الفهرس | Only 14 pages are availabe for public view |
Abstract Background: Neonatal sepsis remains a leading cause of morbidity and mortality among infants, especially in low socioeconomic countries. Blood culture is the cornerstone for diagnosis of neonatal sepsis. Because of its delayed results and due to the increasing need for rapid diagnosis of sepsis, it becomes very important to search for new serum biomarkers which allow rapid diagnosis of sepsis and designing treatment plans accordingly to improve outcome of infants. Aim of the work: The aim of the work is to detect cut-off, sensitivity and specificity of presepsin as a biomarker for the diagnosis of early-onset neonatal sepsis on preterm (PT) babies and its relation to CRP. Methods: This case-control study has been conducted on sixty preterm infant recruited from the NICU of Obstetrics and Gynecology Hospital, Cairo University. 60 infants were divided into two groups; the suspected EOS group: 30 neonates (20 male and 10 female) with maternal history suspecting septicemia and the control group: 30 neonates(17 male and 13 female) without maternal history suspecting septicemia and admitted to NICU as grower, The medical history, maternal data, neonatal date and needed investigations were done and collected from patient’s files while presepsin investigation was done in Abu-Elreish Hospital laboratory by enzyme-linked immunosorbent assay (ELISA), All preterm infants were accurately observed with documentation of all events done during hospital stay with special reference to presepsin results, different lines of treatment and outcome Results: Presepsin levels in the suspected EOS group were higher at 6 hours of life compared to the control group (P<0.001) and there were highly statistically significant difference (P<0.001) in the suspected EOS group regarding the relation between presepsin and CRP in diagnosis of EOS at 6 hours and 24 hour age of life. The area under the receiver operating characteristics (ROC) curve (AUC) for presepsin was 0.963 with sensitivity 96.30 % and specificity of 100.00 % with cut-off value > 454 ng/ml at 6 hour of age, patients above this level are considered septic with PPV=100.00% and NPV=75.00 % while the area under the receiver operating characteristics (ROC) curve (AUC) for presepsin was 0.963 with sensitivity 96.30 % and specificity of 100.00 % with cut-off value > 527 ng/ml at 24 hour of age, patients above this level are considered septic with PPV=100.00 % and NPV=75.00 %. Conclusion: Presepsin is a sensitive and accurate serum biomarker for diagnosis of sepsis |