Background:Late-onset neonatal sepsis stands as a major contributor to neonatal morbidity and mortality worldwide. Early diagnosis plays a pivotal role in effective management and better prognosis. The broad range of nonspecific symptoms and the lack of an optimal diagnostic test pose a considerable challenge in arriving at diagnosis.
Objective: The current study sought to investigate the value of serum pancreatic stone protein (PSP) in diagnosis of late onset neonatal sepsis, in addition to evaluation of its role in determining patients’ outcome.
Methods: This is a case control comparative study that wascarried out at the Neonatal Intensive Care Unit, Ain -shams University Hospitals from May to October 2023. The study encompassed forty neonates diagnosed according to clinical, radiological and laboratory criteria as late-onset neonatal sepsis. They were further subdivided into proven sepsis patients (blood culture positive) and probable sepsis patients (blood culture negative). In addition to healthy age and sex matched forty neonates free of infection as controls. An assay of serum PSP levels was done for all groups by Enzyme-linked immunosorbent assay (ELISA).
Results: The levels of serum PSP were found to be significantly higher in both groups of patients with late-onset sepsis as compared to those of the controls. The best cut-off level of PSP to identify septic cases was > 28.2 ng/ml. At this cutoff,the diagnostic sensitivity was 87.5%, the diagnostic specificity was 67.5%, positive predictive value was 72.9% and negative predictive value was 84.4%. PSP levels in septic cases were not related to blood culture results and were not found to be correlated with patients’ outcome.
Conclusion:PSP is a promising biomarker in detecting cases of late-onset neonatal sepsis; including those with negative blood culture results. On the other hand, the role of PSP as a prognostic marker for such cases was not confirmed and needs further evaluation.
Keywords: Neonate, Sepsis, PSP, Biomarker.