The Role of Pancreatic Stone Protein in Diagnosis of Early Onset Neonatal Sepsis

Anwar A Rass,Mohamed Mohamed Abdelsalam,Mohamed A Talat,Naglaa A Khalifa,Mona A Mansour,Lamiaa Mahmoud Kamel,Mohamed A Arafa,Hosam F El-Saadany,Ezzat K Amin

doi:10.1155/2016/1035856

Anwar A Rass, Mohamed Mohamed Abdelsalam + Show 7 more

Open Access

https://doi.org/10.1155/2016/1035856

Copy DOI

Journal: BioMed research international	Publication Date: Jan 1, 2016
Citations: 40	License type: CC BY 4.0

Affiliation: Zagazig University

Abstract

Introduction. Early diagnosis and treatment of neonatal sepsis may help decrease neonatal mortality. Aim of the Study. To evaluate the role of pancreatic stone protein as a marker for early onset neonatal sepsis. Methods. A hospital-based prospective study was conducted on 104 (52 uninfected and 52 infected neonates) admitted to the Neonatal Intensive Care Unit (NICU) of Zagazig University hospitals during the period from April 2014 to April 2015. All newborns were subjected to full history taking, careful neonatal assessment, blood, C-reactive protein (CRP), and serum pancreatic stone protein. Results. Serum PSP levels were significantly higher in the infected group than in the uninfected group. At a cutoff level of PSP 12.96 ng/mL, the sensitivity was 96.2%, the specificity was 88.5%, positive predictive value was 95.8%, negative predictive value was 89.3%, and area under the curve was 0.87. A significant positive correlation between CRP and PSP was found in infected group. Conclusion. The high negative predictive value of PSP (89.3%) indicates that the serum PSP level is a good marker for diagnosis of early onset neonatal sepsis and can be used to limit hospital stay and antibiotic use in neonates treated for suspected sepsis.

Highlights

Diagnosis and treatment of neonatal sepsis may help decrease neonatal mortality
More than half of the studied neonates were delivered by cesarean section (53.8%); 28.8% of them had history of PROM, 19.2% of them had history of maternal group B Streptococcus (GBS), 19.2% of them had history of maternal fever, 23.1% of them had history of intrapartum antibiotics, 28.8% of them had history of fetal tachycardia, and 46.2% of them had other risk factors like mother age 37, positive consanguinity, oligohydramnios, and diabetes mellitus
As total leukocyte count is difficult to be interpreted in the neonatal period because it varies significantly with days of life and gestational age [39], we studied neutrophils count and we found a significant decrease in neutrophils count in the infected group compared to the uninfected group which runs with other studies [40]

Summary

Introduction

Diagnosis and treatment of neonatal sepsis may help decrease neonatal mortality. A hospital-based prospective study was conducted on 104 (52 uninfected and 52 infected neonates) admitted to the Neonatal Intensive Care Unit (NICU) of Zagazig University hospitals during the period from April 2014 to April 2015. The high negative predictive value of PSP (89.3%) indicates that the serum PSP level is a good marker for diagnosis of early onset neonatal sepsis and can be used to limit hospital stay and antibiotic use in neonates treated for suspected sepsis. The incidence of neonatal sepsis varies from 1 to 4 per 1000 live births in developed countries. Onset neonatal sepsis (EOS) is bacteremia or bacterial meningitis occurring at 72 h in infants hospitalized in the Neonatal Intensive Care Unit (NICU) [6, 7]. The main risk factors for EOS include prematurity, low birth weight, febrile illness in the mother within 2 weeks of delivery, foul smelling and/or meconium stained liquor, premature rupture of membranes, prolonged labor, and perinatal asphyxia [9]

Methods

Results

Conclusion