الفهرس 
IntroductionOnly 14 pages are availabe for public view
 |  | from | 129 |  |  |
| | | from | 129 | | |
Abstract
Infants of any gestational age are susceptible to late-onset sepsis. However, very low birth weight infants (those weighing less than 1,500 g) are particularly vulnerable because of the need for invasive monitoring, impaired host defense mechanisms, limited amounts of normal endogenous flora, reduced barrier function of neonatal skin and frequent exposure to broad-spectrum antibiotics.
Risk factors for neonatal sepsis include maternal factors, neonatal host factors, and virulence of infecting organism
Superoxide Dismutase (SOD) has recently gained notoriety for its connection with amyotrophic lateral sclerosis, more commonly known as Lou Gehrig’s disease. This disease is a degenerative disorder that leads to selective death of neurons in the brain and spinal cord, leading to gradually increasing paralysis over a few years
The aim of the current study was to examine neutrophil counts and various neutrophil indices in preterm very low birth weight (VLBW) newborn infants with culture proven late-onset sepsis to determine whether the neutrophil responses could predict late-onset sepsis. And to evaluate super oxide dismutase (SOD) status as an enzymatic antioxidant in preterm (VLBW) newborn infants with late-onset sepsis.
The present study involved 88 preterm neonates’ admitted to Al Galaa Teaching Hospital during the period between June 2009 and May 2010. A total of 44 preterm neonates with late-onset sepsis and 44 gestational age matched healthy preterm neonates were chosen to complete the study.
All cases were subjected to Full history taking (prenatal, natal, postnatal), Assessment of gestational age using new Ballard score, Thorough clinical examination for manifestations of neonatal sepsis, Laboratory investigations including Complete blood count (CBC), C-reactive protein Blood culture and Super-oxide dismutase (SOD).
Results of the current study show no significant gender difference in both groups with slight male predominance in group A (25/44, 56.8%) and group B (23/44, 52.3%) (p=0.548).
Results of the current study show no significant difference between both study groups regarding maternal age (p=0.388), significant higher vaginal delivery incidence in group A compared to group B (p=0.04), significant higher premature rupture of membranes in group A compared to group B (p=0.04) and highly significant higher maternal diabetes mellitus (DM) in group A compared to group B (p=0.001).
Highly significant lower total leucocytic count and PMNs in group A compared to group B (p=0.005, 0.002 respectively), a significant lower lumphocytes, monocytes and esinophiles (p=0.02, 0.02, 0.03 respectively).
Results of the current study show highly significant higher SOD in group A compared with group B by one way ANOVA test (p=0.0001).
Results of the current study show that sepsis scores of each group: 44 (100%) neonate in group A had scores ≥5. 2 (4.5%) of normal group B neonates had score ≥5 suggesting the presence of sepsis and 20 (45.5%) had scores 3 or 4 suggesting the possibility of sepsis in these cases. 22 (50%) of normal neonates (group B) had score 0-2, which implies sepsis was unlikely in these cases. The difference between study groups was statistically highly significant (p ≤0.005).
In this study considering all four parameters i.e: sensitivity, specificity, positive predictive value and negative predictive value, I:T PMN ratio was the most reliable tests for diagnosing sepsis. An abnormal I:M PMN ratio was highly sensitive in identifying sepsis. Thrombocytopenia was consistently associated with poor prognosis. Though there are several methods for rapid detection of microorganisms in blood cultures of newborn infants using automated blood culture system, DNA probe and fluorometric detection systems, still HSS can be employed as a useful test to distinguish the infected from the non infected infants.