Objective The inflammatory cascade in sepsis is characterised by the coordinated expression of pro-inflammatory cytokines such as tumour necrosis factor alpha (TNF-α) and chemokines RANTES (regulated upon activation normal T-cell expressed and secreted). Our aim was to measure serum levels of TNF-α and RANTES in neonatal sepsis as diagnostic markers and to determine whether early and late-onset neonatal sepsis were associated with differences in their concentrations.
Methods Fifteen neonates showing clinical signs suggestive of an early-onset or late-onset infection were studied. TNF-α and RANTES were determined in the serum at the first suspicion of sepsis and before commencement of antibiotic therapy. Fifteen healthy neonates were included as a control group.
Results Serum TNF-α, white blood cell count and C-reactive protein (CRP) were significantly higher while RANTES levels were significantly lower in the septic compared with the non-septic group. No significant difference in the RANTES or TNF-α levels were found between infants with early-onset or late-onset sepsis nor between premature and term septic neonates. A significant negative correlation between serum levels of TNF-α and RANTES and a significant positive correlation between serum levels of CRP and TNF-α in septic neonates were detected.
Conclusion In our study, TNF-α is proved the best diagnostic test for neonatal sepsis followed by CRP.