DIAGNOSTIC VALUES OF BIOCHEMICAL MARKERSIN ASPHYXED NEWBORNS WITH PROVEN SEPSIS

  • Aspazija Sofijanova PHI University Clinic for Children Diseases, Medical Faculty, University "Ss.Cyril and Methodius", Skopje, Republic of North Macedonia
  • Silvana Naunova Timovska PHI University Clinic for Children Diseases, Medical Faculty, University "Ss.Cyril and Methodius", Skopje, Republic of North Macedonia
  • Hristina Mangjukova PHI University Clinic for Children Diseases, Medical Faculty, University "Ss.Cyril and Methodius", Skopje, Republic of North Macedonia
  • Elizabeta Shuperliska PHI University Clinic for Children Diseases, Medical Faculty, University "Ss.Cyril and Methodius", Skopje, Republic of North Macedonia
  • Olivera Jordanova PHI University Clinic for Children Diseases, Medical Faculty, University "Ss.Cyril and Methodius", Skopje, Republic of North Macedonia
  • Sonja Bojadzieva PPHI University Clinic for Children Diseases, Medical Faculty, University "Ss.Cyril and Methodius", Skopje, Republic of North Macedonia

Abstract

Introduction: The aim of this study was to investigate the predictive values of biochemical parameters, including Procalcitonin (PCT), as an early diagnostic and prognostic marker for sepsis in asphyxed newborns with proven sepsis. Materials and Methods: This study was designed as a prospective study, where we included 110 (M:F=67:43) newborns with proven sepsis hospitalized in the Intensive Care Unit at the PHI University Children’s Hospital – Skopje.PCT and CRP,WBC one serum blood sample was obtained from each patient at the 24h at admission, as well asday 3 and day 7. Procalcitoninlevels were measured by using an immunoassay system Vidas, based on the Enzyme Linked Fluorescent Assay (ELFA) principles. Results: The newborns with proven sepsis have been divided into two groups. The first group included 50 proven septicpreterm newborns with a positive blood culture and the second group included 50 proven sepsis full-term newborns.We isolated forty two that had two or three bacteria at the same time. The identified bacteria included Staphylococcus aureus (n=56) mecA,Streptococcus  (n=6), Acinetobacter baumannii  (n=18), Serratia  marcescens (n=9) and Entrobacteriaceae (n=31), Candida albicans(n= 1), Candida parapsilosis(n=1).Statistical analysis confirmed significantly different values ​​of PCT in the analyzed time period in preterm newborns with proven sepsis p<0.001.Statistical analysis confirmed significantly different values ​​of PCT in the analyzed time period in newborns with proven sepsis with asphyxia p<0.001. Conclusion: The levels of PCT have important clinical significance in predicting the prognosis of asphyxed newborns with sepsis, to prevent the development of severe sepsis and septic shock.


