title: Can melatonin be used as a marker for neonatal sepsis?
abstract: BACKGROUND
  Melatonin, an indolamine endogenously produced by pineal body, has important role as an anti-oxidant, anti-inflammatory and anti-apoptotic. Whether melatonin concentration changes in neonatal sepsis and whether it can be used as a marker of sepsis is unknown.
  
  
  OBJECTIVE
  The objective of this study is to evaluate melatonin concentration in the serum as a marker for neonatal sepsis and compare it to standard markers.
  
  
  METHODS
  We prospectively studied 40 neonates: 20 diagnosed with late neonatal sepsis and 20 healthy neonates as a control group. Markers of sepsis and melatonin concentration were compared between both groups.
  
  
  RESULTS
  The sepsis groups had significantly increased immature to total neutrophils ratio (I/T ratio), and high sensitivity C-reactive protein (HsCRP), and decreased platelet count. Melatonin concentration was increased in sepsis group when compared to control group (27.2 ± 3.3 versus 11.4 ± 3.2 pg/ml, p = 0.001), and positively correlated with HsCRP (r = 0.952, p = 0.001) and I/T ratio (r = 0.326, p = 0.015). Combining melatonin to HsCRP increased sensitivity and specificity to detect neonatal sepsis to 97.3 and 93.3%, respectively.
  
  
  CONCLUSIONS
  Endogenous melatonin concentration is increased in late neonatal sepsis and can potentially be used as a marker for sepsis especially when combined with CRP.
authors.affiliation: a Department of Neonatology , Tanta University , Tanta , Egypt .
authors.forename: Abdel-Rahman
authors.initials: AR
authors.lastname: El-Mashad
authors.affiliation: a Department of Neonatology , Tanta University , Tanta , Egypt .
authors.forename: Heba
authors.initials: H
authors.lastname: Elmahdy
authors.affiliation: b Department of Newborn Services , George Washington University and Children's National Health System , Washington , DC , USA and.
authors.forename: Mohamed
authors.initials: M
authors.lastname: El-Dib
authors.affiliation: c Department of Biochemistry , Tanta University , Tanta , Egypt.
authors.forename: Manal
authors.initials: M
authors.lastname: Elbatch
authors.affiliation: b Department of Newborn Services , George Washington University and Children's National Health System , Washington , DC , USA and.
authors.forename: Hany
authors.initials: H
authors.lastname: Aly
mesh_terms: D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D008550:Melatonin / Q000097:blood*; D000071074:Neonatal Sepsis / Q000097:blood*; D011446:Prospective Studies
chemical_list: D015415:Biomarkers; D008550:Melatonin
keywords: Anti-oxidant; infants; late-onset sepsis; marker