Cord Human Beta Defensin-2 as an Early Predictor of Late onset Neonatal Sepsis

Abstract

Background: Neonatal sepsis is the most important cause of morbidity and mortality in the neonatal period. Late onset sepsis (LOS) is defined as infection occurring after 1 week of life and is often more insidious in onset. Antimicrobial proteins and peptides (APPs) were found to be lower in newborns than in adults. Although APPs could be important to protect newborns from infections during the first weeks of life, upregulation of human beta defensin 2(HBD2) might be reduced in preterm infants due to the immaturity of the immune system.HBD-2 is particularly effective against both Gram-negative and Gram-positive bacteria, such as E. coli and S. aureus, respectively. Aim of the work:The aim of this work is to detect and evaluatecord blood HBD2 in late onset sepsis in preterm, near-term and full term neonates.Methods: This is aclinical comparative follow up study, carried out on 120 neonates; 40 preterm neonates (group I), 40 near term (group II), 40 full term (group III). All neonates were subjected to clinical examination, laboratory investigations; CBC, CRP, cord blood HBD2 and serum HβD2 during the first 30 days follow up.Results: the cord blood levels of HβD2, showed the lowest level in group Ifollowed by group II and the highest level was in group III. The cutoff point of cord blood HβD2 for prediction of LOS was determined for each group. Conclusion: Low level of HBD2 in cord blood is accompanied with increased incidence of LOS in neonates especially in preterm and low birth weight neonates than in full term ones. Cord Human Beta Defensin-2 as an Early Predictor of Late onset Neonatal Sepsis Keywords:Late onset sepsis, Neonates, CordHβD2 Research Article Open Access IntroductionNeonatal sepsis is a type of neonatal infection and refers to the presence of a bacterial blood stream infection (BSI) (such as meningitis, pneumonia, pyelonephritis, or gastroenteritis) and it is the most important cause of morbidity and mortality in the neonatal period [1].Preterm neonates are at risk of suffering from severe infections particularly in the first month of life due to their low immunity against infections. Immaturity of the immune system makes neonatal sepsis more common in preterm than full term and in Caesarean Section (CS) than spontaneous vaginal delivery (SVD) [2].Early onset sepsis (EOS) is defined as the onset of sepsis during the first 3 days of life and is mostly caused by vertical transmission of bacteria from the mother to her infant during the intrapartum period [3]. Late onset sepsis (LOS) is defined as infection that occurs during the first week of life and is caused by the transmission of pathogens acquired postnatally and is often more insidious in onset [4].Antimicrobial proteins and peptides (APPs) are cationic molecules that are released by neutrophils, monocytes, and macrophages. APPs are also produced within the skin and at mucosal surfaces by epithelial cells in the respiratory, gastrointestinal, and urinary tract. They are present in the body fluids, including saliva, tears, nasal secre...