الفهرس 
Aim of The WorkOnly 14 pages are availabe for public view
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Abstract
Neonatal sepsis is defined as a clinical syndrome characterized by signs and symptoms of infection with or without accompanying bacteremia in the first month life. It encompasses various systemic infections of the newborn such as septicemia, meningitis, pneumonia, arthritis, osteomyelitis etc., but it does not include superficial infections like thrush. For many years, a search has been ongoing to find predicators of neonatal sepsis that identify effectively patients who are at a risk of infections.
Endocan, also called endothelial cell-specific molecule-1, is a soluble 50 k Da dermatan sulfate proteoglycan that is secreted from pulmonary and kidney vascular endothelial cells some studies showed that endocan can be acknowledged as a good marker of endothelial dysfunction and multiple organ dysfunction in sepsis.
We aimed to assess the diagnostic and prognostic roles of the serum endocan in neonatal sepsis
A prospective study was conducted on (40) newborns were admitted to neonatal intensive care unit of Menoufia university hospital from May 2019 to March 2020. They were divided into 2groups:
group 1 (cases):
A. 10 preterm neonates with clinically suspected and proven neonatal sepsis admitted at (NICU) according to clinical and hematological sepsis scores.
B. 10 full-term neonates with clinically suspected and proven neonatal sepsis according to clinical and hematological sepsis scores (gestational age more than 37 wks).
group 2 (control):
Included 20 apparently healthy neonates who were sex, age and gestational age matched with cases.
Complete history taking, Full clinical examination. Investigations including C.B.C, Renal & Liver Functions tests, Na, K, Ca, Total & direct bilirubin, CRP, blood culture & sensitivity. Serum level of endocan by ELISA done on 1st day and repeated on 3rd day of suspicion of neonatal sepsis.
Summary
92
The results of the present study revealed that
Laboratory Investigations of the Preterm group (1st day), there was statistically significant difference between preterm cases and controls as regards HCT, WBCS, I.T /ratio, RBCS, HB, Ca, platelet count and total serum bilirubin.
There was highly statistically significant difference between preterm cases and control as regards serum endocan level (71.55±16.15 pg/ml vs 219.65±81.69 pg/ml) as it was higher in cases than control.
1st day Laboratory investigations of the full-term group, there was statistically significant difference between full-term cases and controls as regards HCT, I.T /ratio, RBCS, HB, Platelets and total serum bilirubin; while there was no statistically significant difference between both groups as regards WBCS, ALT and direct serum bilirubin levels.
There was highly statistically significant difference between full term cases and control as regards serum endocan level (70.23±15.39 pg/ml vs 170.74±77.99 pg/ml) as it was higher in cases than control.
On Clinical presentation in cases of study group, there was no statistically significant difference between preterm cases and full-term cases.
Comparison between blood Culture results in-patient groups (preterm and full term), there was no statistically significant difference between preterm cases and full-term cases. Blood culture which was positive in 80% of patients, klebsiella dominated the organisms isolated from blood (30%), followed by E.coli (30% in pre-term and 20% in fullterm neonates)
Comparison of serum endocan level regarding blood culture of cases in study group, there was no statistically significant difference between Serum Endocan level when comparing preterm cases (247.73±86.96 vs 186.07±93.36 pg/ml) and full-term cases (192.80±92.43 vs 192.95±0 pg/ml).
There was statistically significant difference between pre term cases at the first day and after 3 days as regards WBCS, HB, Ca, CRP.
There was highly statistically significant difference between pre term cases at the first day and after 3 days as regards serum endocan levels as it was lower 3rd day in when compared to 1st day (132±57.89 vs 219.65±81.69 pg/ml).
Summary
93
There was statistically significant difference between full term cases at the first day and after 3 days as regards WBCS, I/T Ratio, RBCS, Ca and CRP.
There was statistically significant difference between full term cases at 1st day and after 3 days (92.87±48.78 pg/ml vs 170.74±77.99 pg/ml) as regards serum endocan levels as it rise on 3rd day.
There was highly statistically significant difference between all cases of the Studied Groups regarding maternal risk factors (PROM, UTI, Maternal fever, Diabetes mellitus).
There was no significant difference between all cases and controls regarding outcome.
There was a statistically significant positive correlation between each pair of (Serum endocan level in preterm cases and WBCS, CRP), (Serum endocan level in full term cases and CRP).
As we found in our study, the best cutoff point 97.428 pg/ml of endocan level in full term as a diagnostic value of neonatal sepsis at AUC (0.793), given 100% sensitivity, 94% specificity, 92.31% PPV and 100%NPV.
As we found in our study, the best cutoff point 98.3 pg/ml of endocan level in preterm as a diagnostic value of neonatal sepsis at AUC (1.0), given 94.4% sensitivity, 100% specificity, 94.4% PPV and 100%NPV
We found in our study, the best cutoff point 73.77 pg/ml of endocan level as follow up value of neonatal sepsis on 3rd day in full term, it has 70%Sensitivity, 70% specificity,70% PPV and 70% NPV
We found in our study, the best cutoff point 83.58 pg/ml of endocan level as follow up value of neonatal sepsis on 3rd day in preterm term, it has 100%Sensitivity, 90% specificity,100% PPV and 92% NPV.