Comparative study of diagnostic value of Apo lipoprotein AI in neonatal sepsis in Relation to hematological score

Abstract

Objective The aim of this study is to study serum level of Apolipoprotein A1 as a diagnostic marker in neonatal sepsis in relation to haematological score. Background: Neonatal sepsis has become a global health problem due to its high morbidity and mortality. Blood culture continues to be the main method to diagnose neonatal sepsis. The present work aimed to study of serum level of Apolipoprotein A1 as a diagnostic marker in neonatal sepsis in Relation to Hematological score. Methods: This study is a case control study, which was done on 60 neonates who admitted to neonatal ICU (NICU) of Benha University Hospitals and Benha Teaching Hospitals of both sexes after obtaining an informed consent from the children's caregiver. Group I: 40 neonates with a positive clinical sepsis score (CSS) and hematological sepsis score (HSS). Group I were subdivided into two subgroups A , B: Subgroup A: 20 Neonates with early Sepsis within the first 7 days of life. Subgroup B: 20 Neonates with late Sepsis after 7 days of life. Group II (Controls) included 20 healthy neonates with no evidence of sepsis. This study was carried out in Al-Qalubyia Governorate, from June 2019 to May 2020. Results: There was significant increase in HSS in sepsis group than control. Klebsilla was the common organism. there were statistically significant decrease in serum level of Apolipoprotein A1 at diagnosis among cases than control.There was no statistically significant difference between Early onset neonatal sepsis group and Late onset neonatal sepsis group regarding HSS at diagnosis.There were no statistically significant difference between Early onset neonatal sepsis group and Late onset neonatal sepsis group regarding serum level of Apolipoprotein A1 at diagnosis. Serum level of Apolipoprotein A1 at diagnosis was statistically significant lower among Early onset neonatal sepsis group than Control group. Serum level of Apolipoprotein A1 at diagnosis was statistically significant lower among late onset neonatal sepsis group than Control group. There were statistically significant positive correlation between serum level of Apolipoprotein A1 at diagnosis and Platelet count, and there was no statistically significant difference between serum level of Apolipoprotein A1 at diagnosis and other numerical data.Serum level of Apolipoprotein A1 is more accurate in the diagnosis of neonatal sepsis than HSS. Conclusion: Apo A1 appeared to be a useful marker for the early detection and diagnosis of neonatal sepsis than HSS.