title: Cytokine profiles of preterm neonates with fungal and bacterial sepsis.
abstract: BACKGROUND
  Information on cytokine profiles in fungal sepsis (FS), an important cause of mortality in extremely low birthweight (ELBW) infants, is lacking. We hypothesized that cytokine profiles in the first 21 d of life in ELBW infants with FS differ from those with bacterial sepsis (BS) or no sepsis (NS).
  
  
  METHODS
  In a secondary analysis of the National Institute of Child Health and Human Development Cytokine study, three groups were defined-FS (≥1 episode of FS), BS (≥1 episode of BS without FS), and NS. Association between 11 cytokines assayed in dried blood spots obtained on days 0-1, 3 ± 1, 7 ± 2, 14 ± 3, and 21 ± 3 and sepsis group was explored.
  
  
  RESULTS
  Of 1,066 infants, 89 had FS and 368 had BS. As compared with BS, FS was more likely to be associated with lower birthweight, vaginal delivery, patent ductus arteriosus, postnatal steroids, multiple central lines, longer respiratory support and hospital stay, and higher mortality (P < 0.05). Analyses controlling for covariates showed significant group differences over time for interferon-γ (IFN-γ), interleukin (IL)-10, IL-18, transforming growth factor-β (TGF-β), and tumor necrosis factor-α (TNF-α) (P < 0.05).
  
  
  CONCLUSIONS
  Significant differences in profiles for IFN-γ, IL-10, IL-18, TGF-β, and TNF-α in FS, BS, or NS in this hypothesis-generating secondary study require validation in rigorously designed prospective studies and may have implications for diagnosis and treatment.
authors.affiliation: Department of Pediatrics, Wayne State University, Detroit, Michigan, USA. bsood@med.wayne.edu
authors.forename: Beena G
authors.initials: BG
authors.lastname: Sood
authors.forename: Seetha
authors.initials: S
authors.lastname: Shankaran
authors.forename: Robert L
authors.initials: RL
authors.lastname: Schelonka
authors.forename: Shampa
authors.initials: S
authors.lastname: Saha
authors.forename: Danny K
authors.initials: DK
authors.lastname: Benjamin
authors.forename: Pablo J
authors.initials: PJ
authors.lastname: Sánchez
authors.forename: Ira
authors.initials: I
authors.lastname: Adams-Chapman
authors.forename: Barbara J
authors.initials: BJ
authors.lastname: Stoll
authors.forename: Poul
authors.initials: P
authors.lastname: Thorsen
authors.forename: Kristin
authors.initials: K
authors.lastname: Skogstrand
authors.forename: Richard A
authors.initials: RA
authors.lastname: Ehrenkranz
authors.forename: David M
authors.initials: DM
authors.lastname: Hougaard
authors.forename: Ronald N
authors.initials: RN
authors.lastname: Goldberg
authors.forename: Jon E
authors.initials: JE
authors.lastname: Tyson
authors.forename: Abhik
authors.initials: A
authors.lastname: Das
authors.forename: Rosemary D
authors.initials: RD
authors.lastname: Higgins
authors.forename: Waldemar A
authors.initials: WA
authors.lastname: Carlo
mesh_terms: D019540:Area Under Curve; D016470:Bacteremia / Q000276:immunology*; D016022:Case-Control Studies; D016207:Cytokines / Q000097:blood / Q000276:immunology*; D059788:Dried Blood Spot Testing; D016469:Fungemia / Q000276:immunology*; D006801:Humans; D052577:Infant, Extremely Low Birth Weight / Q000276:immunology*; D007231:Infant, Newborn; D007234:Infant, Premature / Q000276:immunology*; D007371:Interferon-gamma / Q000097:blood; D016753:Interleukin-10 / Q000097:blood; D020382:Interleukin-18 / Q000097:blood; D015233:Models, Statistical; D012372:ROC Curve; D016212:Transforming Growth Factor beta / Q000097:blood; D014409:Tumor Necrosis Factor-alpha / Q000097:blood
chemical_list: D016207:Cytokines; D020382:Interleukin-18; D016212:Transforming Growth Factor beta; D014409:Tumor Necrosis Factor-alpha; D016753:Interleukin-10; D007371:Interferon-gamma