Altered resistin and IL6 in Neonatal sepsis in patients admitted in a tertiary care teaching hospital at Eastern India

Abstract

Background: Neonatal sepsis is a clinical syndrome followed by bacteraemia in the first month of life and appears to be one of the primary causes of mortality and morbidity worldwide. The study aim was to detect the levels of resistin, IL-6, CRP and hs-CRP in clinically suspected cases of neonatal sepsis and establish its association with the pathogenesis of the disease. Materials & Methods: The case control study consists of 78 neonates of whom 42 were clinically suspected case of sepsis admitted in NICU of Paediatric department and were taken as cases and 36 were normal healthy neonates taken as control subjects in a tertiary care teaching hospital, Durgapur, West Bengal. The cases as well as controls were within 28 days of age. Preterm and term neonates (< 28 days of age) of both sexes showing signs of both early and late onset sepsis and also blood culture positive were included in the study. Two ml of blood was collected without anticoagulant and serum was separated by centrifugation at 3500 rpm for 15-20 mins and was used for measurement of hs-CRP, resistin and IL 6. Serum hs-CRP levels was determined with a high-sensitivity nephelometric method while the serum level of IL-6 and Resistin were measured by immunoassay Kits (Raybiotech, USA). Results: Serum resistin levels were increased in sepsis cases as compared to controls and were statistically significant (38.96 ± 17.15 vs 15.49 ± 8.54 ng/ml; p < 0.0001). It was also observed that serum IL 6 levels were higher in sepsis cases as compared to controls which was statistically significant (58.19 ± 39.97 versus 8.48 ± 3.90 pg/ml; P < 0.0001). However, a weak positive correlation was observed between serum resistin with serum IL 6 level (r = 0.343; P = 0.025) among neonatal sepsis subjects while no correlation was seen in controls (r = 0.141; P = 0.411). Conclusion: The measurement of these sepsis markers is extremely important only in case of neonates with unclear infectious status. We have observed a significant rise in Resistin or IL 6 or hs-CRP which may be suggested as specific marker for the identification of neonatal sepsis.  The combination of Resistin or IL 6 or CRP or hs-CRP could therefore be crucial for the diagnosis and would be better predictors of neonatal sepsis and may be crucial in the pathogenesis of the disease.

Keywords: Preterm neonates, neonatal sepsis, mortality and morbidity, serum resistin, interleukin-6 (IL-6), hs-CRP