الفهرس 
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Abstract
Neonatal sepsis is a significant cause of morbidity and mortality of hospitalized newborns and premature infants. Worldwide, sepsis accounts for 7% of neonatal deaths. In Egypt neonatal sepsis is the fifth leading cause of neonatal death.
In the innate immune system, many types of receptors participate in microbe detection. An exciting discovery was the finding that host organisms have developed a set of specific receptors for the recognition of highly conserved and essential molecular structures of microbes.
TLR2 was identified as a receptor for Gram-positive peptidoglycan and bacterial lipopeptides, whereas TLR4 is part of a receptor complex recognizing Gram-negative bacterial LPS and is required for LPS signal transduction. Both finally trigger inflammatory responses through an IL-1 receptor-like pathway. Several studies on Polymorphisms in TLR2 (Arg753Gln) and TLR4 (Asp299Gly) have shown that these polymorphism may be linked to variations in responses to Staphylococcal , and Gram‐negative bacterial infections and to septic shock.There could modify the inflammatory response of carriers of polymorphic alleles to these microorganisms. The aim of the current study was to evaluate the effect of TLR2 Arg753Gln (rs5743708) and TLR4 Asp299Gly (rs4986790) polymorphisms on susceptibility to neonatal sepsis.
To fulfill these objectives, the study was conducted on 80 neonatal sepsis patients, with laboratory confirmed sepsis, The study also included 80 healthy neonates. . All patients were also subjected to history taking (pregnancy, obstetric history and medical history), full clinical examination, complete laboratory sepsis work up and radiological studies as needed. The control group were subjected to history taking and full clinical examination. Blood sample were obtained from both cases and controls, DNA extraction and PCR RFLP were then performed to assess the TLR2 Arg753Gln and TLR4 Asp299Gly polymorphisms in relation to neonatal sepsis. The results of the present study were as follow:
The gestational age of the studied patients ranged from 28 to 41 gestational weeks . Preterm neonates were more common among patients 53.8% than the control group. There was a statistically significant difference implying a strong association between gestational age and the risk of neonatal sepsis. There was 53.8% of studied patients were males and 46.3% were females. There was no significant difference in distribution of sex among patients and control group .
Birth weight (BW) of patients was ranged from 1000.0 gm to 5500.0 gm,there was a statistically significant difference between birth weight and the risk of neonatal sepsis.
Premature rupture of membrane (PROM) was recorded in 82.5% of patients.There was a statistically significant difference with a strong association between PROM and the risk of neonatal sepsis.
The TLR2 Arg753Gln polymorphism genotypes were found as follow (63.7% for the, GG genotype, 36.3% for the GA genotype, no cases with AA genotype) among patients compared to ( 45% for GG genotype, 55% for GA genotype, 0 % for AA) among controls.
There was no statistically significant association observed between the TLR2 Arg753Gln and risk of neonatal sepsis.
The TLR4 Asp299Gly polymorphism genotypes found was as follow (85% for the, AA genotype, 15% for the AG genotype, 0 % for GG genotype) among cases compared to ( 95% for AA genotype, 5% for AG genotype, 0 % for GG) among controls.
There was a statistically significant association observed between TLR4 Asp299Gly and risk of neonatal sepsis.