الفهرس 
Table of ContentsOnly 14 pages are availabe for public view
 |  | from | 200 |  |  |
| | | from | 200 | | |
Abstract
Background: Sepsis remains the most common cause of neonatal morbidity and mortality during the first month of life. The gold standard for diagnosis of sepsis is blood culture, but with limited sensitivity. The most challenging aspect in neonatal sepsis especially LOS is the difficulty of its early and accurate diagnosis. Therefore, novel and precise biomarkers of sepsis are highly needed to detect sepsis during the early stage of the disease to minimize the rate of disease mortality. Also, biomarkers that can help in monitoring and staging of sepsis are required to predict prognosis and help in management of sepsis. sTREM-1 is a novel and promising biomarker that was reported to be effective in diagnosis and prognosis of sepsis. Aim: This work was carried out to evaluate the role of serum levels of sTREM-1 in early diagnosis and prognosis of LOS. Setting: Microbiology Diagnostics and Infection Control Unit (MDICU), in the Medical Microbiology and Immunology Department, Faculty of Medicine, Mansoura University. Results: This study was conducted over a period of 12 months from November 2014 till November 2015, and it included 59 preterm neonates admitted to NICU of Mansoura University Children’s Hospital (MUCH). Thirty infants with suspicion of LOS and 29 gestational age and sex matched infants without sepsis served as controls. All neonates were subjected to blood culture and routine sepsis screening. Levels of sTREM-1 were measured at enrollment and after 48-72 hours of antibiotic therapy in sepsis group. Blood culture was positive in 36.7% of septic neonates. Klebsiella pneumoniae and S. aureus were the most common isolated organisms. sTREM-1 assay by ELISA showed 90% sensitivity and 51.7% specificity for diagnosis of LOS. When both sTREM-1 and CRP were used together, this combination had 100% sensitivity and NPV. As for prognosis, sTREM-1 had 96.3% sensitivity and 100% specificity for prediction of survival. Serum levels of sTREM-1 showed gradual decrease 48-72 hours after treatment. Conclusion: early and accurate diagnosis and prognosis of neonatal sepsis can be aided by utilizing sTREM-1 besides blood culturing especially in ruling out sepsis in those reported to have negative culture results, besides, we found that a combination of sTREM-1 and CRP a has a significant role in timely neonatal sepsis diagnosis with better prognosis of neonates and in making decisions regarding antibiotics treatment and improvement the level of medical care in NICU.