| Background: Calprotectin, a complex of two calcium-binding proteins that
belong to the S100 protein family, is abundant in the cytosolic fraction of
neutrophils. A high level of calprotectin reportedly exists in extracellular fluid
during various inflammatory conditions, but its role in neonatal sepsis was
investigated only in one study as a marker of sepsis in very low birth weight
neonates. Objective: This study aimed to measure the serum calprotectin level
by ELISA in full-term neonates with late onset neonatal sepsis, its correlations
with other laboratory markers of sepsis as interleukin-6, C-reactive protein
(CRP), total leucocytic count and platelet count and its relation to the outcome
of cases. Methods: This study comprised 48 full-term neonates with gestational
ages of 37 to 42 weeks with manifestations of late onset neonatal sepsis
admitted to the neonatal intensive care unit, Minia University Hospital during
the period from February, 2011 to December, 2011 and 40 healthy neonates,
age and sex matched as a control group. Serum levels of calprotectin, IL6 and
CRP were measured for all neonates recruited in this study. Results: Serum
calprotectin levels were significantly higher in term neonates with late onset
neonatal sepsis than controls (3.77±1.85 ?g/ml and 0.70±0.33 ?g/ml
respectively, P-value = 0.000). Cases with positive blood cultures and poor
outcomes had the highest levels of calprotectin (5.8±0.61 ?g/ml and 6.1±0.42
?g/ml respectively). Significant positive correlations were found between
calprotectin levels and IL6 (P-value =0.000, r=0.92), C-reactive protein
(p=0.000,r=0.95) and total leucocytic count (P-value =0.000, r=0.72), and
negative correlations were found between its level and platelet count (P-value
=0.000, r=-0.87), gestational age (P-value =0.014, r=-0.35) and body weight
(P-value=0.018, r=-0.34). No significant differences were observed between
males and females as regards calprotectin levels (3.96±2.10 ?g/ml vs 3.55±1.52
?g/ml, P-value=0.444). Conclusions: Serum calprotectin levels are
significantly higher in full-term neonates with late onset neonatal sepsis. Its
levels correlated well with other laboratory markers of sepsis and neonatal
mortality. It is a sensitive diagnostic marker for late onset neonatal sepsis. |