Article Text

  1. B O Shouman1,
  2. R I Badr2
  1. 1Department of Paediatrics, Mansoura University Children’s Hospital, Mansoura, Egypt
  2. 2Medical Microbiology and Immunology Department, Faculty of Medicine, Mansoura, Egypt


Objective The inflammatory cascade in sepsis is characterised by the coordinated expression of pro-inflammatory cytokines such as tumour necrosis factor alpha (TNF-α) and chemokines RANTES (regulated upon activation normal T-cell expressed and secreted). Our aim was to measure serum levels of TNF-α and RANTES in neonatal sepsis as diagnostic markers and to determine whether early and late-onset neonatal sepsis were associated with differences in their concentrations.

Methods Fifteen neonates showing clinical signs suggestive of an early-onset or late-onset infection were studied. TNF-α and RANTES were determined in the serum at the first suspicion of sepsis and before commencement of antibiotic therapy. Fifteen healthy neonates were included as a control group.

Results Serum TNF-α, white blood cell count and C-reactive protein (CRP) were significantly higher while RANTES levels were significantly lower in the septic compared with the non-septic group. No significant difference in the RANTES or TNF-α levels were found between infants with early-onset or late-onset sepsis nor between premature and term septic neonates. A significant negative correlation between serum levels of TNF-α and RANTES and a significant positive correlation between serum levels of CRP and TNF-α in septic neonates were detected.

Conclusion In our study, TNF-α is proved the best diagnostic test for neonatal sepsis followed by CRP.

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