الفهرس 
Material and methodsOnly 14 pages are availabe for public view
 |  | from | 213 |  |  |
| | | from | 213 | | |
Abstract
Neonatal septicemia remains a major cause of morbidity and
mortality in the ne :matal period.
This study was done in the neonatal intensive care unit ofBenha
University Hospit tI from Oct. 1999 to June 2002 to clarify the role of
defensin (HNP-l) in diagnosis of neonatal septicemia compared to other
more established easures as HSS, CRP and blood culture.
Our study w s carried out on 60 newborns divided into 4 groups:
Group (1): Septic emia full term newborn (n = 20).
Group (2): Health full term newborn (n = 10).
Group (3): Septicemic preterm newborn (n = 20)
Group (4): Uncom licated preterm newborn (n = 10).
Each of the studied newborns was subjected to history taking,
clinical examinatio and laboratory investigations inclUding CBC, blood
culture, CRP, IL-6 a rd defensin (HNP-I).
The serum IL-6 and defensin (HNP-I) were done again after
complete clinical cur: confirmed by negative blood culture, negative CRP
and HSS less than 3.
The clinical anifestations found in septicemic patients were non
specific and the mos common clinical manifestations were poor feeding,
hypothermia, lethargy respiratory distress and abdominal distension.
In our work, the number of septicemic patients with a
hematological score : 3 were 17 cases out of 20 septicemic fullterm so,
its sensitivity was 85 Va while in septicemic preterm the hematological
Score was positive in I ~cases out of20, its sensitivity was 60%.
------------1---
--------- ----------
Summary and Recommendation @@;;;;;;;;;=S;=S;s=l;=S;=S;=S;;;;;;;;;=s;=s;;;;;;;;;;=s;e=s;;s;;;=s;=s;=s;;=s;
As regard to CRP, it was positive in 18 cases out of 20 septicemic
fullterms. Its se sitivity was 90% while in septicemic pretenns. It was
positive in 15 c ses out of 20 septicemic preterms, its sensitivity was
75%.
As regard 0 IL-6, in septicemic fulltenns, it was positive in 19
cases out of 20 ases, with sensitivity of95%. In septicemic preterms, it
was positive in 17 cases out of20 cases, with sensitivity of85%.
As regard t . defensin, in septicemic fulltenns, it was positive in 19
cases out of 20 ases with sensitivity of95%. In septicemic preterms, it
was positive in J 8 ases out of20 cases with sensitivity of90%.
Our study ound that there was a positive correlation between
defensin and neutr lphil count in septicemic non neutropenic cases while,
there was no corr lation in septicemic neutropenic cases, as the level of
defensin also ele ated in septicemic neutropenic neonates. So the
defensin concentration can reflect the number and activity of defensin not
only in circulation b It at the site of infection.
We suggeste I that serun level of defensin is elevated during
infection and can b l used as diagnostic marker for neonatal septicemia
and that increased circulating defensins are dependent in part on
neutrophil count an might playa role in host defense in neonates with
septicemia.
Defensin has roven to be the most sensitive and specific of all
studied parameters b It, it has also been shown to be the last test to return
to the normal values after treatment and therefore, its value as a
prognosits test in ne natal sepsis is limited in comparison to the other
studied parameters.