, Volume 35, Issue 3, pp 1094–1101 | Cite as

Pre-inflammatory Mediators and Lymphocyte Subpopulations in Preterm Neonates with Sepsis

  • Efthalia Hotoura
  • Vasileios Giapros
  • Ageliki Kostoula
  • Polixeni Spyrou
  • Styliani Andronikou


The aim of this study is to investigate prospectively specific immune system factors in preterm neonates with late-onset sepsis and infection-free controls. Matched preterm neonates (n = 82) were divided into three groups: suspected infection (n = 25), sepsis (n = 17), and infection-free controls (n = 40). Serial measurements were made of interleukin-6 (IL-6), IL-1β, tumor necrosis factor-α (TNF-α), lymphocyte subsets [CD3+, CD4+, CD8+, natural killer (NK) cells, and B cells], the immunoglobulins (IgG, IgM, and IgA), C-reactive protein (CRP), and the total blood count, before, 2 days after initiation of treatment, and after stopping treatment. The percentages of NK and B cells were higher in the sepsis group, but those of CD3+, CD4+, and CD8+ showed no differences. IgG was lower in the sepsis group. IL-6 >30 pg/ml and TNF-α >30 pg/ml were sensitive sepsis predictors with sensitivity 1 (0.78–1) and 1 (0.79–1), respectively, but their specificity was poor. CRP was a specific [0.90 (0.80–0.96)] but not sensitive index [0.68 (0.48–0.85)], and its combination with IL-6 or TNF-α could enhance their diagnostic accuracy. It is concluded that NK and B cells may be elevated in late neonatal sepsis. IL-6 or TNF-α combined with CRP is a good diagnostic marker for late-onset sepsis in preterm neonates.


interleukin-6 NK cells TNF-α lymphocyte subpopulations C-reactive protein neonates sepsis 


Conflict of interest

None is declared.


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Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  • Efthalia Hotoura
    • 1
  • Vasileios Giapros
    • 1
    • 4
  • Ageliki Kostoula
    • 2
  • Polixeni Spyrou
    • 3
  • Styliani Andronikou
    • 1
  1. 1.Neonatal Intensive Care UnitUniversity Hospital of IoanninaIoanninaGreece
  2. 2.Microbiology DepartmentUniversity Hospital of IoanninaIoanninaGreece
  3. 3.Rheumatology UnitUniversity Hospital of IoanninaIoanninaGreece
  4. 4.University Hospital of IoanninaIoanninaGreece

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