PEDIATRICS Vol. 108 No. 1 July 2001, p. e12

ELECTRONIC ARTICLE:
Neutrophil CD11b Expression and Circulating Interleukin-8 as Diagnostic Markers for Early-Onset Neonatal Sepsis

Received Oct 11, 2000; accepted Feb 12, 2001.

Irmeli Nupponen^*, , Sture Andersson^{*, §}, Anna-Liisa Järvenpää^*, Hannu Kautiainen, and Heikki Repo^{, ¶}

From the ^* Hospital for Children and Adolescents, University of Helsinki, Finland;  Department of Bacteriology and Immunology, Haartman Institute, University of Helsinki, Finland; ^§ Department of Obstetrics and Gynecology, University of Helsinki, Finland;  Rheumatism Foundation Hospital, Heinola, Finland; ^¶ Department of Medicine, Division of Infectious Diseases, University of Helsinki, Finland.

Objective.  To assess neutrophil CD11b and circulating interleukin 8 (IL-8) as markers of early-onset infection in neonates.

Methods.  The study comprised 39 neonates, with a gestational age of 29 to 41 weeks, suspected of infection within 48 hours of life. Neutrophil surface expression of CD11b was quantified with flow cytometry and plasma IL-8 with an enzyme-linked immunosorbent assay. Both data were available from 35 of 39 neonates. Serum C-reactive protein was determined at initial evaluation and, later, on the basis of the clinical picture. Neonates were allocated retrospectively into 2 groups. In the sepsis group (N = 22), 4 had culture-proven sepsis, and 14 had an antenatal risk factor for infection. In the possible-infection group (N = 13), each neonate had a noninfective disorder, but co-occurring infection remained a possibility. Twelve healthy term infants served as controls.

Results.  CD11b expression and IL-8 levels both increased in order of sepsis > possible infection > healthy. Sensitivity and specificity by the CD11b test for sepsis were equal, at 1.00, and those by the IL-8 test 0.91 and 1.00, respectively; 6 (17.1%) of the 35 neonates had CD11b and IL-8 below cutoff levels.

Conclusions.  Measuring neutrophil CD11b expression and circulating IL-8 provides a means to identify early-onset neonatal sepsis. The findings may be helpful in planning strategies to safely reduce the use of antimicrobials in neonates.  Key words:  circulating IL-8, C-reactive protein, early-onset sepsis, neutrophil CD11b expression, newborn infant.

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