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Abstract
SUMMARY and CONCLUSION
Neonatal sepsis is a clinical syndrome characterized by systemic signs of infections and accompained by bacteremia in the first month of life (Stoll et al., 1996).
Serum amyloid-A (SAA) is an acute-phase protein. In response to inflammatory, infection and also non-infection processes the SAA concentration increase to a multiple of their normal concentration (up to 1000-fold) within a short period of time (6-8 hours until the first suspected result). It’s short half-life, low baseline concentrations with only minor inter-individual variance, and also its renal-independent clearance contribute to the particular sensitivity of SAA in response to even minor changes in the disease process (Malle, E. De Beer, F.C., 1996).
The aim of this study to potential contribution of SAA to the early diagnosis of bacterial sepsis in newborn infant and to compare SAA level with various hematological parameters, that anticipate and screen neonates with sepsis. The purpose is to obtain tests that are highly sensitive and specific for detection of sepsis.
This study included 40-neonates, we choose 30 cases with clinical evidence of neonatal septicemia as the test group and 10 healthy neonates as controls, according to the blood culture the studied newborns were categorized into 3-groups:
Group (1): (sepsis group)
This group comprised 15-newborn, with clinical and biochemical evidence of infection and positive blood cultures.
Group (2) (suspected group)
This group comprised 15-newborn with clinical presentation of sepsis but with negative blood cultures and no evidence of localized infection.
Group (3) (control group)
This group comprised 10-newborn with good general condition and all laboratory investigation was negative, this group considered as the control group.
All newborn infants were subjected to the following:
• Full history including perinatal history, recent neonatal history and nursy history.
• Full clinical examination (general and systemic examination including neonatal reflexes, CNS, chest and heart, abdominal and genitalia with special attention to sepsis manifestation.
• Anthropometric measurement (weight, height, BMI) were done for all individuals of all groups.
For every selected newborns the following tests were done:
1 – Complete blood picture (CBC):
• Differential leucocyte count.
• Total leucocyte count (TLC).
• Total neutrophil count (TNC).
• Immature neutrophil count (INC).
• Band form count.
2 – Platelets count.
3 – C-reactive protein (CRP).
4 – Serum amyloid-A (SAA).
5 – Blood culture and antibiotic sensitivity.
The results of the study revealed the following:
• There is no statistical different between sepsis and control groups according to gestational age, weight, height, BMI and sex.
• Also no statistical different between suspected and control groups according to gestational age, weight, height, BMI and sex.
• The clinical examination show that difficult of feeding with not doing well were the main clinical presentation followed by jundice,