Salivary and Serum Interleukin-10, C-Reactive Protein, Mean Platelet Volume, and CRP/MPV Ratio in the Diagnosis of Late-Onset Neonatal Sepsis in Full-Term Neonates

Salivary markers could serve as potential noninvasive markers in the diagnosis of neonatal infections. We aimed to investigate the diagnostic role of salivary and serum interleukin 10 (IL-10), C-reactive protein (CRP), mean platelet volume (MPV), and CRP/MPV ratio in the diagnosis of late-onset neonatal sepsis in full-term neonates. Seventy full-term neonates were enrolled in this prospective case-control study, 35 with late-onset neonatal sepsis, and 35 controls. Salivary IL-10, serum IL-10, and CRP concentrations were measured by enzyme-linked immunosorbent assay (ELISA). Complete blood (CBC) count was measured by an automated blood cell counter. The salivary IL-10, serum IL-10, CRP, MPV, and CRP/MPV ratio levels were much higher in neonates with late-onset sepsis than in control ( <a:math xmlns:a="http://www.w3.org/1998/Math/MathML" id="M1"> <a:mn>220</a:mn> <a:mo>±</a:mo> <a:mn>150</a:mn> </a:math> vs. <c:math xmlns:c="http://www.w3.org/1998/Math/MathML" id="M2"> <c:mn>18</c:mn> <c:mo>±</c:mo> <c:mn>9</c:mn> <c:mtext> </c:mtext> <c:mtext>pg</c:mtext> <c:mo>/</c:mo> <c:mtext>ml</c:mtext> </c:math> , <e:math xmlns:e="http://www.w3.org/1998/Math/MathML" id="M3"> <e:mi>P</e:mi> <e:mo><</e:mo> <e:mn>0.001</e:mn> </e:math> ), ( <g:math xmlns:g="http://www.w3.org/1998/Math/MathML" id="M4"> <g:mn>316</g:mn> <g:mo>±</g:mo> <g:mn>198</g:mn> </g:math> vs. <i:math xmlns:i="http://www.w3.org/1998/Math/MathML" id="M5"> <i:mn>23.7</i:mn> <i:mo>±</i:mo> <i:mn>14</i:mn> <i:mtext> </i:mtext> <i:mtext>pg</i:mtext> <i:mo>/</i:mo> <i:mtext>ml</i:mtext> </i:math> , <k:math xmlns:k="http://www.w3.org/1998/Math/MathML" id="M6"> <k:mi>P</k:mi> <k:mo><</k:mo> <k:mn>0.001</k:mn> </k:math> ), ( <m:math xmlns:m="http://www.w3.org/1998/Math/MathML" id="M7"> <m:mn>78.2</m:mn> <m:mo>±</m:mo> <m:mn>34</m:mn> </m:math> vs. <o:math xmlns:o="http://www.w3.org/1998/Math/MathML" id="M8"> <o:mn>3.3</o:mn> <o:mo>±</o:mo> <o:mn>1.7</o:mn> <o:mtext> </o:mtext> <o:mtext>mg</o:mtext> <o:mo>/</o:mo> <o:mtext>L</o:mtext> </o:math> , <q:math xmlns:q="http://www.w3.org/1998/Math/MathML" id="M9"> <q:mi>P</q:mi> <q:mo><</q:mo> <q:mn>0.001</q:mn> </q:math> ), ( <s:math xmlns:s="http://www.w3.org/1998/Math/MathML" id="M10"> <s:mn>11.2</s:mn> <s:mo>±</s:mo> <s:mn>0.9</s:mn> </s:math> vs. <u:math xmlns:u="http://www.w3.org/1998/Math/MathML" id="M11"> <u:mn>8.6</u:mn> <u:mo>±</u:mo> <u:mn>0.4</u:mn> <u:mtext> </u:mtext> <u:mtext>fL</u:mtext> </u:math> ), and ( <w:math xmlns:w="http://www.w3.org/1998/Math/MathML" id="M12"> <w:mn>7.08</w:mn> <w:mo>±</w:mo> <w:mn>3.3</w:mn> </w:math> vs. <y:math xmlns:y="http://www.w3.org/1998/Math/MathML" id="M13"> <y:mn>0.4</y:mn> <y:mo>±</y:mo> <y:mn>0.2</y:mn> </y:math> , <ab:math xmlns:ab="http://www.w3.org/1998/Math/MathML" id="M14"> <ab:mi>P</ab:mi> <ab:mo><</ab:mo> <ab:mn>0.001</ab:mn> </ab:math> ), respectively. At the cutoff point of >31 pg/ml, salivary IL-10 showed 97.1% sensitivity and 94.3% specificity. Serum IL-10 at a cutoff value of ≥33.6 pg/ml had a sensitivity of 97.1% and specificity of 80%. MPV showed a sensitivity of 100% and specificity of 94.4% at a <cb:math xmlns:cb="http://www.w3.org/1998/Math/MathML" id="M15"> <cb:mtext>cutoff</cb:mtext> <cb:mtext> </cb:mtext> <cb:mtext>value</cb:mtext> <cb:mo>≥</cb:mo> <cb:mn>9.2</cb:mn> <cb:mtext> </cb:mtext> <cb:mtext>fL</cb:mtext> </cb:math> . CRP/MPV ratio showed a sensitivity of 100% and specificity of 97.1% at a <eb:math xmlns:eb="http://www.w3.org/1998/Math/MathML" id="M16"> <eb:mtext>cutoff</eb:mtext> <eb:mtext> </eb:mtext> <eb:mtext>value</eb:mtext> <eb:mo>></eb:mo> <eb:mn>0.9</eb:mn> </eb:math> . Salivary and serum IL-10 showed a positive correlation with CRP and CRP/MPV ratio in septic neonates. The current study shows for the first time that both salivary IL-10 and CRP/MPV showed statistically significant differences between neonates with late-onset sepsis and controls. Accordingly, salivary IL-10 could serve as a potential noninvasive biomarker for the diagnosis of late-onset sepsis in full-term neonates.