title: IP-10 is an early diagnostic marker for identification of late-onset bacterial infection in preterm infants.
abstract: Very low birth weight (VLBW) infants with suspected late-onset infection requiring sepsis screening were enrolled in a prospective study to evaluate the diagnostic utilities of a comprehensive panel of key chemokines and cytokines, both individually and in combination, to identify diagnostic markers for early recognition of bacterial sepsis and necrotizing enterocolitis (NEC). Plasma chemokines interleukin (IL)-8, interferon-gamma-inducible protein 10 (IP-10), monokine induced by interferon-gamma (MIG), monocyte chemoattractant protein 1 (MCP-1), growth-related oncogene-alpha (GRO-alpha), and regulated upon activation of normal T cell expressed and secreted (RANTES) and cytokines IL-1beta, IL-6, IL-10, IL-12p70, and tumor necrosis factor alpha (TNF-alpha) were measured at the onset of sepsis (0 h) and 24 h later. Of 155 suspected infection episodes, 44 were classified as infected. Concentrations of all studied inflammatory mediators (except IL-1beta and RANTES) were significantly higher in the infected than in the noninfected group at 0 h, but the levels decreased precipitously by 24 h. IP-10 with a plasma cutoff concentration > or = 1250 pg/mL could identify all septicemic and NEC cases and had the highest overall sensitivity (93%) and specificity (89%) at 0 h. We conclude that preterm infants have the ability to induce a robust chemokine and cytokine response during sepsis, and IP-10 is a sensitive early marker of infection.
authors.affiliation: Department of Pediatrics, Prince of Wales Hospital, Chinese University of Hong Kong, Hong Kong, China. pakcheungng@cuhk.edu.hk
authors.forename: Pak C
authors.initials: PC
authors.lastname: Ng
authors.forename: Karen
authors.initials: K
authors.lastname: Li
authors.forename: Kit M
authors.initials: KM
authors.lastname: Chui
authors.forename: Ting F
authors.initials: TF
authors.lastname: Leung
authors.forename: Raymond P O
authors.initials: RP
authors.lastname: Wong
authors.forename: Winnie C W
authors.initials: WC
authors.lastname: Chu
authors.forename: Eric
authors.initials: E
authors.lastname: Wong
authors.forename: Tai F
authors.initials: TF
authors.lastname: Fok
mesh_terms: D017668:Age of Onset; D001424:Bacterial Infections / Q000175:diagnosis* / Q000378:metabolism*; D015415:Biomarkers; D054357:Chemokine CXCL10; D019743:Chemokines, CXC / Q000378:metabolism*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D008297:Male; D018805:Sepsis / Q000175:diagnosis / Q000378:metabolism
chemical_list: D015415:Biomarkers; C114753:CXCL10 protein, human; D054357:Chemokine CXCL10; D019743:Chemokines, CXC