Natural Inhibitor; Antithrombin and Protein S Levels among Neonates Suffering from Sepsis
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Date
2021-01-01
Journal Title
Journal ISSN
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Publisher
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.