***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: OBJECTIVE To explore the significance of interleukin-6 ( IL-6 ) and IL-8 in the diagnosis of neonatal sepsis . METHODS This was a prospect i ve study conducted between August 2014 and February 2015 . A total of 140 neonates who were suspected infectious were enrolled and classified into a sepsis group ( n=49 ) and a local infection group ( n=91 ) . Sixty-one neonates who were non-infectious served as the control group .  Serum levels of IL-6 and IL-8  were measured before treatment and 3 days after treatment . The value of serum IL-6 and IL-8  for the diagnosis of neonatal sepsis was assessed by receiver operating characteristic ( ROC ) curve analysis . RESULTS Before treatment , serum levels of IL-6 and IL-8 in the sepsis group were higher than those in the local infection and control groups ( P<0.05 ) , and the local infection group had higher serum levels of IL-6 and IL-8 than the control group ( P<0.05 ) . After three days of treatment , the serum IL-6 level in the sepsis group remained higher than that in the local infection and control groups ( P<0.05 ) , and the local infection group had higher serum level of IL-6 than the control group ( P<0.05 ) . There was no significant difference in the serum IL-8 level among the three groups . According to the ROC curve , when the cut-off value of serum IL-6 was 32 pg/mL , the sensitivity , specificity and accuracy of serum IL-6 for the diagnosis of neonatal sepsis were 87.8 % , 79.6 % and 81.6 % respectively ; when the cut-off value of serum IL-8 was 54 pg/mL , the sensitivity , specificity and accuracy of serum IL-6 for the diagnosis of neonatal sepsis were 77.6 % , 63.8 % and 67.2 % respectively . With the combination of serum IL-6 and IL-8 levels , the sensitivity , specificity and accuracy for the diagnosis of neonatal sepsis were 71.4 % , 86.2 % and 82.6 % respectively . CONCLUSIONS IL-6 and IL-8 participate in the inflammatory response and the serum levels of both vary with the severity of infection . The diagnostic value of IL-6 for neonatal sepsis is higher than IL-8 . The combined detection of serum levels IL-6 and IL-8 may increase the accuracy of diagnosis of neonatal sepsis Objective : To identify the best combination of serum cytokines and clinical parameters to diagnose rapidly early-onset neonatal infection ( EONI ) in critically ill preterm infants . At birth , most critically ill neonates are receiving broad-spectrum antibiotics pending bacterial culture results , because distinguishing infected from noninfected infants at birth is difficult . Design : Prospect i ve study . Setting : Neonatal intensive care unit in a tertiary care hospital . Patients : Two hundred thirteen infants , born before 33 wks ’ gestation , admitted to the neonatal intensive care unit within 6 hrs of life with a presumptive diagnosis of EONI . Intervention : A presumptive diagnosis of EONI was associated with a 300-&mgr;L blood sample to measure six cytokine ( interleukin [IL]-1&bgr ; , IL-6 , IL-8 , IL-10 , IL-12 , tumor necrosis factor-&agr ; ) concentrations  , using the cytometric bead array technique . Measurements and Main Results : Of the 213 infants included , 31 had a definite or possible EONI and 182 were not infected . Concentrations of IL-6 , IL-8 , and IL-10 were significantly increased in infected neonates , in comparison with infants without EONI . In contrast , IL-1&bgr ; , IL-12 , and tumor necrosis factor-&agr ; concentrations were not . Logistic regression analyses were performed to construct multivariate predictive models that could distinguish infected from noninfected infants at birth . A clinical score was based on three parameters independently associated with EONI ( i.e. , interval of > 12 hrs between the membranes rupture and delivery , prenatal maternal colonization and mechanical ventilation at birth ) . This score was compared with scores including clinical parameters and serum cytokines , alone or in combination . The best predictive model combined the three clinical parameters , IL-6 ( positive threshold , 300 pg/mL ) and IL-8 ( positive threshold , 300 pg/mL ) concentrations . Conclusion : A predictive model combining serum IL-6 and IL-8 measurements and