Find in Library

<b>Objective:</b> To study the association of tumor necrosis factor-a (TNF-a) and C - reactive protein (CRP) with microbiologically documented cases of sepsis versus clinically documented cases of sepsis. <b>Materials and Methods:</b> Seventy nine pediatric patients with sepsis were studied. Relevant specimens were processed for bacterial or fungal etiology. TNF-a was detected by enzyme immunoassay and CRP was detected by latex agglutination. Thirty healthy cases were included in the study to establish baseline TNF-&#945; levels. <b>Results:</b> Forty two (53.2&#x0025;) patients had a microbiologically documented sepsis. Among Gram negative bacilli <i>Escherichia coli</i> was the most common isolate followed by <i>Klebsiella spp.</i> <i>Staphyloccus aureus</i> and <i>Streptococcus pneumoniae</i> predominated among the Gram positive cocci. Patients with a positive culture had significantly higher TNF-&#945; levels than patients with a negative culture (70pg/ml vs. 33 pg/ml <i>P</i> &lt; 0.01). Further, pure gram negative infection correlated with significantly higher TNF-&#945; levels than pure (<i>P</i> &lt; 0.01) gram positive infection. The CRP values did not highlight these differences significantly. <b>Conclusions:</b> TNF-&#945; level was significantly raised in patients with sepsis. TNF-a levels were raised significantly in culture positive cases in general and in Gram negative infections in particular. Serum TNF-&#945; was a more sensitive marker for different categories of sepsis compared to CRP and microbiology culture.