-27（IL-27）的水平，以确定其作为细菌性败血症诊断生物标志物的潜在作用。这项前瞻性研究纳入了90例疑似新生儿败血症的新生儿。采用酶联免疫吸附测定法（ELISA）测量IL-27的血浆水平；进行血培养、16s r DNA和C反应蛋白（CRP）水平检测以诊断败血症。进行ROC曲线分析以评估IL-27和CRP单独及联合识别新生儿细菌性败血症的预测能力。研究的新生儿分为45例新生儿败血症患者和45例未感染的全身炎症反应综合征（SIRS）患者作为对照。感染组中30例新生儿通过血培养结果阳性确诊（66.6%），15例患者通过16s r DNA阳性确诊（33.3%）。对于IL-27，曲线下面积（AUC）为0.991，截断点>485.56，敏感性为95.56%，特异性为100%。对于CRP，AUC值为0.933，截断点>32，敏感性为88.89%，特异性为82.22%。总之，我们的结果表明，在患有血流感染的新生儿患者中，IL-27升高与细菌性败血症密切相关，并且可能与其他可用的生物标志物一起提供额外的诊断价值。
