(Cary, NC, USA). Differences between the two infection subgroups (suspected

and documented sepsis) and the control group for each parameter at the first and second study check details periods were evaluated using the one-way anova test followed by the Fisher’s PLSD test, which was also used to estimate differences within the groups at the three study periods. Differences were considered significant at P < 0.05. Diagnostic accuracy of the inflammatory mediators was evaluated by estimating the sensitivity, specificity and the positive and negative predictive value at the first day of suspicion of infection, calculated using the optimal cut-off value. To quantify the overall ability of any study index to discriminate between neonates with infection and those without, infection

receiver operation curves (ROC) were constructed and the area under the ROC was calculated. This allowed comparison of the infection indices independently HIF cancer of the selected cut-off point for each of them. In the 25 neonates with a positive blood culture, the following organisms were isolated: Escherichia coli, (7 cases), Klebsiella (3), Staphylococcus aureus (2), Streptococcus group B (2), Corynobacter (1), Listeria (1), Streptococcus viridans (1), Staphylococcus coagulase negative (8). In 13 cases, the sepsis was classified as early (less than third day of life) and in other 12 cases as late (greater than third day). Comparisons between the three groups were made only for the first two study periods as the age of the neonates at the third study period was different (mean age 14, 7, 28 days for the sepsis, suspected infection and control groups, respectively). Table 1 shows the measurements of the parameters examined in the three study groups. At the first study period, CRP, IL1-b, IL6 and TNF-α were higher in the sepsis group than in the other two groups. At the second study period, IL1-b, IL-6 and

TNF-α had decreased in the sepsis group, but remained higher in the other two groups. IgM was Megestrol Acetate higher in the sepsis group at the second study period, and IgG was lower in the sepsis and the suspected infection groups at both first and second study periods than in the control group. NK cells and B cells were higher in the sepsis group and in the suspected infection group at the first and second study periods while the CD3+/CD4+, CD3+/CD8+ and CD4+/CD8+ ratios did not differ between the groups at any study period (Table 2). The WBC count, differential count and platelet count in the three groups were similar at all three study periods. In the control group of healthy full-term neonates with no signs of infection, the cytokine levels were low and remained unchanged during the first month of life while the levels of IgA and IgM increased and IgG decreased (Table 1).