الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
infections remain common and sometimes life-threatening in neonates
admitted to the neonatal intensive care unit (NICU).
For many years, a search has been ongoing to find predictors of
neonatal sepsis that identify effectively patients who are at risk of
infection.
Mannose-binding lectin (MBL) is a plasma protein that plays an
important role in the innate immune defense.
The aim of our study was to investigate whether low MBL
levels are associated with the occurrence of neonatal sepsis, which will
help us in early and accurate diagnosis as well as in early initiation of
appropriate therapy.
This study was conducted on 45 neonates diagnosed as having
sepsis, and 41 healthy neonates with no clinical signs or laboratory
evidence for sepsis serving as a control group.
The case group compromised 45 newborns; 16 males (35.6%)
and 29 females (64.4%), with mean gestational age of (36.47± 2.13 ),
mean birth weight of (2.81 ± 0.8) and mean serum MBL level of
(0.49± 0.1).
The control group compromised 41 healthy newborns; 20 males
(48.8%) and 21 females (51.2%), with mean gestational age of (37.15
± 1.47), mean birth weight of (2.87 ± 0.5) and mean serum MBL level
of (1.4 ± 0.39).
In the case group, 19 (42.2%) neonates were delivered
vaginally, and 26 (57.8%) neonates were delivered by caesarian
section. In the control group, 14 (34.1%) neonates were delivered
vaginally, and 27 (65.9%) neonates were delivered by caesarian
section.
For all neonates, the following were performed:
1- History taking (To detect risk factors for sepsis).
2- Thorough clinical examination (To detect clinical signs of
sepsis).
3- Laboratory investigations:
Blood samples were withdrawn from all neonates by
venipuncture to determine the MBL serum level by enzymelinked
immunosorbent assay (ELISA).
Complete blood count with differential leukocytic count.
CRP quantitative assay.
Blood culture, when clinically indicated.
Statistical tests were done to determine whether low MBL levels
were associated with increased risk of neonatal sepsis.
The results of our study were:
Infants who developed sepsis had their serum MBL levels
significantly lower than those of the control group.
Regarding the most frequent clinical presentation, 100% of
cases needed O2 requirement, 95.6% developed respiratory
distress, 93.3% had petechiae, 91.1% had temperature
instability, 77.8% had mottling, 55.6% of cases had poor
suckling reflex, 28.9% were lethargic, 13.3% had jaundice 13.3% had hepatosplenomegally, 11.1% had abdominal
distention, 11.1% had poor Moro reflex, 6.7% had abnormal
muscle tone, 2.2% had convulsions, and 2.2% had apnea.
ROC analysis of the data showed that the best cutoff MBL value
for the risk of sepsis was 0.67 μg/ml (sensitivity = 93.33%;
specificity = 100%; area under the curve = 1.0; PPV =100%;
NPV =93.18%; Accuracy =96.51%).
MBL serum levels correlated positively with gestational age and
birth weight in the studied group.