THE VALUE OF IMMUNOGLOBULIN AND COMPLEMENT LEVELS IN THE EARLY DIAGNOSIS OF NEONATAL SEPSIS

Abstract

Newborn infants, especially premature infants are prone to fulminant bacterial sepsis because of their immature immune system (Quie, 1990). A decreased interferon-gamma production by T-lymphocytes, deficient immunoglobulin production by B-lymphocytes and lower opsonization potential due to decreased function of complement contribute to this relative immune deficiency state (Wilson et al., 1986). Early recognition of sepsis in the neonates is one of the most difficult problems facing clinicians today. Such infants often present with non-specific symptoms and signs so that failure or delay in treatment may result in significant mortality and morbidity (Holy, 1992). Although various hematological indices had been utilized to screen for sepsis, most were neither highly sensitive nor specific and were commonly affected by perinatal factors like maternal hypertension, Asphyxia and hemolytic disease (Chan et al., 1997). Neonatal sepsis has a high morbidity and mortality the incidence of which ranges from 1 to 10 cases per 1000 live births. The frequency of neonatal sepsis varies in different neonatal departments and depends on predisposing conditions such as arterial and venous catheters, tracheal intubations and indwelling urinary catheter. A wide range of investigations had been done for the early diagnosis of sepsis in the newborn. However, a reliable test for early diagnosis of neonatal sepsis has not been identified up to now (kalayci et al., 1997)