الفهرس 
Neonatal SepsisOnly 14 pages are availabe for public view
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Abstract
Neonatal sepsis is a life threatening emergency with a high morbidity and mortality. Initial signs of neonatal sepsis are often slight and non-specific making early diagnosis is so difficult. Diagnosis can be confirmed by blood culture, but may be delayed up to 72 hours or more. So, several studies have searched for parameters that could be useful in the early and accurate diagnosis of neonatal sepsis.
The present study was performed to evaluate the use of serum Amyloid A (SAA) as an early diagnostic tool for neonatal sepsis and to compare the results obtained to those of and other hematological parameters.
The study included 75 neonates, 50 with suspected sepsis (suspected group), and the other 25 were healthy matched neonates serving as control group.
According to the blood culture results, the suspected group (n=50), was subdivided into confirmed sepsis subgroup (n=35) with positive blood culture and clinical and biochemical evidence of sepsis and clinically septic subgroup (n=15) with negative blood culture
All neonates were subjected to full history taking, clinical examination and laboratory investigations including, complete blood count with differential count (CBC), C-reactive protein (CRP), blood culture and sensitivity test, and SAA level measurement by ELISA.
All investigations were done for the suspected group when sepsis was first suspected.
The most clinical presentations among the septic group were, poor suckling, lethargy, and poor Moro.
As regard the blood culture results, Gram negative organisms were predominant in 65.59% of cases, mainly klebseilla, which represented 37.1% of all the isolated organisms.
The mean value of SAA in confirmed sepsis subgroup was (77.1+5.5) μg/ml, compared to clinically septic subgroup (18.5+1.32) and control group (4.7+1.1) μg/ml, and this was proved highly statistically significant.
By using the receiver-operating characteristic (ROC) curve, comparison of the SAA protein data to the tested other markers of sepsis including CRP,TLC, I:T ratio and the platelets count, showed that the SAA protein was the most sensitive marker (91.42%) compared to the sensitivity of CRP (90%), TLC (80%), of I:T ratio (80%), and that of PLT (40%).
As regarding the specificity of the markers the SAA protein was the most specific (86.66%), CRP was (80%), TLC was (53.33%), I:T ratio was (75.3%) and that of PLT was (34%).
The ROC curve also showed that the positive predictive value (PPV) of SAA in this study was (94.11%) which was higher than the PPV of CRP (67%), that of TLC (63.16%), that of I:T ratio (87.20%) and that of PLT (37.50%).
The SAA protein had the highest negative predictive value (NPV) (81.25%), compared to CRP (69%), TLC (72.73%), I:T (77.00%) and PLT (35.71%).
from the results, we can concluded that SAA seems to be an early, highly sensitive and specific marker for the diagnosis of neonatal sepsis at the first suspicion of infection,
The Quick and reliable use of SAA in early diagnosis of neonatal sepsis can be useful in early initiation of antibiotic treatment, duration, response, and outcome after therapy.