Keywords:sepsis,C-reactive protein,procalcitonin PCT, asphyxed newborns

References

1. Thornberg E, Thiringer K, Odeback A, et al. Birth asphyxia: incidence, clinical course and outcome in a Swedish
population. Acta Paediatr 1995;84:927–932.
2. Airede AI. Birth asphyxia and hypoxic-ischaemic encephalopathy: incidence and severity. Ann Trop Paediatr
1991;11:331–335.
3. Oswyn G, Vince JD, Friesen H. Perinatal asphyxia at Port Moresby General Hospital: a study of incidence, risk
factors and outcome. P N G Med J 2000;43:110–120.
4. Birth asphyxia, neonatal risk factors for hypoxic ischemic encephalopathy Pálsdóttir K, Thórkelsson T,
Hardardóttir H, Dagbjartsson A.Laeknabladid. 2007 Oct;93(10):669-73.
5. Kliegman RM, Stanton B, Geme JS, St Schor NF, Behrman RE. Nelson textbook of pediatrics. 20th ed.
Philadelphia (PA): Elsevier Health Sciences; 2015
6. Whicher J, Bienvenu J, Monneret G. Procalcitonin as an acute phase marker. Ann Clin Biochem. 2001;38(Pt 5):483–493.
7. Gogos CA, Drosou E, Bassaris HP, Skoutelis A. Pro- versus anti-inflammatory cytokine profile in patients with severe sepsis: a marker for prognosis and future therapeutic options. J Infect Dis. 2000;181:176–180.
8. Müller B, White JC, Nylén ES, Snider RH, Becker KL, Habener JF. Ubiquitous expression of the calcitonin-i gene in multiple tissues in response to sepsis. J Clin Endocrinol Metab. 2001;86:396–404.
9. Chiesa C, Panero A, Rossi N, Stegagno M, De Giusti M, Osborn JF, et al. Reliability of procalcitonin concentrations for the diagnosis of sepsis in critically ill neonates. Clin Infect Dis. 1998;26:664–672.
10. Christ-Crain M, Müller B. Procalcitonin in bacterial infections: hype, hope, more or less? Swiss Med Wkly. 2005;135:451–460.
11. Uzzan B, Cohen R, Nicolas P, Cucherat M, Perret GY. Procalcitonin as a diagnostic test for sepsis in critically ill adults and after surgery or trauma: a systematic review and meta-analysis. Crit Care Med. 2006;34:1996–2003.
12. Lapillonne A, Basson E, Monneret G, Bienvenu J, Salle BL. Lack of specificity of procalcitonin for sepsis diagnosis in premature infants. Lancet. 1998;351:1211–1212.
13. Guibourdenche J, Bedu A, Petzold L, Marchand M, Mariani-Kurdjian P, Hurtaud-Roux MF, et al. Biochemical markers of neonatal sepsis: value of procalcitonin in the emergency setting. Ann Clin Biochem. 2002;39(Pt 2):130–135.
14. Turner D, Hammerman C, Rudensky B, Schlesinger Y, Goia C, Schimmel MS. Procalcitonin in preterm infants during the first few days of life: introducing an age related nomogram. Arch Dis Child Fetal Neonatal Ed. 2006;91:F283–F286. ]
15. Assumma M, Signore F, Pacifico L, Rossi N, Osborn JF, Chiesa C. Serum procalcitonin concentrations in term delivering mothers and their healthy offspring: a longitudinal study. Clin Chem. 2000;46:1583–1587.
16. Barbara S. Infections of the neonatal infant. In: Behrman Re, Kliegman R, Jensen HB., editors. Nelson Textbook of Pediatrics. Philadelphia: WB Saunders CO; 2008. pp. 794–811.
17. Young LS. Sepsis syndrome. In: Mandell GL, Bennett JE, Dolin R, editors. Principles and Practice of Infectious Diseases. Philadelphia: Churchill livingstone; 2005. pp. 910–920.
18. Remington JS, Klein JO. Bacterial sepsis and meningitis. Infectious diseases of the fetus and newborn infant. Philadelphia: W.B.Saunders Company; 2001.
19. Brun-Buisson C. The epidemiology of the systemic inflammatory response. Intensive Care Med. 2000;26:S74–S79.
20. Black S, Kushner I, Samols D. C-reactive protein. Minireview. J Biol Chem. 2004;279:48487–48490.
21. Ng P. Diagnostic markers of infection in neonates. Arch Dis Child Fetal Neonatal Ed. 2004;89:229–235.
22. Weinschenk NP, Farina A, Bianchi DW. Premature infants respond to early-onset and late onset sepsis with leukocyte activation. J Pediatr. 2000;137:345–350.
23. Chiesa C, Panero A, Rossi N. Reliability of procalcitonin concentrations for the diagnosis of sepsis in critically ill neonates. Clin Infect Dis. 1998;26:664–672.
24. Vincent JL. Procalcitonin: The marker of sepsis? Crit Care Med. 2000;28:1226–1228.
25. Athhan F, Akagunduz B, Genel F, Bak M, Can D. Procalcitonin: A marker of neonatal sepsis. J Trop Pediatr . 2002;48:10–14.
26. Carrol ED, Newland P, Riordan FAI, Thomson APJ, Curtis N, Hart CA. Procalcitonin as a diagnostic marker of meningococcal disease in children presenting with fever and a rash. Arch Dis Child. 2002;86:282–285.
27. Carrol ED, Thomson AP, Hart CA. Procalcitonin as a marker of sepsis. Int J Antimicrobe Agents. 2002;20:1–9.
28. Schuetz P, Albrich W, Mueller B. Procalcitonin for diagnosis of infection and guide to antibiotic decisions: past, present and future. BMC Med 2011;9:107
29. Ugarte H, Silva E, Mercan D, De Mendonça A, Vincent JL. Procalcitonin used as a marker of infection in the intensive care unit. Crit Care Med 1999;27:498–504.
30. Hansson LO, Lindquist L. C-reactive protein: its role in the diagnosis and follow-up of infectious diseases. Curr Opin Infect Dis 1997;10:196–201.
Published
2020-07-03
How to Cite
SOFIJANOVA, Aspazija et al. DIAGNOSTIC VALUES OF BIOCHEMICAL MARKERSIN ASPHYXED NEWBORNS WITH PROVEN SEPSIS. Journal of Morphological Sciences, [S.l.], v. 3, n. 2, p. 3-12, july 2020. ISSN 2545-4706. Available at: <http://jms.mk/jms/article/view/126>. Date accessed: 22 oct. 2020.
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Articles