C-reactive protein, interleukin-6, and procalcitonin in diagnosis of late- onset bloodstream infection in very preterm infants

Journal of the Pediatric Infectious Diseases SocietyBerka I, et al. | August 04, 2021


This study suggests a great potential of the combination of interleukin-6 (IL-6) and C-reactive protein (CRP) in routine rapid diagnosis of late-onset bloodstream infection (LOBSI) development. Antibiotic treatment could be discontinued early due to high negative predictive value of all tested markers.

  • Positive blood culture, clinical signs of infection, and onset more than 72 hours after birth defined LOBSI.

  • Relative to other markers (procalcitonin and CRP), IL-6 level was superior.

  • For the presence of LOBSI, IL-6 levels greater than 100 ng/L had a sensitivity of 94% and a specificity of 99%.

  • The optimal cutoff values of IL-6, CRP, and PCT showed negative predictive values of 99%, 95%, and 93%, respectively.

  • In 97.9% of cases, successful prediction of LOBSI was achieved with the logistic regression model of IL-6 > 100 ng/L or CRP > 10 mg/L.

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