Role of 16S rRNA gene and Activin-A in Detection of Neonatal Sepsis

Objective: A bloodstream infection in a newborn less than 28 days is referred to as neonatal sepsis (NS). A novel quick and sensitive markers are required for the early detection of bacterial infections in neonates with sepsis, even if blood culture is a great way to diagnose sepsis because the results are delayed. This study was done to estimate the value of activin-A and molecular method (16S rRNA gene) by PCR as new methods for diagnosis of neonatal sepsis. Methods: Fifity neonates came to the Mansoura University Children Hospital (MUCH) divided into two Groups: Group І (Sepsis group) Group ІІ (non-sepsis group) blood samples were obtained from all members centrifuged and then the serum was estimated for activin- A level by ELISA kit. Genomic DNA was extracted from blood samples for detection of 16S r RNA gene by PCR. Result: Serum Activin A could be used to distinguish cases with sepsis at a cutoff level of > 111.8, with 100% sensitivity (Sn), 78.9% specificity (Sp), 88.6% PPV and 100% negative predicted value (NPV) (AUC = 0.89 & p-value < 0.001). The diagnostic performance of 16s rRNA in diagnosis of sepsis in all studied cases: 16s rRNA results had the sensitivity (Sn) of 100%, specificity (Sp) of 73.6%, positive predicted value (PPV) of 86.1%, NPV of 100% and accuracy of 90% in diagnosis of sepsis in all studied cases when compared with blood culture results. Conclusion: Neonatal sepsis can be diagnosed by the new method (16S rRNA gene) using pcr that has quicker turn around time and higher sensitivity than blood culture ,and activin-A could be utilized as anew ,early and predictive biomarker for bacterial sepsis.