Orfanos Ioannis, Krusell Emilie Thorén, Elfving Kristina
Department of Clinical Sciences, Lund University, Lund, Sweden.
Department of Pediatrics, Skåne University Hospital, Lund, Sweden.
Acta Paediatr. 2025 Jan;114(1):173-179. doi: 10.1111/apa.17422. Epub 2024 Sep 17.
The aim of this study is to investigate the utility of interleukin-6 (IL-6) in the early diagnosis of serious bacterial infections (SBI) in febrile infants and to compare it with C-reactive protein (CRP).
Retrospective study conducted in the paediatric emergency department in Gothenburg, Sweden, on previously healthy, full-term infants aged ≤60 days with fever without a source (FWS) from 2014 to 2017.
We included 536 infants with FWS, of whom IL-6 was analysed in 364 (68%) and CRP was analysed in 494 (92%). Approximately 70% of the infants presented with a fever duration of less than 12 h. The prevalence of SBIs was 14.8% (95% CI,11.3-18.9) in the IL-6 group and 17.8% (95% CI,14.5-21.5) in the CRP group. The sensitivity, specificity, negative predictive value (NPV), and positive predictive value (PPV) of IL-6 ≥50 ng/L were 93%, 66%, 98% and 33%, respectively. For CRP ≥20 mg/L, the sensitivity, specificity, NPV, and PPV were 76%, 89%, 95%, and 55%, respectively. Logistic regression analysis showed that CRP was significantly associated with SBI (p < 0.0001) in the entire population, whereas IL-6 was not.
Interleukin-6 showed high sensitivity and NPV, which might assist in identifying SBIs early in febrile infants. However, IL-6 was not shown to be superior to CRP and further studies are needed to investigate whether IL-6 should be incorporated in clinical management.
本研究旨在探讨白细胞介素-6（IL-6）在发热婴儿严重细菌感染（SBI）早期诊断中的效用，并将其与C反应蛋白（CRP）进行比较。
在瑞典哥德堡的儿科急诊科对2014年至2017年期间年龄≤60天、既往健康、无明确病因发热（FWS）的足月婴儿进行回顾性研究。
我们纳入了536例FWS婴儿，其中364例（68%）分析了IL-6，494例（92%）分析了CRP。约70%的婴儿发热持续时间少于12小时。IL-6组SBI的患病率为14.8%（95%CI，11.3 - 18.9），CRP组为17.8%（95%CI，14.5 - 21.5）。IL-6≥50 ng/L时的敏感性、特异性、阴性预测值（NPV）和阳性预测值（PPV）分别为93%、66%、98%和33%。对于CRP≥20 mg/L，敏感性、特异性、NPV和PPV分别为76%、89%、95%和55%。逻辑回归分析表明，在整个人群中CRP与SBI显著相关（p＜0.0001），而IL-6并非如此。
白细胞介素-6显示出高敏感性和NPV，这可能有助于在发热婴儿中早期识别SBI。然而，IL-6并未显示优于CRP，需要进一步研究以探讨IL-6是否应纳入临床管理。
