Granulocyte colony-stimulating factor as a marker for bacterial infection in neonates.
OBJECTIVE
To evaluate granulocyte colony-stimulating factor (G-CSF) as an early marker of bacterial or fungal infection in neonates.


METHODS
We measured G-CSF levels in infants of varying gestational and postnatal ages. We separated the infants into three groups: group 1, positive bacterial or fungal blood culture result; group 2, negative blood culture result but evidence of clinical sepsis; and group 3, negative blood culture result and no or weak evidence of sepsis. Comparison of mean G-CSF levels by group was accomplished by an analysis of variance.


RESULTS
One hundred seventy-six evaluations for sepsis were done for 156 infants with gestational ages ranging from 24 to 43 weeks; 50% of these infants were less than 35 weeks of gestational age. The mean G-CSF levels of groups 1 and 2 were significantly higher than those of group 3. The mean G-CSF level of each group was 2278 pg/ml (group 1), 1873 pg/ml (group 2), and 280 pg/ml (group 3) (p < 0.001). On the basis of a cutoff level of 200 pg/ml, the sensitivity of the test was 95%, specificity 73%, positive predictive value 40%, and negative predictive value 99%.


CONCLUSIONS
G-CSF levels represent a sensitive marker of infection in neonates of all gestational ages.
Kennon
C
C
Department of Pediatrics, University of New Mexico School of Medicine, Albuquerque 87131, USA.
Overturf
G
G
Bessman
S
S
Sierra
E
E
Smith
K J
KJ
Brann
B
B
D016470:Bacteremia / Q000175:diagnosis / Q000276:immunology; D001424:Bacterial Infections / Q000175:diagnosis* / Q000276:immunology; D016469:Fungemia / Q000175:diagnosis / Q000276:immunology; D005865:Gestational Age; D016179:Granulocyte Colony-Stimulating Factor / Q000097:blood*; D006801:Humans; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000175:diagnosis* / Q000276:immunology; D009181:Mycoses / Q000175:diagnosis / Q000276:immunology; D011237:Predictive Value of Tests; D012016:Reference Values
D016179:Granulocyte Colony-Stimulating Factor