Volume 10,Issue 1
Fall 2025
IL-6, IL-8, TNF-α, and C-Reactive Protein Levels in the Diagnosis and Prognosis of Neonatal Sepsis
Objective: This study aimed to determine the importance and reliability of interleukin-6 (IL-6), IL8, tumor necrosis factor-α (TNF-α), and C-reactive protein (CRP) levels in terms of diagnosis and prognosis in neonatal sepsis. Methods: Thirty newborns who were followed up and treated in the neonatal intensive care unit with a pre-diagnosis of neonatal sepsis and 20 healthy newborns who were born without any problem from mothers without any disease were included in the study. Gender, gestational age, postnatal age, place and mode of delivery, birth weight, IL-6, IL-8, TNF-α, and CRP levels were recorded. Results: Of the 30 cases diagnosed with sepsis, 16 (53.3%) were male and 14 (46.7%) were female. In the control group of 20 cases, 11 (55%) were male, and 9 (45%) were female. Of the cases diagnosed with sepsis, 8 were considered early-onset (26.6%) and 22 were considered late-onset (73.4%) neonatal sepsis. The mortality rate in early-onset sepsis was 25%, while this rate was 36.3% in late-onset sepsis cases. The levels of CRP, IL-6, and IL-8 were significantly higher in the sepsis group than in the control group. The difference between the groups in terms of TNF-α levels was not statistically significant. IL-6 (P = 0.001) and IL-8 (P = 0.007) levels were found to be statistically significantly higher in the deceased cases than in the healing cases. Conclusion: CRP, IL-6, and IL-8 levels were found to be useful parameters in the diagnosis of neonatal sepsis, while TNF-α was not found to have diagnostic value. IL-6 and IL-8 levels were found to be significant in the prognosis of neonatal sepsis.
1. Ferrieri P, Wallen LD. Newborn Sepsis and Meningitis. In: Gleason CA, Juul SE (eds). Avery’s Diseases of the Newborn, 10th ed. 2018, Elsevier, Philadelphia, PA, 553–565.
2. Shane AL, Sánchez PJ, Stoll BJ, 2017, Neonatalsepsis. Lancet, 390: 1770–1780.
3. Ericson JE, Laughon MM, 2015, Chorioamnionitis: Implications for the Neonate. Clin Perinatol, 42(1): 155–165.
4. Karakuş M, Karaca Derici Y, Günçiner Ş, 2007, Gebelerde grup B streptokok kolonizasyonuve antimikrobiyal direnç paterni [Group B streptococcal colonization and antimicrobial resistance pattern in pregnant woman]. Ege J Med, 46(3): 151–154.
5. Polin RA, Committee on Fetus and Newborn, 2012, Management of Neonates with Suspected or Proven Early-Onset Bacterial Sepsis. Pediatrics, 129(5): 1006–1015.
6. Puopolo KM, Draper D, Wi S, et al., 2011, Estimating the Probability of Neonatal Early Onset Infection on the Basis of Maternal Risk Factors. Pediatrics, 128(5): 1155–1163.
7. Cohen J, Brun-Buisson C, Torres A, et al., 2004, Diagnosis of Infection in Sepsis: An Evidence-Based Review. Crit Care Med, 32(11): 466–494.
8. Töllner U, 1982, Early diagnosis of Septicemia in the Newborn. Clinical Studies and Sepsis Score. Eur J Pediatr, 138(4): 331–337.
9. Burstein B, Beltempo M, Fontela PS. 2021, Role of C-Reactive Protein for Late-Onset Neonatal Sepsis. JAMA Pediatr, 175(1): 101–102.
10. Bunduki GK, Adu-Sarkodie Y, 2020, The Usefulness of C-reactive Protein as a Biomarker in Predicting Neonatal Sepsis in a Sub-Saharan African Region. BMC ResNotes, 13(1): 194.
11. Morad EA, Rabie RA, Almalky MA, et al., 2020, Evaluation of Procalcitonin, C-Reactive Protein, and Interleukin-6 as Early Markers for Diagnosis of Neonatal Sepsis. Int J Microbiology, 2020: 8889086.
12. Ye Q, Du L, Shao WX, et al., 2017, Utility of Cytokines to Predict Neonatal Sepsis. Pediatr Res, 81(4): 616–621.
13. Hisamuddin E, Hisam A, Wahid S, et al., 2015, Validity of C-Reactive Protein (CRP) for Diagnosis of Neonatal Sepsis. Pak J Med Sci, 31(3): 527–531.
14. Adib M, Bakhshiani Z, Navaei F, et al., 2012, Procalcitonin: A Reliable Marker for the Diagnosis of Neonatal Sepsis. Iran J Basic Med Sci, 15(2): 777–782.
15. Forest JC, Larivière F, Dolcé P, et al., 1986, C-Reactive Protein as Biochemical Indicator of Bacterial Infection in Neonates. Clin Biochem, 19(3): 192–198.
16. Vasiljević B, Antonović O, Maglajlić-Djukić S, et al., 2008, The Serum Level of C-Reactive Protein in Neonatal Sepsis. Srp Arh Celok Lek, 136(5–6): 253–257.
17. Gyllensvärd J, Ingemansson F, Hentz E, et al., 2020, C-Reactive Protein and Clinical Symptoms-Guided Strategy in Term Neonates with Early-Onset Sepsis Reduced Antibiotic Use and Hospital Stay: A Quality Improvement Initiative. BMC Pediatr, 20(1): 531.
18. Rukmono P, Dharmasetiawani N, WarsonoW, et al., 2016, Tumor Necrosis Factor-Alpha and Interleukin-6 in Early-Onset Neonatal Sepsis. PI, 56(1): 15.
19. Tracey KJ, Beutler B, Lowry SF, et al., 1986, Shock and Tissue Injury Induced by Recombinant Human Cachectin. Science, 234(4775): 470–474.
20. Hack CE, de Groot ER, Felt-Bersma RJF, et al., 1989, Increased Plasma Levels of Interleukin-6 in Sepsis. Blood, 74(5): 1704–1710.
21. Hibbert J, Strunk T, Simmer K, et al., 2020, Plasma Cytokine Profiles in Very Preterm Infants with Late Onset Sepsis. PLoS One, 15(5): e0232933.
22. Friedland JS, Suputtamongkol Y, Remick DG, et al., 1992, Prolonged Elevation of Interleukin-8 mRNA Levels During Septicemic and Localized Pseudomonas pseudomallei Infection. Infect Immun, 60(6): 2402–2408.
23. Ng PC, Lam HS, 2006, Diagnostic Markers for Neonatal Sepsis. Curr Opin Pediatr, 18(2): 125–131.
24. Kocabaş E, Sarikçioğlu A, Aksaray N, et al., 2007, Role of Procalcitonin, C-Reactive Protein, Interleukin-6, Interleukin-8 and Tumor Necrosis Factor-Alpha in the Diagnosis of Neonatal Sepsis. Turk J Pediatr, 49(1): 7–20.
25. Sullivan JS, Kilpatrick L, Costarino AT, et al., Correlation of Plasma Cytokine Elevations with Mortality Rate in Children with Sepsis. J Pediatr, 120(4): 510–515.