Natural Inhibitor; Antithrombin and Protein S Levels among Neonates Suffering from Sepsis

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Date
2021-01-01
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جامعة الشيخ عبدالله البدري
Abstract
Abstract Neonatal sepsis is a fatal disease with significant neonatal morbidities and mortalities worldwide, despite preventive measures and efforts that target neonatal sepsis, morbidity and mortality statistics were not promising. Common clinical symptoms of sepsis make earlier diagnosis challenging. Objectives: the study aimed to assess antithrombin (AT) and Protein S (PS) among Sudanese neonates with sepsis and compare them with healthy neonates to study the susceptible alteration in both natural inhibitors of hemostasis (AT and PS) considering different variables (gender, mode of delivery, gestational age, sepsis mode, outcome and causative bacterial agent Methods: a prospective case-control study achieved in the maternity hospital, Omdurman, Sudan in the period between Jun.2013 and Apr.2015 on a total of 100 samples divided into the case (neonates diagnosed with proven sepsis) and a control group of health neonates (50 for each) selected by non-probability sampling, Protein S was assessed by the clotting procedure using semi-automated coagulometer (Stago stat four), AT was assessed spectrophotometrically by the turbimetric method using semi-automated chemistry analyzer (Mindray BA-88A). Results: the gender distribution was 23, 27 and 24, 26 males and females for case and control respectively, among case group; 17 neonates with early mode sepsis (0-7 days), and 33 with late onset (7-28 days). Considering the outcome in case group; 40 were recovered (80%) and 10 neonates dead (20%) of them; 4 (40%) with early onset sepsis, and 6 (60%) with late onset. Blood culture distributions were; Pseudomonas 23 (46%), Salmonella 9 (18), Klebsiella 7 (14%), Staph. epidermidis 3 (6%), Strep. fecailis 3 (6%), E. coli 2 (4%), Staph. aureus 2 (4%), and 1 Streptococci (Non group B) (2%). AT was significantly decreased in the case compared to the control group (mean; 183.9 and 221.5 Mg/ml) P. value 0.003. PS was insignificantly decreased (33.4 and 34.7%) P. value 0.76. Among the case group; None of the gender, mode of delivery, Mode of sepsis, etiologic agent and sepsis outcome showed significant correlation with AT or PS. Conclusion: it has been concluded that antithrombin was significantly decreased in septic neonates than healthy ones (P. value 0.003). It can be used as a diagnostic marker to offer quick reliable useful test feedback for septic neonates.
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