Neonatal Sepsis Şüphesi Olan Yenidoğanlarda Akut Faz Reaktanı Olarak C Reaktif Protein, Prokalsitonin, İnterlökin-18 Düzeylerinin Değerlendirilmesi

Yıl 2022, Cilt: 17 Sayı: 2, 46 - 52, 15.07.2022

Büşra Seğmen Sadık Yurttutan , Nurten Seringeç Akkeçeci , Fatma İnanç Tolun , Aydın Bozkaya

https://doi.org/10.17517/ksutfd.879147

Öz

Amaç: Neonatal sepsis yaşamın ilk ayında sistemik infeksiyon bulguları ve bakteriyemiyle nitelenen klinik bir sendromdur. Neonatal sepsis neonatal mortalite ve morbiditenin önemli bir nedenidir ve doğru teşhisi için klinik ve laboratuvar bulguların bir kombinasyonu gereklidir. Bu çalışma neonatal sepsisin erken
tanı ve takibinde C reaktif protein (CRP), prokalsitonin (PCT) ve İnterlökin-18 (IL-18) düzeylerinin incelenmesi ve karşılaştırılması amacıyla planlanmıştır.
Gereç ve Yöntemler: Çalışmaya toplam 103 olgu dahil edildi. Elli beş olgu klinik belirti ve bulgularıyla sepsis grubunu oluşturken, sepsis belirti ve bulgularını taşımayan 48 olgu kontrol grubu olarak çalışmaya dahil edildi. Hastaların demografik özellikleri, prenatal ve maternal özellikleri kaydedildi. Hematolojik
bulguları, CRP, PCT ve IL-18 düzeyleri ölçüldü.
Bulgular: C reaktif protein (CRP) (53.42±61.94 vs 3.2±0.53 mg/dl, p<0.001), PCT (11.53±18.68 vs 0.44±0.66 ng/ml, p<0.001) ve IL-18 (18.62±15.64 vs 13.00±11.83 ng/L) düzeyleri sepsis grubunda kontrol grubuna kıyasla istatistiksel olarak anlamlı yüksek bulundu. ROC eğrisi analizi sonuçlarına göre CRP, PCT ve IL-18 neonatal sepsis tanı ve takibi için anlamlı parametreler olarak saptandı (p<0.05). 0. saatte IL-18 için eşik değer 11.35 ng/L (duyarlılık %63.6, özgüllük %68.7, AUC: 0.627, p=0.027) ve 24. saatte IL-18 için eşik değer 12,56 ng/L (duyarlılık %63.6, özgüllük %70.8, AUC: 0.662, p=0.005) idi.
Sonuç: Duyarlılık ve özgüllüğü CRP ve PCT’den düşük olmasına rağmen; IL-18 neonatal sepsis tanı ve takibine katkıda bulunan yardımcı veri olarak kabul edilebilir.

Anahtar Kelimeler

C reaktif protein, İnterlökin-18, Neonatal sepsis, Prokalsitonin

Destekleyen Kurum

KSÜ Bilimsel Araştırma Projeleri (BAP)

Proje Numarası

2017/2-44D

Evaluation of CRP, Procalcitonin, Interleukin-18 Levels as Acute Phase Reactants in Newborns with Suspected Neonatal Sepsis

Öz

Objective: Neonatal sepsis is a clinical syndrome characterized by signs of systemic infection and bacteremia in the first month of life. Neonatal sepsis is an important cause of neonatal mortality and morbidity, and a combination of clinical and laboratory findings is required for the correct diagnosis of neonatal sepsis. This study was planned to examine and compare C reactive protein (CRP), procalcitonin (PCT) and Interleukin-18 (IL-18) levels in the early diagnosis and follow-up of neonatal sepsis.
Material and Methods: A total of 103 cases were included in the study. While 55 cases with the clinical signs and symptoms were in the sepsis group, 48 cases without the signs and symptoms of sepsis were included in the study as the control group. Demographic characteristics, prenatal and maternal characteristics of the patients were recorded. Hematological findings, CRP, PCT and IL-18 levels were measured.
Results: C reactive protein (CRP) (53.42±61.94 vs 3.2±0.53 mg/dl, p<0.001), PCT (11.53±18.68 vs 0.44±0.66 ng/ml, p <0.001) and IL-18 (18.62±15.64 vs 13.00±11.83 ng/L) levels were found to be statistically significantly higher in the sepsis group compared to the control group. According to the results of ROC curve analysis, CRP, PCT and IL-18 were found to be significant parameters for the diagnosis and follow-up of neonatal sepsis (p<0.05). The cut-off value for IL-18 at 0 h was 11.35 ng/L (sensitivity 63.6%, specificity 68.7%, AUC:0.627, p=0.027) and the cut-off value for IL-18 at 24 h was 12.56 ng/L (sensitivity 63.6%, specificity 70.8%, AUC:0.662, p=0.005).
Conclusion: Although sensitivity and specificity are lower than CRP and PCT; IL-18 can be considered as helpful data contributing to the diagnosis and follow-up of neonatal sepsis.

Anahtar Kelimeler

Neonatal sepsis, C reactive protein, Procalcitonin, Interleukin-18

Proje Numarası

2017/2-44D

Kaynakça

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