HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) 062075.Supplemental Data All Versions of this Article: clinchem.2005.062075v1 52/6/1181    most recent Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Web of Science (10) Citing Articles via Google Scholar Google Scholar Articles by Ng, P. C. Articles by Fok, T. F. Search for Related Content PubMed PubMed Citation Articles by Ng, P. C. Articles by Fok, T. F. Related Collections Pediatric Clinical Chemistry

Early Prediction of Sepsis-Induced Disseminated Intravascular Coagulation with Interleukin-10, Interleukin-6, and RANTES in Preterm Infants

¹ Department of Pediatrics, and ² Center of Epidemiology and Biostatistics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong Special Administrative Region.

^aAddress correspondence to this author at: Department of Pediatrics, Level 6, Clinical Sciences Bldg, Prince of Wales Hospital, Shatin, New Territories, Hong Kong, SAR. Fax 852-2636-0020; e-mail pakcheungng{at}cuhk.edu.hk.

Background: The progression to disseminated intravascular coagulation (DIC) in infected very low birth weight (VLBW; <1500 g) infants is difficult to predict with precision at the onset of sepsis. We investigated the immunologic profiles of preterm infants with sepsis, using chemokine and cytokine measurements to predict the development of sepsis-induced DIC at the onset of infection.

Methods: We measured a panel of chemokines and cytokines at 0 and 24 h after clinical presentation in VLBW infants with suspected infection requiring full sepsis screening. The chemokines measured were interleukin (IL)-8, interferon--inducible protein-10 (IP-10), monokine induced by interferon-, monocyte chemoattractant protein-1, and regulated upon activation normal T-cell expressed and secreted (RANTES), and the cytokines were IL-6, IL-10, and tumor necrosis factor-.

Results: Of 195 episodes of suspected clinical sepsis investigated, 62 were culture-confirmed septicemia or necrotizing enterocolitis (28 of these infants developed DIC), 22 were culture-negative clinical infections, and 111 involved noninfected episodes. All studied inflammatory mediators except RANTES showed significantly greater up-regulation in culture-positive infected infants than in noninfected infants at 0 and 24 h, whereas RANTES showed significant down-regulation. The model that used plasma IL-10 (>208 ng/L), IL-6 (>168 ng/L), and RANTES (<3110 ng/L) at 0 h had sensitivity, specificity, and positive and negative predictive values of 100%, 97%, 85%, and 100%, respectively, for identifying infected patients who subsequently developed DIC.

Conclusions: IL-10, IL-6, and RANTES measured at clinical presentation sensitively and accurately predicted the development of DIC in severely infected infants. This information could be vital for early and effective treatment of neonatal sepsis.

The following articles in journals at HighWire Press have cited this article:

				H.-L. Chen, C.-H. Hung, H.-I Tseng, and R.-C. Yang Plasma IP-10 as a Predictor of Serious Bacterial Infection in Infants Less than 4 Months of Age J Trop Pediatr, April 1, 2009; 55(2): 103 - 108. [Abstract] [Full Text] [PDF]

				S. Cetin, C. L. Leaphart, J. Li, I. Ischenko, M. Hayman, J. Upperman, R. Zamora, S. Watkins, H. R. Ford, J. Wang, et al. Nitric oxide inhibits enterocyte migration through activation of RhoA-GTPase in a SHP-2-dependent manner Am J Physiol Gastrointest Liver Physiol, May 1, 2007; 292(5): G1347 - G1358. [Abstract] [Full Text] [PDF]

eLetters: