Діагностичне значення окремих імунологічних маркерів у верифікації раннього неонатального сепсиса

Abstract

Objective: is to optimize the verification of early sepsis in infants with a view to rational antibiotic therapy during the first 48 hours of life. Material and methods: by simple sequential selection, a cohort of 100 infants aged 0-48 hours of life was formed. The criteria for including into the study were: age 0-48 hours of life, the continuity of patient involvement, enrollment of patients in the same obstetric institution, the presence of susceptibility factors for early neonatal sepsis of on the mother’s and/or baby’s side, considering the propensity factors, the presence of clinical manifestations of organ dysfunction which can be caused by both infectious and noninfectious causes. The results of the research were analyzed using computer packages "STATISTICA" StatSoft Inc. and Excel XP for Windows on a PC using parametric and nonparametric methods of calculation. Results: аn analysis of the diagnostic value of certain immunological verification tests in early neonatal sepsis showed that they mostly had moderate specificity, but their use is combined with a high incidence of false negative results with low values of prognostic value of the negative test. In this regard, these tests can probably justify prescription of antibiotics in infants with suspected early neonatal sepsis but not afford ground for not applying the antibiotic therapy in conditions that imitate it. Conclusions: immunological indices of inflammatory response can not be used as stand-alone tests for early detection of neonatal sepsis because of low sensitivity, lack of prognostic value of a negative result and a low likelihood ratio, while pointing to the likely risk of its occurrence.