66 Original Article
Diagnostic Value of Immature Myeloid Information in Early-onset Bacterial Infection in Term and Preterm Neonates Diagnostischer Wert der immature myeloid Information bei der frühen Form der bakteriellen Infektion bei Früh- und Neugeborenen Authors
F. Neunhoeffer1, M. T. Dabek2, H. Renk1, P. Rimmele3, C. Poets3, R. Goelz3, T. Orlikowsky4
Affiliations
1
Key words ▶ immature myeloid ● information ▶ bacterial infection ● ▶ neonate ● ▶ interleukin-6 ● ▶ interleukin-8 ● ▶ C-reactive protein ● Schlüsselwörter ▶ immature myeloid informa● tion ▶ bakterielle Infektion ● ▶ Neonate ● ▶ interleukin-6 ● ▶ interleukin-8 ● ▶ C-reaktive Protein ●
Bibliography DOI http://dx.doi.org/ 10.1055/s-0034-1395552 Published online: February 4, 2015 Klin Padiatr 2015; 227: 66–71 © Georg Thieme Verlag KG Stuttgart · New York ISSN 0300-8630 Correspondence Felix Neunhoeffer Department of Paediatric Cardiology Pulmology and Paediatric Intensive Care Medicine University Children’s Hospital Hoppe-Seyler-Str. 1 72076 Tübingen Germany Tel.: + 49/70712/985 801 Fax: + 49/707/1295 804 Felix.Neunhoeffer@med. uni-tuebingen.de
Abstract
Zusammenfassung
Background: For quick detection of neonatal early-onset bacterial infection (EOBI) pro-inflammatory cytokines like Interleukin-6 (IL-6) and Interleukin-8 (IL-8) in combiantion with C-reactive Protein (CRP) have been used. Automated determination of immature myeloid informa-tion (IMI) seems to be an additional useful tool in the diagnosis of NBI. Objective: To compare the diagnostic value of IMI, I/T-Ratio, plasma IL-6 and IL-8 levels and CRP in term and preterm neonates at time of clinical suspicion of EOBI. Patients and Methods: 31 preterm and 123 term neonates with clinical and serological signs of EOBI were analysed. 91 preterm and 159 term neonates with risk factors but without proven EOBI served as non-infected controls. Results: Neonates with EOBI showed significantly elevated IMI levels at time of first clinical suspicion of EOBI (Preterm: 1 028/µL (38-8 759) vs. 289/µL (6-3 126); Term: 1 268/µL (48-14 035) vs. 856/µL (19-5 735); p 10 mg/L within 24 h after first clinical suspicion, or positive blood culture results. Based on previous studies [1, 12, 32], clinical signs were defined as follows: Fever (≥ 37.8 ° C rectal), hypothermia (≤ 36.5 ° C), temperature instability (≥ 1.5 ° C), pallor, greyish skin colour, poor perfusion (capillary refill > 2 s), tachypnea (> 60 respirations per minute at rest), dyspnea (grunting, nasal flaring, retractions), respiratory insufficiency, apnea, rising FiO2 in previously stable neonate, arterial hypotension (mean arterial blood pressure
Diagnostic Value of Immature Myeloid Information in Early-onset Bacterial Infection in Term and Preterm Neonates Diagnostischer Wert der immature myeloid Information bei der frühen Form der bakteriellen Infektion bei Früh- und Neugeborenen Authors
F. Neunhoeffer1, M. T. Dabek2, H. Renk1, P. Rimmele3, C. Poets3, R. Goelz3, T. Orlikowsky4
Affiliations
1
Key words ▶ immature myeloid ● information ▶ bacterial infection ● ▶ neonate ● ▶ interleukin-6 ● ▶ interleukin-8 ● ▶ C-reactive protein ● Schlüsselwörter ▶ immature myeloid informa● tion ▶ bakterielle Infektion ● ▶ Neonate ● ▶ interleukin-6 ● ▶ interleukin-8 ● ▶ C-reaktive Protein ●
Bibliography DOI http://dx.doi.org/ 10.1055/s-0034-1395552 Published online: February 4, 2015 Klin Padiatr 2015; 227: 66–71 © Georg Thieme Verlag KG Stuttgart · New York ISSN 0300-8630 Correspondence Felix Neunhoeffer Department of Paediatric Cardiology Pulmology and Paediatric Intensive Care Medicine University Children’s Hospital Hoppe-Seyler-Str. 1 72076 Tübingen Germany Tel.: + 49/70712/985 801 Fax: + 49/707/1295 804 Felix.Neunhoeffer@med. uni-tuebingen.de
Abstract
Zusammenfassung
Background: For quick detection of neonatal early-onset bacterial infection (EOBI) pro-inflammatory cytokines like Interleukin-6 (IL-6) and Interleukin-8 (IL-8) in combiantion with C-reactive Protein (CRP) have been used. Automated determination of immature myeloid informa-tion (IMI) seems to be an additional useful tool in the diagnosis of NBI. Objective: To compare the diagnostic value of IMI, I/T-Ratio, plasma IL-6 and IL-8 levels and CRP in term and preterm neonates at time of clinical suspicion of EOBI. Patients and Methods: 31 preterm and 123 term neonates with clinical and serological signs of EOBI were analysed. 91 preterm and 159 term neonates with risk factors but without proven EOBI served as non-infected controls. Results: Neonates with EOBI showed significantly elevated IMI levels at time of first clinical suspicion of EOBI (Preterm: 1 028/µL (38-8 759) vs. 289/µL (6-3 126); Term: 1 268/µL (48-14 035) vs. 856/µL (19-5 735); p 10 mg/L within 24 h after first clinical suspicion, or positive blood culture results. Based on previous studies [1, 12, 32], clinical signs were defined as follows: Fever (≥ 37.8 ° C rectal), hypothermia (≤ 36.5 ° C), temperature instability (≥ 1.5 ° C), pallor, greyish skin colour, poor perfusion (capillary refill > 2 s), tachypnea (> 60 respirations per minute at rest), dyspnea (grunting, nasal flaring, retractions), respiratory insufficiency, apnea, rising FiO2 in previously stable neonate, arterial hypotension (mean arterial blood pressure
