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Intensive Care Medicine

, Volume 28, Issue 9, pp 1324–1331 | Cite as

Diagnostic accuracy of G-CSF, IL-8, and IL-1ra in critically ill children with suspected infection

  • Joachim E. Fischer
  • Anne Benn
  • Stephan Harbarth
  • David Nadal
  • Sergio Fanconi
Neonatal and Pediatric Intensive Care

Abstract

Objective. To elucidate the diagnostic accuracy of granulocyte colony-stimulating factor (G-CSF), interleukin-8 (IL-8), and interleukin-1 receptor antagonist (IL-1ra) in identifying patients with sepsis among critically ill pediatric patients with suspected infection.

Design and setting. Nested case-control study in a multidisciplinary neonatal and pediatric intensive care unit (PICU)

Patients. PICU patients during a 12-month period with suspected infection, and plasma available from the time of clinical suspicion (254 episodes, 190 patients).

Measurements and results. Plasma levels of G-CSF, IL-8, and IL-1ra. Episodes classified on the basis of clinical and bacteriological findings into: culture-confirmed sepsis, probable sepsis, localized infection, viral infection, and no infection. Plasma levels were significantly higher in episodes of culture-confirmed sepsis than in episodes with ruled-out infection. The area under the receiver operating characteristic curve was higher for IL-8 and G-CSF than for IL-1ra. Combining IL-8 and G-CSF improved the diagnostic performance, particularly as to the detection of Gram-negative sepsis. Sensitivity was low (<50%) in detecting Staphylococcus epidermidis bacteremia or localized infections.

Conclusions. In this heterogeneous population of critically ill children with suspected infection, a model combining plasma levels of IL-8 and G-CSF identified patients with sepsis. Negative results do not rule out S. epidermidis bacteremia or locally confined infectious processes. The model requires validation in an independent data-set.

Intensive care, newborns Granulocyte colony-stimulating factor Interleukin-8 Interleukin-1 receptor antagonist Logistic regression models 

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Copyright information

© Springer-Verlag 2002

Authors and Affiliations

  • Joachim E. Fischer
    • 1
  • Anne Benn
    • 1
  • Stephan Harbarth
    • 2
  • David Nadal
    • 3
  • Sergio Fanconi
    • 4
  1. 1.Department of Pediatrics, University Children's Hospital, Steinwiesstrasse 75, 8032 ZurichSwitzerland
  2. 2.Division of Infectious Diseases, CHUV, University of Geneva, GenevaSwitzerland
  3. 3.Division of Infectious Diseases, University Children's Hospital, Steinwiesstrasse 75, 8032 ZurichSwitzerland
  4. 4.Department of Pediatrics, CHUV, University of Lausanne, LausanneSwitzerland

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