Skip to main content

Lund University Publications

LUND UNIVERSITY LIBRARIES

Utility of interleukin-6 to identify serious bacterial infections in febrile infants aged ≤60 days

Orfanos, Ioannis LU orcid ; Krusell, Emilie Thorén and Elfving, Kristina LU (2024) In Acta Pædiatrica
Abstract

AIM: The aim of this study is to investigate the utility of interleukin-6 (IL-6) in the early diagnosis of serious bacterial infections (SBI) in febrile infants and to compare it with C-reactive protein (CRP).

METHODS: Retrospective study conducted in the paediatric emergency department in Gothenburg, Sweden, on previously healthy, full-term infants aged ≤60 days with fever without a source (FWS) from 2014 to 2017.

RESULTS: We included 536 infants with FWS, of whom IL-6 was analysed in 364 (68%) and CRP was analysed in 494 (92%). Approximately 70% of the infants presented with a fever duration of less than 12 h. The prevalence of SBIs was 14.8% (95% CI,11.3-18.9) in the IL-6 group and 17.8% (95% CI,14.5-21.5) in the CRP... (More)

AIM: The aim of this study is to investigate the utility of interleukin-6 (IL-6) in the early diagnosis of serious bacterial infections (SBI) in febrile infants and to compare it with C-reactive protein (CRP).

METHODS: Retrospective study conducted in the paediatric emergency department in Gothenburg, Sweden, on previously healthy, full-term infants aged ≤60 days with fever without a source (FWS) from 2014 to 2017.

RESULTS: We included 536 infants with FWS, of whom IL-6 was analysed in 364 (68%) and CRP was analysed in 494 (92%). Approximately 70% of the infants presented with a fever duration of less than 12 h. The prevalence of SBIs was 14.8% (95% CI,11.3-18.9) in the IL-6 group and 17.8% (95% CI,14.5-21.5) in the CRP group. The sensitivity, specificity, negative predictive value (NPV), and positive predictive value (PPV) of IL-6 ≥50 ng/L were 93%, 66%, 98% and 33%, respectively. For CRP ≥20 mg/L, the sensitivity, specificity, NPV, and PPV were 76%, 89%, 95%, and 55%, respectively. Logistic regression analysis showed that CRP was significantly associated with SBI (p < 0.0001) in the entire population, whereas IL-6 was not.

CONCLUSION: Interleukin-6 showed high sensitivity and NPV, which might assist in identifying SBIs early in febrile infants. However, IL-6 was not shown to be superior to CRP and further studies are needed to investigate whether IL-6 should be incorporated in clinical management.

(Less)
Please use this url to cite or link to this publication:
author
; and
organization
publishing date
type
Contribution to journal
publication status
epub
subject
in
Acta Pædiatrica
publisher
Wiley-Blackwell
external identifiers
  • scopus:85204232612
  • pmid:39287096
ISSN
1651-2227
DOI
10.1111/apa.17422
language
English
LU publication?
yes
additional info
© 2024 The Author(s). Acta Paediatrica published by John Wiley & Sons Ltd on behalf of Foundation Acta Paediatrica.
id
475a1d99-ed81-4602-b08f-53f996517f9a
date added to LUP
2024-09-25 07:52:44
date last changed
2024-09-26 04:02:20
@article{475a1d99-ed81-4602-b08f-53f996517f9a,
  abstract     = {{<p>AIM: The aim of this study is to investigate the utility of interleukin-6 (IL-6) in the early diagnosis of serious bacterial infections (SBI) in febrile infants and to compare it with C-reactive protein (CRP).</p><p>METHODS: Retrospective study conducted in the paediatric emergency department in Gothenburg, Sweden, on previously healthy, full-term infants aged ≤60 days with fever without a source (FWS) from 2014 to 2017.</p><p>RESULTS: We included 536 infants with FWS, of whom IL-6 was analysed in 364 (68%) and CRP was analysed in 494 (92%). Approximately 70% of the infants presented with a fever duration of less than 12 h. The prevalence of SBIs was 14.8% (95% CI,11.3-18.9) in the IL-6 group and 17.8% (95% CI,14.5-21.5) in the CRP group. The sensitivity, specificity, negative predictive value (NPV), and positive predictive value (PPV) of IL-6 ≥50 ng/L were 93%, 66%, 98% and 33%, respectively. For CRP ≥20 mg/L, the sensitivity, specificity, NPV, and PPV were 76%, 89%, 95%, and 55%, respectively. Logistic regression analysis showed that CRP was significantly associated with SBI (p &lt; 0.0001) in the entire population, whereas IL-6 was not.</p><p>CONCLUSION: Interleukin-6 showed high sensitivity and NPV, which might assist in identifying SBIs early in febrile infants. However, IL-6 was not shown to be superior to CRP and further studies are needed to investigate whether IL-6 should be incorporated in clinical management.</p>}},
  author       = {{Orfanos, Ioannis and Krusell, Emilie Thorén and Elfving, Kristina}},
  issn         = {{1651-2227}},
  language     = {{eng}},
  month        = {{09}},
  publisher    = {{Wiley-Blackwell}},
  series       = {{Acta Pædiatrica}},
  title        = {{Utility of interleukin-6 to identify serious bacterial infections in febrile infants aged ≤60 days}},
  url          = {{http://dx.doi.org/10.1111/apa.17422}},
  doi          = {{10.1111/apa.17422}},
  year         = {{2024}},
}