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Apoptotic Changes in the Early Diagnosis and Severity Determination of Neonatal Sepsis
Barseem, Naglaa Fathy & Helwa, Mohamed Ahmed
Abstract
Objectives: The aim of this study was to assess the presence of DNA damage in full-term newborns with neonatal sepsis.
Methods: Sixty neonates with early onset neonatal sepsis and 45 apparently healthy controls were enrolled in the study. Screening of neonates was
done using a modified clinical sepsis score and hematological scoring system, adjusted to the results of blood culture and screening tests. Complete
blood count, C-reactive protein (CRP), and DNA studies were done.
Results: Sepsis was likely in 41 (68.3%) patients with scores of 3 or 4 and CRP levels of 12 - 48 mg/L. Sepsis was very likely in 19 (31.7%) patients with
scores of ≥ 5 and CRP of 48 - 96 mg/L. Sepsis was unlikely in all controls with scores of ≤ 2. The mean neutrophil count was 9700 ± 4600/𝜇L in
patients and 4230±1400/𝜇L in controls. The higher the total polymorphonuclear count and CRP level, the more severe was the sepsis. Twenty-six
of 60 (43.3%) sepsis patients and 5 of 45 controls (11%) had DNA damage. There was a highly significant negative correlation between DNA damage,
blood culture results, and CRP levels.
Conclusions: DNAdamage, demonstrated by clinical and laboratory evidence with a combination of blood cultures, CRP, and hematological scoring
system results, can be used as an indicator of both the immune status of the neonate and the severity of the sepsis.
Keywords
Apoptosis; Neonatal sepsis; Newborn; Sepsis
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