Abstract:
Neonatal Infection, including bacterial sepsis, is a major health care issue with an
annual global mortality in excess of one million lives. This study aimed to evaluate
the potential diagnostic value of CRP, E-selectin, procalcitonin, IL-1β, IL-6, IL-18,
IL-22, IFN-γ and TNF-α both independently and in combination for the diagnosis
of neonatal sepsis in its earliest stages. A total of 320 subjects were included in this
study. A prospective cross-sectional study was conducted among neonates
admitted to neonatal intensive care unit (NICU) at King Abdulaziz Medical City,
Riyadh, KSA during the period from January 2014 to August 2016, the study based
on three study groups categorized according to clinical symptoms and blood
culture result. Study groups include healthy control neonates (n=80), clinical sepsis
group (n=80) with clinical signs of sepsis but their blood culture was negative and
sepsis group with clinical signs of sepsis and their blood culture was positive
|(n=160). This group is subdivided into EOS (n=80) and LOS (n=80).The study
observed significant difference in serum levels of all markers in patients group
when compared with control group (p <0.001). Furthermore the levels are
significantly different between patient groups including clinical sepsis, early onset
sepsis and late onset sepsis groups (p <0.05) with exception of IL-18 (p value=
0.24)|. Moreover result observed significant difference in CRP, IL-1β, IL-6, IL-22
and IFN-γ in early onset sepsis (EOS) when compared with late onset sepsis (LOS)
neonates (P<0.05). Regarding biomarkers accuracy, the result showed that IL-1β
and CRP has best diagnostic accuracy with cut-off value of 37.4 ng/ml and
3.6ng/ml respectively. Best combination is shown for IL-1β with INF-γ or IL-22 in
which sensitivity increased to 91 % and specificity to 83 %.It was concluded that
infected new-born babies have a higher E-selectin, PCT IL-6, Il-22, IL-1β, INF-γ
TNF-α and CRP compared with the neonates with clinical sepsis and control.
