Article Text

  1. K Piperkova1,
  2. A Papazovska-Cerepnalkovski1,
  3. A Sofijanova2
  1. 1Department of Neonatology, Pediatric Clinic, Medical Faculty, Skopje, Macedonia
  2. 2Intensive Care Unit, Pediatric Clinic, Medical Faculty, Skopje, Macedonia


Objective To determine through serial measurements the sensitivity and specificity of biological markers: C-reactive protein (CRP), interleukin-6 (IL-6), and elastase-α1-proteinase inhibitor (E-α1-PI) in early, pre-symptomatic diagnosis of neonatal infections, as well as prognostic significance of these markers.

Methods 93 newborns were examined and divided in the following groups: proven early sepsis, proven late sepsis, suspected infection, and a control group. Serial measurements were performed: in the first 24 hours, in 48 hours and every following day afterwards. A quantitative method for CRP and ELISA were used. Statistical analysis was performed using Friedman, Mann–Whitney U and Wilcoxon test.

Results The obtained results showed statistically significant (p<0.001) early increase of IL-6 in the group with sepsis contrary to CRP and E-α1-PI that increased significantly (p<0.001) during the following measurements compared to the control group. Simultaneous use of IL-6 and CRP revealed highest sensitivity (87%) and specificity (96%) in early diagnosis of neonatal infection. Serial measurements of E-alpha1-PI showed an improvement in cases of good response to therapy and a rapid decrease when the condition worsened.

Conclusions There is an apparent need for serial use of markers for early diagnosis and monitoring of neonatal infections. Simultaneous use of IL-6 and CRP showed highest sensitivity and specificity. E-α1-PI appeared as a good marker for chronological follow up of the infection, response to therapy and complications’ development.

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