selected clinical variables could distinguish infected from noninfected preterm infants at birth and should help the clinician in reducing or shortening the unnecessary use of antibiotics We evaluated the utility of routine hematologic parameters and  volume , conductivity , and scatter ( VCS ) parameters from umbilical cord blood in predicting pathologically confirmed chorioamnionitis . Chorioamnionitis is strongly associated with early neonatal sepsis and is the major in utero source of infectious exposure . We prospect ively identified mothers who had placenta su bmi tted for pathology and subsequently identified corresponding neonate cord blood sent for routine blood typing ( n = 99 ) . Cord blood was then sent for routine complete blood count with differential ( CBCD ) . Among the same neonates , we retrospectively identified those who had peripheral blood sent for CBCD .  We collected  VCS parameter data , which are used in determining an automated leukocyte differential , from our hematology analyzer . Routine hematologic as well as VCS parameters  from both cord and peripheral blood were then evaluated for predicting pathologically confirmed chorioamnionitis . In the study population , the absolute neutrophil count , neutrophil differential , mean neutrophil conductivity , and neutrophil conductivity st and ard deviation ( SD ) from cord blood showed the best predictive ability for chorioamnionitis . Among neonates with intrapartum antibiotic prophylaxis exposure , the b and differential , immature neutrophil precursor differential , and neutrophil conductivity SD showed the best predictive ability . Lastly , among the neonates who had peripheral blood CBCD , the b and differential and immature neutrophil precursor differential showed the best predictive ability . Overall , the peripheral blood b and differential and immature neutrophil precursor differential showed better specificity and positive predictive value for chorioamnionitis than the cord blood parameters . However , the cord blood absolute neutrophil count , neutrophil differential , and mean neutrophil conductivity showed better negative predictive value . Cord blood can be a valuable source of diagnostic laboratory testing for neonates because of their small blood volume . This is the first study demonstrating that routine hematologic and VCS parameters from cord blood can be used to predict pathologically confirmed chorioamnionitis Objective ( s ) : Bacterial infection contributes substantially to neonatal morbidity and mortality . Early diagnosis of neonatal sepsis is difficult because clinical signs are non-specific . We have evaluated serum IL-6 , 8 and 10 as potential early diagnostic markers of neonatal infection and their relationship to mortality rate and poor prognosis . Material s and Methods : A total of 84 infants , aged ≥ 72 hr were enrolled in this prospect i ve case-control trial . The case group ( n=41 ) included babies with clinical and laboratory findings compatible with sepsis and /or positive blood or cerebrospinal fluid cultures . The control group ( n=43 ) included healthy infants .  IL-6 , 8 and 10  were measured for all infants . Receiver-operating characteristic ( ROC ) curves were used for the determination of thresholds . Results : Statistically significant differences were observed between control and case groups for serum median level of IL-6 , 8 and 10 ( P<0.001 ) . IL-6 cut-off values of 10.85 Pg/ml for discriminating between cases and controls and 78.2 Pg/ml for predicting mortality are suggested . IL-8 at a cut-off value of 60.05 Pg/ml was valuable for differentiation of definite versus indefinite infection . Conclusion : Evaluating the IL-6 , 8 and 10 simultaneously , could improve the sensitivity and specificity of early diagnosis of the neonatal sepsis . Regarding our results , interleukin 6 had the greatest value for predicting infection and possible mortality , whereas IL-8 was valuable for diagnosing definitive infection The first objective of this article was to determine the diagnostic accuracy of tumor necrosis factor-alpha , interleukin-6 ( IL-6 ) , and interleukin-8 ( IL-8 ) in differentiating infected from noninfected neonates during the first 24 hours of suspected sepsis and to compare them to the currently used laboratory parameters : C-reactive protein ( CRP ) , immature-to-total neutrophil ratio , and leukocyte and platelet count . The secondary objective was to compare the cytokine levels in sub population s of neonates . Seventy-five premature and 30 term infants were enrolled .  