Apoptotic Changes in the Early Diagnosis and Severity Determination of Neonatal Sepsis

Objectives: The aim of this study was to assess the presence of DNA damage in full-term newborns with neonatal sepsis. Methods: Sixty neonates with early onset neonatal sepsis and 45 apparently healthy controls were enrolled in the study. Screening of neonates was done using a modified clinical sepsis score and hematological scoring system, adjusted to the results of blood culture and screening tests. Complete blood count, C-reactive protein (CRP), and DNA studies were done. Results: Sepsis was likely in 41 (68.3%) patients with scores of 3 or 4 and CRP levels of 12 - 48 mg/L. Sepsis was very likely in 19 (31.7%) patients with scores of >= 5 and CRP of 48 - 96 mg/L. Sepsis was unlikely in all controls with scores of <= 2. The mean neutrophil count was 9700 +/- 4600/mu L in patients and 4230 +/- 1400/mu L in controls. The higher the total polymorphonuclear count and CRP level, the more severe was the sepsis. Twenty-six of 60 (43.3%) sepsis patients and 5 of 45 controls (11%) had DNA damage. There was a highly significant negative correlation between DNA damage, blood culture results, and CRP levels. Conclusions: DNA damage, demonstrated by clinical and laboratory evidence with a combination of blood cultures, CRP, and hematological scoring system results, can be used as an indicator of both the immune status of the neonate and the severity of the sepsis.