الفهرس 
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Neonatal sepsisOnly 14 pages are availabe for public view
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Abstract
Neonatal sepsis is a major cause of neonatal mortality and morbidity in preterm and VLBW infants. It is classified into early-onset neonatal sepsis (EONS); occurs in the 1st 72 hours of the postnatal life or Late-onset neonatal sepsis (LONS); occurs between 72 hours and 90 days after birth. Lactoferrin (Lf) is an iron-binding glycoprotein of the transferrin family, which is expressed in most biological fluids with particularly high levels in mammalian milk. Lf can bind and sequester lipopolysaccharides, thus preventing pro-inflammatory pathway activation, sepsis and tissue damages. It is also considered a cell-secreted mediator that bridges the innate and adaptive immune responses.
Human Lf (HLf) and bovine Lf (bLf) possess high sequence homology and exert identical multifunctions; antibacterial, antifungal, antiviral and antiparasitic, anti-inflammatory and immunomodulatory activities . Therefore, the majority of the in-vitro and in-vivo studies have been carried out using bLf, generally recognized as a safe substance (GRAS). The study included 80 preterm infants during their first 72 hours of life, after exclusion of early onset sepsis by clinical examination and laboratory investigations. Preterm infants included were randomly assigned to one of two equal groups; 40 preterm infants received oral lactoferrin at a dose of 100 mg/kg/day for 28 days (Lactoferrin Group) and 40 preterm infants received distilled water for the same duration serving as controls (Control Group). All of them continued till the end of the study; 28 days after randomization. Each group was further subdivided into two subgroups according to their gestational age (28 to 33 weeks’ GA) and (>33 to <37 weeks’ GA). We found that serum level of TNF-α among preterm infants with suspected LOS decreased significantly on 7th day post-randomization in Lactoferrin group compared to Control group. However, no significant difference as regards serum TNF-α level was detected one week after suspected LOS development when we compared both gestational age subgroups.
As regards secondary outcomes studied, we did not find any significant difference between Lactoferrin and Control groups in our study including incidence of BPD or NEC or mortality rate before discharge. But, there were significant differences regarding feeding intolerance, time to full enteral feeding, duration of antibiotics treatment and length of hospital stay being greater in Control group when compared to Lactoferrin group.