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Vol.4 No.4 – 8 : Procalcitonin as a diagnostic marker for neonatal sepsis

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By : Omar A. K. Al-azaowi1, Samir A. Abd El-kaream2, Gihan Hosny1*

1Environmental Health Division, Dept. of Environmental Studies, Institute of Graduate Studies & Research, Alexandria University, Egypt.

2Dept. of Applied Medical Chemistry, Medical Research Institute, Alexandria University, Egypt.

Abstract

Background : Sepsis is the most common cause of neonatal mortality. Isolation of bacteria from blood is the most specific and standard method used to diagnose neonatal sepsis. The drawback of culture-based diagnosis is the 24–48 hour assay time. Procalcitonin (PCT) has high specificity and positive predictive values. Thus, the current study was undertaken to investigate the released serum-procalcitonin as a biomarker for predicting neonatal sepsis among newly born infants.  Subjects and Methods: A case-control study design was set in order to perform the underlying work. Forty five neonates were included in this study. Blood samples were collected and processed for laboratory investigations and culture.  Laboratory investigations included complete blood picture, blood culture and PCT. Results: Positive blood cultures were detected in all cases of confirmed sepsis group (100%) and in 66.66% of cases of suspected sepsis group. The ROC curve analysis, used to evaluate the diagnostic value of serum procalcitonin depending on the area under the curves (AUC), showed very high AUC (91.7%) corresponds to a better diagnostic test. The optimum cut off value of PCT (<0.05 ng/ml) was with a corresponding sensitivity of 100% and specificity of 83.33%, a positive predictive value (100%), and a negative predictive value (74.99%). Conclusion: The current findings showed high sensitivity and specificity of PCT test for diagnosis of neonatal sepsis. The results so far are very encouraging and may suggest that in the near future the PCT may be used routinely for diagnosis of neonatal sepsis and can provide a life-saving approach for newborns.

Procalcitonin as a diagnostic marker for neonatal sepsis-converted (1)

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Vol.1 No.5 -1 : Association of some adipokines and oxidative stress biomarkers with septic patients.

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By : Ramy Mostafa, 1; Mohamed Afify, 2 Ahmed I.Amin, 3 Amr Saad4

Abstract

The incidence of sepsis has increased considerably since the late few decades. Sepsis became one of the major causes of death in developed countries. We became in desperate need of updated models for assessing severity of sepsis with no limitations. Therefore, the objective of this study was to determine the diagnostic role of some adipokines and oxidative stress biomarkers in assessing severity and prediction of early outcomes among septic patients. we conducted a cross-sectional analysis of individuals developing sepsis. Consecutive series of all eligible patients had a double venous blood sample drawn one on hospital admission and one after 48 hour of admission for assaying some adipokines such as lipocalin-2 (LCN 2) & resistin and some oxidative stress biomarkers such as malondialdehyde (MDA) & glutathione peroxidase activity (GPX). Admitted patients were followed up to assess early outcomes (length of hospital stay and mortality). The results identified 30 septic cases of them 4 (13%) have SIRS, 5 (17%) have sever sepsis and 21 (70%) with septic shock. We found that lipocalin-2 exhibited elevated levels after 48 hour of admission as compared with on admission measurements (102.9 vs. 85.7 pg/mL, p = <0.001).Resistin showed elevated levels on admission as compared with 48 hour of admission measurements. Malondialdehyde exhibited elevated levels after 48 hour of admission as compared with on admission measurements.Glutathione peroxidase showed significant decrease in its levels after 48 hour of admission as compared with on admission measurements.Also, we found that serum levels of lipocalin-2,resistin and malondialdehyde were significantly higher in non-survivors but glutathione peroxidase were significantly lower in nonsurvivors than survivors at 28 days -follow-up for mortality. In addition, our markers were positively correlated with APACHE II and SOFA scores respectively. It is concluded from this work that lipocalin-2, resistin, malondialdehyde and glutathione peroxidase are valuable for the risk stratification, early diagnosis and prognostication of sepsis in the ICU.

1. Association of some adipokines and oxidative stress biomarkers with septic patients.
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