E-selectin, G-CSF and other immunological markers in late onset neonatal sepsis

الملخص EN

The current study included fourty neonate's wit late onset neonatal sepsis (L.O.N.S) their mean age was 16.2 +-8.

6 days with full-term to preterm ratio, 1.86: 1 another sixteen apparently healthy newborns of matchable age and sex were considered as control group.

All the patients and the control group were evaluated by complete history and examination, the following investigations were estimated once far the control group and twice for the diseased newborns, firstly on admission and The second assay was 24 hours after starting antibiotics treatment.

C-reactive protein (C.R.P) Granulocyte colony stimulating factor (G-CSF) interleukin -6 (IL6) E-selections and complete blood count were done for cases & controls.

Blood culture was withdrawn for all the diseased Neonates on admissions.

According to the results of blood culture and tollener sepsis score 20 patients were considered as proved sepsis group: group-1.

While the other 20 neonates with—ve blood culture and clinical of sepsis were considered as unproven-sepsis group- II All the studied diseased neonates showed significantly higher mean\values of C-RP,G-CSF, IL6, E-selection leuckocytic count and % of band cells in comparison to the control group.

Both on admission .

(p<0.

005 for each) as well as on second assay (p<0.005, p< 0.05.

p< 0.05, p<0 005, p-'<0.01, p <0.005 respectively) On the other hand, hemoglobin value and platelet count were significantly reduced in all the studied patients in comparison to- the control group both on the 1 st and 2 nd assay (p<0.OO5 for each and p<0.005, p<0.005 respectively Neonates group (1) showed persistently higher mean values of C-RP,G-CSF, IL6E- selection.

WBC count and % of band cells in comparison to patients of group (11).

This was true for the first assay (p<0.005, p<0.005, p<0.005, p<0.005, p<0.005 respectively) as well as for the second.

Assay (p<0.005, p<0.025, p<0.01, p<0.01, p<0.01, p<0.005 respectively) although all the diseased neonates showed significant decline of the values of C-RP.

G.-CSF-IL6, E-selection and %of band cells on the second assay yet, these values.

Were still significantly higher among proved 102 Sepsis group, whereas neonates of unproved sepsis group exhibited insignificant higher mean value of C-RP, G-CSF-, IL6 and E-selection in comparison to control group.

Significant +ve correlations were detected between C-RF and each ofG-CSFIL6, E-selection and WBC among all the diseased neonates as well as among those with proved sepsis on admission.

Such significant correlations were not observed among the unproven sepsis group of neonates.

Furthermore, significant- ve correlations were detected between the platelet count and each of C-RP and IL6 for all the diseased neonates on admission and on 2 nd assay.

the values of E-selection and G-CSF for all the diseased newborns and those of group i showed +ve correlations with each of lL6 and WBC whereas, these, findings could not detected for neonates of group (II) No significant differences could be defected for Sit the studied parameters between the full term and preterm diseased infants.

E-selection showed the highest -ve predictive value 95% while G-CSF and C-RP had the best specificity (96% and 95% respect) .to detect neonatal sepsis in the proved sepsis group of neonates.

Meanwhile.

IL.6 and G-CSF exhibited the best sensitivity indices for diagnosing LONS In conclusion: The previous results suggested that cytokine, network to already active in neonatal period and may be induced by infectious process.

G-CSF,E-selection .

IL6 and C-RF could be considered as valuable markers for early diagnosis of late onset neonatal sepsis and should be serially evaluated to help in the early discontinuation of antibiotics