Serum concentrations of interleukin-1 alpha, interleukin-6 and tumor necrosis factor-alpha in neonatal sepsis and meningitis.

OBJECTIVE To investigate whether serum levels of interleukin-1alpha (IL-1alpha), IL-6, tumor necrosis factor alpha (TNF-alpha), C-reactive protein (CRP) are useful in the diagnosis of neonatal sepsis and meningitis and differentiate them. METHODS Blood samples were collected from 35 full term neonates with suspected infection who admitted to the Neonatology Unit, Pediatric Department, King Abdul-Aziz University Hospital, Jeddah, Saudi Arabia during January 2002 - June 2003. On the basis of laboratory and bacteriological results, newborns were classified into: sepsis (n = 28), meningitis (n = 7), and healthy controls (n = 16). Sepsis groups were further subdivided according to culture results into: group 1 = proven sepsis (n = 6), group 2 = clinical sepsis (n = 14), and group 3 = possible-infected (n = 8). Serum levels of IL-1alpha, IL-6, TNF-alpha were measured using Enzyme-Linked Immunosorbent Assay while CRP by nephelometer. RESULTS In sepsis and meningitis patients, serum levels of CRP (p < 0.01, p < 0.05,) and IL-1alpha (p < 0.001, p < 0.05) were elevated than controls. C-reactive protein levels elevated in proven sepsis (p < 0.001) and IL-1alpha elevated in all subgroups of sepsis (groups 1, 2, 3) compared with (p < 0.05, p < 0.001, p < 0.01) controls. Interleukin-6, TNF-alpha showed no significant differences between studied groups. In sepsis and meningitis, IL-1alpha had a highest sensitivity (89%, 86%), and negative predictive values (89% and 93%). CONCLUSION Interleukin-1alpha and CRP increased in neonatal sepsis and meningitis, but cannot differentiate between them. Interleukin-1alpha had a highest sensitivity in prediction of neonatal infection and its assessment may improve accuracy of diagnosis.