Introduction: Neonatal sepsis is a major cause of mortality in developing countries. Accurate and quick diagnosis are difficult because clinical presentation are non-specific, bacterial cultures are time-consuming and other laboratory tests lack sensitivity and specificity. Serum procalcitonin (PCT) has been proposed as an early marker of infections in neonates. Objectives: This study investigated the value of PCT in the diagnosis of Neonatal Sepsis. Methods: Neonates undergoing sepsis evaluation at the Special Baby Care Unit, Federal Medical Centre, Abeokuta, Nigeria between January and April 2013 were included. Blood samples were obtained for white cell count, blood cultures, serum CRP and PCT analysis. Neonates were categorised into Proven Sepsis, Suspected Sepsis and Clinical Sepsis groups on the basis of laboratory findings and risk factors. A control group with no clinical and biological data of infection was also included. Predictive values and area under the receiver operating characteristic curve (AUC) of PCT were evaluated. Result: Of the 85 neonates, 19 (22.4%) had positive blood culture. PCT level was significantly higher in neonates in all sepsis groups in comparison with those in the control group (P< 0.05). At a cutoff of 0.5 ng/ml, the negative predictive value (NPV) of PCT was 80% and the positive predictive value (PPV) 39%. There were no significant statistical difference between the AUC values of PCT in Early onset and Late onset sepsis, as well between AUC in Preterm and term cases. A higher percentage of neonates who died (96%) had elevated PCT levels compared to those who survived (46%). Conclusion: These findings support the usefulness of the PCT in diagnosis of Neonatal sepsis.
Context: Fumonisin B1 (FB1), a mycotoxin produced by Fusarium verticillioides and other Fusarium species that grow on maize worldwide, has been documented to cause various physiological responses in animals. Consumption of lesser amounts of fumonisins at levels below those that cause overt toxicity may exert haematological, serum biochemical and/or histopathological effects in animals. Objective:The effects of dietary FB1 on haematology, serum biochemistry and histopathology were assessed in female Wistar rats in a short-term toxicity study. Materials and Methods:Thirty-nine mature female Wistar rats (Rattus norvegicus) weighing between 167.5 -170.5 g were used in the study. The rats were assigned to diets containing 0.2, 10.0 and 20.0 mg FB1/kg constituting diets 1, 2 and 3, respectively. After 14 days of feeding, blood samples were obtained from four rats per treatment. The rats were sacrificed by cervical dislocation, eviscerated for organ collections and subsequently processed for histology.Results: Significant differences in feed consumption and body weight gains were not observed. The final live weight of the rats, however, seemed to decline with an increase in dietary FB1 levels. Significant (P<0.05) alterations were observed in the haematological and serum biochemical parameters with increasing levels of dietary FB1. Diets containing different FB1 concentrations, the decreased values of PCV, Hb, erythrocyte and monocyte counts could be attributed to the FB1 effects on the blood-forming tissues in animals placed on diets 2 and 3 as compared to those fed diet 1. Also, histopathological changes were observed in the livers, kidneys, spleens and hearts of rats fed diets 2 and 3. Conclusion:This study revealed that the No-observable adverse effect level (NOAEL) of dietary FB1 above which may cause significant physiological changes without overt toxicity for short-term toxicity study in female Wistar rats is <0.74 mg/kg bw per day.
Neonatal sepsis, a bacterial infection of blood in the first month of life is a common cause of morbidity and mortality in developing countries and factors associated with positive blood culture and perinatal deaths among neonates are rarely described. This study was conducted at the Special Baby Care Unit of Federal Medical Centre, Abeokuta (FMCA), Southwest Nigeria, to identify the predictors of positive blood culture and deaths due to neonatal sepsis among neonates admitted with clinical diagnosis of septicemia between January and April 2013. Data on socio-demographic characteristics, peripatal events and clinical characteristics of neonates were collected on proforma designed for the study. Blood culture was done on Brain Heart Infusion broth and Thioglycolate broth followed by identification of isolates using conventional methods. Serum Procalcitonin (PCT) and Serum C reactive protein (CRP) Levels were determined by immunochromatographic and immuno-turnidimetric assay respec-tively. The neonates were monitored until discharge from the hospital. Among 180 neonates admitted during the study period, there were 85 cases of clinically suspected sepsis. Forty (47.1%) were males and 45(52.9%) were females while 55 (63.5%) neonates and 30 (36.5%) neonates presented with early and late onset sepsis respectively. Positive blood culture was found in 19 (22.4%) of the neo-nates; 14 (73.7%) of neonates with positive blood cultures had early onset neonatal sepsis and 5 (26.3%) had late onset sepsis. Factors that predicted positive blood culture in both early and late onset neonatal sepsis were mode of delivery (p=0.033), estimated gestational age (p=0.039), and CRP (p=0.000). None of the clinical characteristics was found to be statistically significant with positive blood culture. Deaths occurred in 27 (36%) of neonates. The case-fatality rate was 29%. Predictors of death were booking status (p=0.011), birth after prolonged labour (p=0.014), place of delivery (p=0.001), place of antenatal care (p=0.021), respiratory distress (p=0.034), poor cry (p=0.040), con-vulsion (p=0.011) and PCT (p=0.001). Our findings suggest that mode of delivery and estimated ges-tational age are significantly associated with positive blood culture in both early and late onset neona-tal sepsis. Mortality from neonatal sepsis is high in this study. Booking status, place of delivery, place of antenatal care significantly contributed to mortality suggesting that antenatal and perinatal care remains associated with neonatal mortality.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.