ArticleClinical and experimental pediatrics2025
Differential roles of interleukin-6 and adrenomedullin in early diagnosis and mortality predictions in late-onset neonatal sepsis.
Article in Clinical and experimental pediatrics, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.
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Who cites it
2 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Diagnostic accuracy of interleukin-6 (IL-6) as a significant biomarker in late-onset neonatal sepsis: an updated systematic review and meta-analysis.European journal of pediatrics · 2025Pooled it
- Integrated pan-cancer analysis of ADM's role in prognosis, immune modulation and resistance.Frontiers in immunology · 2025Article
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7 authors.
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Abstract
backgroundDiagnosing and predicting neonatal sepsis is challenging because of its nonspecific symptoms, lack of diagnostic criteria consensus, and absence of early, sensitive, and specific diagnostic laboratory tests. PURPOSE: To evaluate the diagnostic and prognostic potential of adrenomedullin (ADM), interleukin-6 (IL-6), and C-reactive protein (CRP) in late-onset neonatal sepsis (LOS).
methodsWe studied 53 neonates with culture-proven LOS by sampling at admission and on antibiotic treatment days 3 and 7. These data were compared with those of 22 healthy full-term controls sampled on day 3 before hospital discharge. Survivors and nonsurvivors in the sepsis group were analyzed separately.
resultsCoagulase-negative Staphylococcus was the most commonly detected pathogen. ADM (cutoff, 0.5 ng/mL) and CRP (cutoff, <5 mg/L) values aligned with manufacturer recommendations, while IL-6 levels (cutoff, 10 pg/mL) were higher than expected, likely due to labor stress. The median biomarker levels significantly distinguished neonates with sepsis from controls (P<0.0001) at all time points with ADM and IL-6 levels elevated at admission, indicating their potential as early diagnostic markers. CRP level was diagnostically useful starting on day 3. Prognostically, IL-6 (P<0.001) and ADM (P<0.05) differentiated survivors from nonsurvivors; however, only IL-6 consistently predicted mortality at all time points (area under the curve [AUC] >0.90). ADM and CRP levels showed poor prognostic value (AUC<0.70). ADM and IL-6 demonstrated strong diagnostic utility in early LOS, whereas CRP became relevant later. IL-6 was the only reliable biomarker for predicting mortality, supporting its integration into clinical protocols. Combining IL-6 with CRP may enhance early detection and management, potentially improving neonatal outcomes.
conclusionIL-6 is a robust biomarker for the early diagnosis and prognosis of LOS. Incorporating IL-6 into clinical practice with CRP could improve early neonatal LOS diagnosis and patient outcomes.
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