At Admission Evaluation of the Score for Neonatal Acute Physiology (SNAP II) and Estimation of Serum Procalcitonin Allow Early Diagnosis of Early-Onset Neonatal Sepsis
Abdel Maqsoud, Y., Sobeih, A., Assar, E., Elshabrawy, D., Hassan, M., Mohammed, R. (2022). At Admission Evaluation of the Score for Neonatal Acute Physiology (SNAP II) and Estimation of Serum Procalcitonin Allow Early Diagnosis of Early-Onset Neonatal Sepsis. EKB Journal Management System, 38(1), 27-37. doi: 10.21608/besps.2018.8101
Yehia H. Abdel Maqsoud; Ahmed A. Sobeih; Effat Assar; Deena A. Elshabrawy; Manal Hassan; Raafat R. Mohammed. "At Admission Evaluation of the Score for Neonatal Acute Physiology (SNAP II) and Estimation of Serum Procalcitonin Allow Early Diagnosis of Early-Onset Neonatal Sepsis". EKB Journal Management System, 38, 1, 2022, 27-37. doi: 10.21608/besps.2018.8101
Abdel Maqsoud, Y., Sobeih, A., Assar, E., Elshabrawy, D., Hassan, M., Mohammed, R. (2022). 'At Admission Evaluation of the Score for Neonatal Acute Physiology (SNAP II) and Estimation of Serum Procalcitonin Allow Early Diagnosis of Early-Onset Neonatal Sepsis', EKB Journal Management System, 38(1), pp. 27-37. doi: 10.21608/besps.2018.8101
Abdel Maqsoud, Y., Sobeih, A., Assar, E., Elshabrawy, D., Hassan, M., Mohammed, R. At Admission Evaluation of the Score for Neonatal Acute Physiology (SNAP II) and Estimation of Serum Procalcitonin Allow Early Diagnosis of Early-Onset Neonatal Sepsis. EKB Journal Management System, 2022; 38(1): 27-37. doi: 10.21608/besps.2018.8101

At Admission Evaluation of the Score for Neonatal Acute Physiology (SNAP II) and Estimation of Serum Procalcitonin Allow Early Diagnosis of Early-Onset Neonatal Sepsis

Bulletin of Egyptian Society for Physiological Sciences
Article 3, Volume 38, Issue 1, January 2022, Page 27-37  XML PDF (695.48 K)
Document Type: Original Article
DOI: 10.21608/besps.2018.8101
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Authors
Yehia H. Abdel Maqsoud1; Ahmed A. Sobeih1; Effat Assar1; Deena A. Elshabrawy2; Manal Hassan* 3; Raafat R. Mohammed4
1Department of Pediatrics, Faculty of Medicine, Benha University
2Department of Clinical Pathology, Faculty of Medicine, Benha University
3Department of Medical Biochemistry, Faculty of Applied Medical Sciences, 6 October University
4Fellow and Researcher in Biochemistry, Clinical Pathology Department, Benha University, Benha, Egypt
Abstract
Abstract
Objectives: The study aimed to evaluate the discriminative ability of, at admission, estimation of serum high-sensitivity C-reactive protein (hsCRP), interleukin-6 (IL-6) and procalcitonin (PCT) between neonates with various grades of early-onset sepsis (EOS) using the Score for Neonatal Acute Physiology (SNAP II). Patients & Methods: The study included 87 neonates with suspected EOS within the 1st week of life. All neonates were evaluated using the SNAP II and scores >40 indicate severe, 20-40 indicate moderate and score <20 indicate mild infection. At admission, venous blood samples were obtained for blood culture, total (TLC) and differential leucocytic count and ELISA estimation of serum hsCRP, IL-6 and PCT.Results: EOS neonates were categorized as Confirmed (n=44), Suspected (n=18) and EOS-free (n=25) according to severity of clinical sepsis and result of blood culture. Estimated laboratory parameters were significantly higher in patients than controls and in EOS than EOS-free neonates. Serum hsCRP and IL-6 levels could not, while PCT could differentiate between neonates with confirmed or suspected EOS. ROC curve analysis defined high serum PCT and IL-6, SNAP II score, neutrophil percentages, serum hsCRP and TLC as significant predictors for positive blood culture in decreasing order of significance, while Regression analysis defined high serum PCT as a persistently significant predictor for positive culture, followed by high serum IL-6 and high SNAP II score. Combined SNAP II scoring and serum PCT could define 61.4%, while combined estimation of serum hsCRP, IL-6 and PCT levels could define 52.3% of neonates with combined EOS.  Conclusion: Combined estimation of hsCRP, IL-6 and PCT could increase the diagnostic yield of neonatal sepsis; however, clinical evaluation using SNAP II score and serum PCT did better and could define neonates with positive blood culture earlier so as to allow early treatment.
Keywords
Early-onset neonatal sepsis; Score for Neonatal Acute Physiology; Procalcitonin; Interleukin-6; High-sensitivity; C- reactive protein
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