Assessment of Serum Interleukins 18 and 22 in Predicting Neonatal Sepsis and Mortality: A Case-Control Study

Background: Sepsis is a leading cause of neonatal morbidity and mortality, but its early diagnosis remains challenging. Neonatal sepsis (NS) induces an immune response with the release of Inflammatory cytokines, which may serve as early diagnostic biomarkers. Limited data indicate interleukin (IL)-18 and IL-22 levels are elevated in NS and associated with mortality. Objectives: To investigate the diagnostic performance of serum IL-18 and IL-22 levels in predicting NS and mortality. Design: Case-control study. Methods: We enrolled 55 newborns with culture-positive sepsis and 34 age- and sex-matched healthy controls. Serum IL-18 and IL-22 levels were measured using enzyme-linked immunosorbent assay. Receiver operating characteristic (ROC) curve analysis was used to assess the diagnostic performance of IL-18 and IL-22 in predicting NS and mortality. Results: Compared with controls, newborns with NS had significantly higher median levels of IL-18 (910 vs 256 pg/mL, P < .001) and IL-22 (96 vs 20 pg/mL, P < .001). Among septic neonates, non-survivors had significantly higher median levels of IL-18 (1820 vs 873 pg/mL, P < .001) and IL-22 (139 vs 91 pg/mL, P < .001) than survivors. ROC curve analysis demonstrated excellent performance of IL-18 and IL-22 in predicting NS (area under the curve [AUC] 0.990 and 0.998, respectively) and mortality (AUC 0.942 and 0.994, respectively). Conclusion: IL-18 and IL-22 are potentially promising biomarkers for identifying NS and predicting neonatal mortality.