Blood sample s for the " currently used laboratory tests " and the  cytokine levels  were obtained at the first suspicion of sepsis ( " 0-hour " ) and 18 to 30 hours later ( " 24-hours " ) . Patients were classified as septic ( 48 ) or nonseptic ( 57 ) . Thirty-two septic patients had positive blood cultures and 16 showed clinical signs of sepsis . Twenty septic patients had early-onset and 28 had late-onset sepsis . Sensitivity , specificity , and positive and negative predictive values ( PPV and NPV ) were calculated for each test . Receiver-operating characteristic curves were analyzed to determine the optimal thresholds . A combination of  CRP  > 10 pg/mL plus IL-6 > 18 pg/mL ( sensitivity = 89 % , specificity = 73 % , PPV = 70 % , NPV = 90 % ) was the best " 0-hour " test , and CRP ( sensitivity = 78 % , specificity = 94 % ) was the best " 24-hours " test . Lower IL-6 at 0-hour ( p = 0.018 ) and IL-8 at 24 hours ( p = 0.023 ) were detected among the patients infected with coagulase-negative staphylococci then with other bacteria . In conclusion , a combination of CRP +  IL-6  provided additional diagnostic accuracy for differentiation between septic and nonseptic patients during the first 24 hours of suspected sepsis BACKGROUND Neonatal sepsis is a common and life-threatening disorder , particularly among preterm infants . Early initiation of antibiotic therapy is frequently delayed because the first clinical signs of sepsis are non-specific and there are no reliable early laboratory indicators . We investigated the time course of expression and the prognostic power of the early inflammatory mediators interleukin-1 receptor antagonist ( IL-1ra ) , interleukin-6 ( IL-6 ) , and circulating intercellular adhesion molecule-1 ( cICAM-1 ) before clinical diagnosis of sepsis . METHODS In a prospect i ve multicentre study , we monitored 182 very-low-birthweight infants in six intensive-care units for occurrence of sepsis . During routine or clinical ly indicated blood sampling , an additional sample was collected for measurement of  IL-1ra , IL-6 , cICAM-1 , and C-reactive protein ( CRP ) .  Infants were grouped into those with proven sepsis , no infection , or unclassified . The mean study duration was 34 days . Whenever sepsis occurred , a study period of 10 days was defined : day 0 was the day of clinical diagnosis of sepsis ; days -4 to -1 were the 4 days before diagnosis ; days + 1 to + 5 were the 5 days after . We compared the concentrations of the immune mediators during the 10-day study period with group-specific baseline values from before day -4 . FINDINGS 101 infants were included in the analysis : 21 with proven sepsis , 20 with no infection , and 60 unclassified . We excluded 57 because of incomplete data sets and 24 who had early-onset sepsis .  IL-1ra and IL-6 increased significantly 2 days before diagnosis of sepsis ; maximum median increases within the study period were 15-fold for IL-1ra and 12-fold for IL-6 . The diagnostic sensitivities of IL-1ra , IL-6 , and CRP concentrations on day 0 of diagnosis were 93 % , 86 % , and 43 % , respectively ; corresponding values on day -1 were 64 % , 57 % , and 18 % . The specificities of IL-1ra , IL-6 , and CRP concentrations were 92 % , 83 % , and 93 % . cICAM-1 had a specificity of only 64 % . INTERPRETATION IL-1ra and IL-6 are superior to cICAM-1 and CRP as predictors of sepsis 1 or more days before clinical diagnosis . Ad-hoc measurement of these cytokines could allow earlier initiation of antibiotic therapy with corresponding improvement in outcome in very-low-birthweight infants with sepsis The aim of this study is to investigate prospect ively 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- 
    Output:
    
Our results suggested that IL-6 is a valid and accurate index in diagnosing early neonatal sepsis , but it still needs to be combined with other laboratory tests and specific clinical manifestations