A STUDY OF SOME
HEMATOLOGICAL CHANGES IN NEONATAL INFECTION
El-Deeb S 1,
Hashem E 1, Brandis M 2, El-Kabsh M 3,
Khalaf M 1
1Pediatric Department,
Assiut University, Egypt
2Pediatric Hospital,
Freiburg University, Germany
3Clinical Pathology
Department, Assiut University, Egypt
Objective:
To find
out a reliable test or a combination of tests which has a good diagnostic
value for detection of early neonatal infection as well as a good
prognostic forecast of the outcome of such cases.
Methods: The study included 74
neonates; 9 with definite infection; 19 with propable infection; 13 with
local infection and 33 non-infected. Beside full clinical assessment, ear,
nose, throat and umbilicus swabs were taken from all the studied newborns
for culture, in addition to blood, cerebrospinal fluid (when indicated),
urine, nasopharyngeal secretion and tracheal aspirate for chemical
analysis, culture and sensitivity. Also, full blood count, serum level of
C-reactive protein (CRP), granulocyte- colony stimulating factor (G-CSF),
interleukin-6 (IL-6), and intercellular adhesion molecule-1 (ICAM-1) were
estimated initially and after 24-36 hours for follow-up.
Results: The infected group had
significantly higher values for follow-up neutrophil count, initial ICAM-1
level and intitial as well as follow up values for I/T ratio, CRP, G-CSF
and IL-6 than non-infected group. Also, the follow-up IL-6 level decreased
significantly than the initial in the infected group. The combination of
I/T ratio > 0.2 + ICAM-1 > 454.3 ng/ml had the highest sensitivity
(100%) and a good specificity (77.4%) for the prediction of neonatal sepsis
among the infected neonates.
Conclusion: The combination of CRP and IL-6 may be an
ideal tool for the early diagnosis of neonatal infection, and the magnitude
of drop of the follow-up IL-6 level is a good pointer to the severity of
infection and for monitoring the case progress. ICAM-1 showed a very high
sensitivity to predict early neonatal ifection, while G-CSF had a good
prognostic value for such cases.