白细胞介素-6在早期区别新生儿不同细菌血流感染和鉴别血培养污染的意义

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Abstract Objective To study the significance of serum interleukin-6 (IL-6) concentration in distinguishing neonatal bloodstream infection caused by different bacteria and identification of neonatal blood culture contamination in the early stage. Methods A total of 100 neonates with bloodstream infections admitted to Foshan Sanshui District People′s Hospital from January 2016 to June 2020 were selected as the observation group, and IL-6, procalcitonin (PCT) and Creactive protein were measured before the first day of treatment, and the blood culture was performed at the same time.According to the results of blood culture, 100 neonates with bloodstream infections were divided into Gram-negative(G-) bacterial group (27 cases) and Gram-positive (G+) bacterial group (73 cases), and according to the bacterial culture identification results, the G+ bacterial group was divided into Streptococcus group (26 cases) and coagulase-negative staphylococcus (CNS) group (47 cases). The concentrations of IL-6, PCT and CRP in serum of different bacterial groups were compared. And the value of IL-6 in identification of neonatal bloodstream infection caused by G- bacteria and G+bacteria was analyzed by the receiver operating characteristic (ROC) curve in the early stage. The blood culture contamination cases (63 cases) were selected as the control group at the corresponding period, and the value of IL-6 in identifying neonatal blood culture contamination was analyzed by the ROC curve. Results The serum concentrations of IL-6, PCT and CRP in G- bacteria group were 2033.0 (75.0-15 600.0) ng/L, 4.0 (0.58-18.99) ng/mL and 2.89 (0.51-21.40) μg/mL, respectively, and the concentrations of serum IL-6, PCT and CRP in G+bacteria group were 61.9 (26.1-1066.7) ng/L, 0.75 (0.26-2.70) ng/mL and 5.45 (0.82-11.86) μg/mL, respectively. There were statistically significant differences in IL-6 and PCT between the G- bacteria group and G+ bacteria group (P<0.05), but no statistically significant difference in CRP (P>0.05). The areas under the ROC curve of IL-6, PCT and CRP in distinguishing neonatal bloodstream infection caused by G- bacteria and G+ bacteria were 70.2%, 64.9% and 52.6%, respectively. The concentration of IL-6 in the Streptococcus group was higher than that in the CNS group, with statistically significant difference (P<0.05). The concentration of IL-6 in the observation group was higher than that in the control group, with statistically significant difference (P<0.05). The areas under ROC curve of IL-6, PCT and CRP in identifying neonatal blood culture contamination were 94.2%, 91.0% and 72.9%, respectively. Conclusion The concentration of IL-6 is valuable in the early identification of neonatal bloodstream infection caused by G- bacteria and G+ bacteria and in distinguishing neonatal blood culture contamination. Its effect is similar to PCT, but obviously superior to CRP. It can preliminarily distinguish early bloodstream infection caused by Streptococcus and CNS in G+ bacteria group. It is helpful for providing the basis for early treatment, which can save critical life.

Key words： Interleukin-6 Bloodstream infection Gram-negative bacteria Gram-positive bacteria Blood culture contamination

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	Articles by authors
	LIANG Jie-chang
	XU Zhi-ming
	LI Wan-mei
	YOU Fang-fang
	YE Mu-feng

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LIANG Jie-chang,XU Zhi-ming,LI Wan-mei, et al. Significance of interleukin-6 distinguishing neonatal bloodstream infection caused by different bacteria and identification of blood culture contamination in the early stage[J]. 中国当代医药, 2021, 28(3): 21-24.

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http://dangdaiyiyao.com/EN/ OR http://dangdaiyiyao.com/EN/Y2021/V28/I3/21

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