ROLE OF MANNOSE-BINDING LECTIN (MBL) LEVELS IN DIAGNOSIS OF NEONATES WITH PNEUMONIA AND SEPSIS

Abstract

Neonatal sepsis is a major problem across the world. Infections are a major contributor to neonatal deaths in developing countries. Majority of these deaths occur at home without coming to medical attention. The child survival cannot be achieved without substantial reductions in infection-specific neonatal mortality. The complement system helps or “complements” the ability of antibodies and phagocytic cells to clear pathogens from an organism. It is part of the immune system called the innate immune system MBL (mannose-binding lectin) is an important component of innate immunity and a central recognition molecule of the lectin pathway of complement, which probably represents the most ancient pathway of complement activation . The aim of the work is to evaluate role of serum mannose binding-lectin in diagnosis of neonatal pneumonia and sepsis. The study included 24 neonates diagnosed with sepsis or pneumonia clinically & laboratory (group 1) and another 24 comparable healthy neonates as control group. All the newborns included in the study were subjected to detailed comprehensive history taking including antenatal history, natal history, postnatal history, family history, complete examination including cardiac, chest, abdominal, and neurological examination, laboratory investigations including CBC, CRP & blood culture in addition to estimation of serum mannose-binding lectin using ELISA (enzyme linked immunosorbent assay) technique at admission and at proven sepsis. All neonates were followed up for development of clinical symptoms and signs and laboratory evidence of sepsis and stati stical testes were done to determine whether low MBL levels were associated with increased risk of neonatal sepsis. The patient group compromised 17 males (70.3 %) and 7 females (29.17%) with mean gestational age of (35.542.86 wks), mean birth weight of (2.410.70 kg) and median serum MBL (0.175 g/ml at admission and 0.145 g/ml at proved sepsis). In this group, 12 (50%) neonates were delivered vaginally and 12 (50%) neonates were delivered by caesarean section The control group compromised 9 males (37.5%) and 15 females (62.5%) with mean gestational age of (36.462.38 wks), mean birth weight of (2.940.52 kg) and median serum MBL (0.340g/ml). In this group 9 (37.50%) were delivered vaginally and 15 (62.5%) were delivered by caesarean section. The results of the study shows: - Statistically significant difference between groups as regard sex, with p= 0.020. - Our results shows statistically significant difference between groups as regard wt. (kg), with increase in mean control group, with p= 0.005, and statistically significant difference between groups as regard A pgar 1 min, with increase median control group, with p <0.001 - .No statistically significant difference between groups as regard mannose 1 at admission, the median of control group is increased but non significant, with p= 0.170 . - Our results shows statistically significant difference between groups as regard mannose 2 at proved sepsis, with increase median control group, with p-value 0.013 Sig. - No statistically significant correlations between mannose 1 and gestational age, Wt. (KG), Apgar 1 min, Apgar 5min, CRP 1 at admission, TLC 1 at admission, Hb 1 at admission, Platelet 1 at admission. - Negative statistically significant correlation between mannose 2 and both CRP2 and Platelet 2.