Thesis (M.Sc.) - Cairo University - Faculty of Medicine - Department of Pediatrics

Objective: The Aim of the study is to evaluate the diagnostic and prognostic values of serum neopterin level in neonatal sepsis and to evaluate risk factors for neonatal sepsis in neonatal intensive care unit of Abo El-Reesh hospital Cairo University. Background: Neonatal sepsis has been used to describe the systemic response to infection in the newborn infant younger than one month age. Neopterin is one of biochemical markers of immune activity, which seems to be useful in monitoring inflammatory diseases. Increased concentration of neopterin in serum is observed in conditions with involvement of cell mediated immune response. Patient and Methods: this study is prospective cohort study which carried out on 91 neonates, {u2264}35 weeks divided to Group Ї (suspected sepsis), it includes 31 neonates with symptoms and signs suggestive of sepsis or at high risk of infection with negative blood culture. Group ЇЇ (proven sepsis), It includes 30 neonates who are septic with clinical picture of sepsis and laboratory data showing sepsis with positive blood culture, Group Ш (Controls), It includes 30 healthy neonates with no evidence of sepsis, all groups were subjected to history taking, clinical examination and laboratory Investigations included complete blood count, blood cultures, Quantitative C reactive protein (CRP) and Serum neopterin level. Results: Serum neopterin was significantly high in Group I (44.46±24.72) and Group II (108.37±22.38) than in controls and the best cutoff value of serum neopterin to detect sepsis is 70.56 nmol/L with sensitivity 94.7% and specificity 88.6% .and that neopterin correlated well with mortalities due to sepsis. Conclusion: Neopterin found to be a diagnostic and prognostic factor in patients with sepsis

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