[Reliability of polymorphonuclear elastase for the diagnosis of neonatal sepsis].
Infections are a major problem in neonatal intensive care units throughout the world, and early diagnosis and therapy would certainly reduce associated morbidity and mortality as well as decrease unnecessary antibiotic treatment.


OBJECTIVE
To evaluate the usefulness of polymorphonuclear elastase (PMN-E) serum concentration as an early indicator of neonatal sepsis in comparison with routinely used infection markers.


METHODS
PMN-E was measured in 74 newborns with suspicion of systemic bacterial infection treated in a tertiary intensive care unit. The measurements were performed with commercially available enzyme immunoassay (Milenia).


RESULTS
Mean PMN-E value in non-infected newborns was 38.85 ng/ml, and for infected 184.12 ng/ml (p < 0.05) (t-student test). The sensitivity to the diagnosis of culture--proven bacterial systemic infection was 76% for PMN-E, 60% for C-reactive protein, 59% for the immature to total neutrophil ratio and 56% for the total white blood cell count. The corresponding specificity amounted to 81%, 86%, 100% and 80% respectively.


CONCLUSIONS
Serum PMN-E level determination yields diagnostic advantages in comparison with infection markers routinely used in sepsis screen and may serve as a valuable early indicator of neonatal systemic bacterial infection.
Wojsyk-Banaszak
Irena
I
Klinika Zakazeń Noworodków Katedry Neonatologii Akademii Medycznej w Poznaniu.
Szczapa
Jerzy
J
D002097:C-Reactive Protein / Q000378:metabolism; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D019102:Infant, Very Low Birth Weight; D019272:Leukocyte Elastase / Q000097:blood / Q000378:metabolism*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D015203:Reproducibility of Results; D018746:Systemic Inflammatory Response Syndrome / Q000175:diagnosis* / Q000201:enzymology*
D002097:C-Reactive Protein; D019272:Leukocyte Elastase