Diagnostic value of umbilical cord blood procalcitonin level as an early marker of neonatal sepsis

Septicemia is a systemic disease associated with the presence and persistence of bacteria and their toxins in the blood. It is one of the major causes of morbidity and mortality in the neonatal period. Early diagnosis and proper manag-ement of neonatal septicemia can bring down the morbidity and mortality rates. Procalcitonin [PCT] has recently become of interest and proposed as a possible marker of the systemic inflammatory response to infection in critically ill patients. The aim of this study was to clarify the diagnostic value of serum Procalcitonin [PCT] level as an early marker for diagnosis of neonatal sepsis. Twenty neonates with maternal risk factors for sepsis were included in this study. They included 8 males, 12 females with a mean gestational age of 38.2 +/- 1.76 weeks and mean birth weight of 3.25 +/- 0.34 kg. Twenty healthy children of matched age and sex with no maternal risk factors for sepsis were included in the study as a control group. Serum PCT concentrations were measured at umbilical cord blood samples, taken at time of delivery and peripheral blood samples taken 48 hours later using an immunochromatographic semi quantitative test [PCT-Q; Brahms, Hennigsdorf, Germany] and C- reactive protein [CRP] concentration was measured using an immune-oreactive quantitative method. Serum PCT concentrations were significantly higher in neonates with confirmed sepsis than both control group and neonates with clinically suspected but not confirmed sepsis. PCT is a more sensitive and specific early marker of neonatal sepsis compared with other laboratory parameters of sepsis

Prognostic value of serum S100 protein level in newborn infants with hypoxic ischemic encephalopathy

Hypoxic ischemic encephalopathy [HIE] is the most common cause of neurologic disease during neonatel period and is associated with high mortality and morbidity rate including cerebral palsy, mental retardation and seizures. S100 beta[2] is normally present in serum in very low concentrations, but found in high concentrations in the brain both in glial cells and in neurons. Serum S100 protein peaked in the first day after birth in asphyxiated newborn infants. The aim of this study was to clarify the prognostic value of serum S100 protein level as a marker of cerebral injury in newborn infants with birth asphyxia [HIE]. 20 newborns with HIE were investigated successively in the first 3 days after birth in comparison with 20 healthy newborn infants as a control group. S100 protein levels were detected by a monoclonal two-site immuno-luminometric assay. Follow up of the cases for 6 months after discharge from incubators was done to detect cases that developed cerebral palsy. We found significant increase in serum S100 protein level in newborn infants with birth asphyxia as compared to control group, also we found significant positive correlation between day 1 S100 protein levels and severity of HIE and positive correlation between day 1 S100 protein levels and future development of cerebral palsy. Early determination of serum S100 protein in first day after birth in newborn infants with hypoxic ischemic encephalopathy may be used as a good marker for assessment of severity of HIE and extent of brain damage and to predict the possibility of future development of cerebral palsy in newborn infants with HIE