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Subject Area

Anesthesiology and Intensive Care

Article Type

Original Study

Abstract

Objective This study aimed to test whether clinical characteristics, laboratory parameters, and measurements of serum fibroblast growth factor-23 (sFGF23) can discriminate between babies with neonatal sepsis and normal babies. Background Neonatal sepsis is associated with severe morbidity and mortality in the neonatal period, especially in developing and underdeveloped countries. Patients and methods This was a prospective (case–control) study conducted between April 2018 and November 2018, at the Neonatal ICU, Menoufia University Hospital, Menoufia, Egypt. The study comprised 79 full-term neonates. The neonates were categorized in two groups based on International Pediatric Sepsis Consensus Conference and Biochemical Markers, including complete blood count, C-reactive protein, and blood culture: first, control group included 30 neonates with routine screening; and second, sepsis group comprised 49 neonates with clinical sepsis (32 with sepsis and 17 with severe sepsis) (clinical and laboratory signs of infection with or without positive blood culture). Receiver operating characteristic curves were used for the determination of thresholds for the infection group vs healthy neonate group. Results A total of 79 neonates were enrolled in this study. sFGF23 increased in order of infection severity, being higher in patients with clinical sepsis than healthy subjects. Sensitivity, specificity, positive predictive value, and negative predictive value for sFGF23 levels were 89.8, 76.67, 86.3, and 82%, respectively. sFGF23 (cutoff point for sFGF23 >21.68 pg/ml) (P < 0.001), and there was a positive correlation between sFGF23 level and severity of sepsis (r = 0.37, P = 0.004). Conclusion sFGF23 may be a valid and early diagnostic marker of neonatal infection. Moreover, sFGF23 is associated with severity of sepsis.

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