Diagnostic Value of IL-6, CRP, WBC, and Absolute Neutrophil Count to Predict Serious Bacterial Infection in Febrile Infants

  • Marjaneh Zarkesh Mail Pediatrics growth disorders research center, 17 Shahrivar Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
  • Fatemeh Sedaghat Pediatrics growth disorders research center, 17 Shahrivar Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
  • Abtin Heidarzadeh Department of Social Medicine, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
  • Manizheh Tabrizi Pediatrics growth disorders research center, 17 Shahrivar Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
  • Kobra Bolooki Moghadam Pediatrics growth disorders research center, 17 Shahrivar Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
  • Soheil Ghesmati Pediatrics growth disorders research center, 17 Shahrivar Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
Keywords:
CRP, Febrile infants, IL-6, Serious bacterial infection

Abstract

Since  clinical  manifestations  of  most  febrile  infants  younger  than  three  months  old  are nonspecific, differentiation of Serious Bacterial Infection (SBI) from self-limiting viral illness is a significant challenge for pediatricians. This study was performed to assess the diagnostic value of white blood cell count (WBC), Absolute Neutrophil Count (ANC), Interleukin -6 (IL-6) and C-reactive protein   (CRP) level to predict SBI in febrile infants younger than three months old who were hospitalized. This was a diagnostic test validation study. In this prospective study, 195 febrile infants admitted to 17 Shahrivar Hospital underwent a full sepsis workup including blood, urine, cerebrospinal fluid cultures and chest radiography. WBC count, ANC and CRP and Il-6 level were measured in all patients. Serum IL-6 concentration was measured by Enzyme-linked Immunosorbent Assay test. Then diagnostic, values of these tests for predicting SBI was compared with each other. Of total cases, 112 (57.4%) infants were male. SBI was diagnosed in 29 (14.9%) patients. The most common type of SBI was Urinary Tract Infection (UTI). Serum IL-6 (³20pg/dl) had sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of 79/1%, 91.6%,75.4%,  60.3%,  respectively  and  for  CRP  (³  10mg/l)  values  were  81.6%,  89.8%,  78.2%,  and  52%,respectively. The predictive values of CRP and IL-6 were higher than WBC and ANC. IL-6 and CRP are more valid and better diagnostic markers for predicting SBI than WBC count and ANC. CRP level seems to be an accessible and cost-effective marker for early diagnosis of SBI. Since by no marker we can totally rule out SBI in febrile infants < three months of age, it is recommended to administer systemic antibiotics until culture results become available.

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Published
2015-10-06
How to Cite
1.
Zarkesh M, Sedaghat F, Heidarzadeh A, Tabrizi M, Bolooki Moghadam K, Ghesmati S. Diagnostic Value of IL-6, CRP, WBC, and Absolute Neutrophil Count to Predict Serious Bacterial Infection in Febrile Infants. Acta Med Iran. 53(7):408-411.
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