Deoxyribonuclease 1 as a Marker of Neonatal Sepsis and Its Comparison with CRP

Abstract

Background: Neonatal sepsis is a bacterial bloodstream infection that causes severe clinical symptoms and is often fatal or results in  permanent, irreversible impairments. In order to prevent the development of serious and sometimes deadly consequences, it is  imperative that babies suspected of having sepsis have timely diagnosis and treatment.

Objective: This work aimed to investigate DNAse  1 level in neonates with neonatal sepsis and compare DNASe 1 to CRP as markers of neonatal sepsis.

Patients and methods: This  is a prospective case-control study that included 60 neonates admitted to the neonatal intensive care unit (NICU) in Menoufia  University Hospital from January 2023 to February 2024.

Results: TLC, CRP, AST, and DNASE1 were significantly higher among cases than  controls. While PH, PCO₂, HCO₃, and albumin were significantly lower among cases than controls. As well as total serum bilirubin (TSB),  direct serum bilirubin (DSB), and Na+ were significantly lower among cases. On the other hand, there was no significant difference among the studied groups regarding urine culture, ALT, creatinine, Urea, and K+ (P>0.05). In the current study, 11 cases had positive  blood culture (36.7%), 5 of them had Methicillin-resistant Staphylococcus aureus (MRSA) (16.7%), 4 had klebsiella MDR (13.3%), one case  had E. coli or Gram -ve bacilli (3.3%).

Conclusion: In conclusion, DNASE1 was significantly higher among CS LBW and pneumonia+ LONS  diagnoses than NVD, NBW, and another diagnosis. DNASE1 was significantly higher among cases than controls. Both CRP and DNASE1  can be used as predictor tools for neonatal sepsis, but DNASE1 had more sensitivity and specificity (98.7%, 68%) at cutoff level 0.9926 ng/ ml, as compared to CRP (96.2%, 70.3%) at cutoff level 2.40.