الفهرس 
NEONATAL SEPSISOnly 14 pages are availabe for public view
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Abstract
N
eonatal sepsis is a blood infection that occurs in an infant younger than 90 days old.
Sepsis is a severe illness in which the bloodstream is overwhelmed by bacteria. It is a clinical syndrome that complicates severe infection and is characterized by systemic inflammation and widespread tissue injury and complicated by acute organ dysfunction.
Fibronectin plays a major role in the attachment and opsonization of numerous intracellular pathogens, It might be a critical molecule produced by TH1 cells involved in pathogen eradication, so changes in the circulating level specially plasma fibronectin can potentially be used as an early indicator or marker of systemic neonatal sepsis.
The aim of the study is to assess the diagnostic value of Fibronectin in cases of neonatal sepsis.
Study conducted on 86 newborn infants who were recruited from the neonatal intensive care units of Obstetrics and Gynecology and Pediatric hospitals Ain Shams University in the period from 10/2011 till 3/2012.
The studied population was divided into three groups: control group 26 healthy neonates, septic cases 30 and query septic cases 30 patient, all groups included equal number of fullterm and preterm neonates.
Sepsis was diagnosed by clinical picture including (respiratory dysfunction, cardiac dysfunction, perfusion abnormality, and altered mental status) and calculations of clinical sepsis score according to Töllner (1982) and by lab findings including (CBC, blood culture, CRP, liver and kidney function) with calculation of hematological sepsis score (Rodwell et al., 1993) and needs for medical support.
This study revealed the following results: The studied septic cases had lower plasma fibronectin level compared to controls and query septic cases with statistically highly significant difference. sepsis was higher among died cases compared to alive with lower plasma fibronectin level with statistically highly significant difference in between, and lower with culture positive than culture negative patients with statistically highly significant difference.
Plasma fibronectin showed lower level in septic cases than non-septic cases among query septic group with highly significant difference.
Plasma fibronectin was negatively correlated with INR, sepsis score using the hematological and clinical scoring system with significant correlation, but no significant correlation with CRP.
According to our work, at ≤330mg/l plasma fibronectin is good predictor for sepsis with 81%sensitevity and 88.5% specificity among cases, but CRP showed 9.5 % sensitivity and 90% specificity. We compared plasma fibronectin level between fullterm and preterm among septic cases with no significant difference that need further studies to be confirmed.
Plasma fibronectin decreases just before and during septic process, so it can predict neonatal sepsis.