American Journal of Infectious Diseases and Microbiology
ISSN (Print): 2328-4056 ISSN (Online): 2328-4064 Website: https://www.sciepub.com/journal/ajidm Editor-in-chief: Maysaa El Sayed Zaki
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American Journal of Infectious Diseases and Microbiology. 2015, 3(4), 137-140
DOI: 10.12691/ajidm-3-4-4
Open AccessArticle

Serum Nitric Oxide as Early Predictor of Poor Outcome in Neonatal Sepsis

Minerva Riani Kadir1, , Tetty Yuniati1 and Dadang Hudaya Somasetia1

1Department of Child Health, Dr. Hasan Sadikin General Hospital-Universitas Padjadjaran, Bandung, Indonesia

Pub. Date: September 20, 2015

Cite this paper:
Minerva Riani Kadir, Tetty Yuniati and Dadang Hudaya Somasetia. Serum Nitric Oxide as Early Predictor of Poor Outcome in Neonatal Sepsis. American Journal of Infectious Diseases and Microbiology. 2015; 3(4):137-140. doi: 10.12691/ajidm-3-4-4

Abstract

Objective This study examines the serum nitric oxide (NO) as an indicator of poor outcome in neonatal sepsis. Study Design This prospective observational study was conducted in Dr. Hasan Sadikin General Hospital, Bandung, from September to November 2014. All subjects fulfilled inclusion criteria were tested serum NO metabolite at admission, then were followed up to determine the final outcome, grouped as Group I-good outcome, Group II-poor outcome. Logistic regression analysis was performed to determine independent variables associated with poor outcome, estimated as the odds ratio (OR) and the 95% confidence interval (95% CI). Results Fifty seven neonates were enrolled in this study. There was a good relation between NO level and poor outcome in neonatal sepsis (p<0.01). The level of NO metabolite was a significant independent factor of the poor outcome in neonatal sepsis in the multivariate regression logistic analysis (OR 25.975, p=0.000, 95% CI 4.354–154.952). It showed good discrimination with AUC 0.815 (95% CI 0.676 to 0.955), and good calibration (p=0.192). Conclusion A high serum NO level is independently associated with poor outcome in neonatal sepsis.

Keywords:
nitrit oxide neonatal sepsis outcome

Creative CommonsThis work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/

References:

[1]  Wynn JL, Wong HR, Shanley TP, Bizzarro MJ, Saiman L, Polin RA. Time for a neonatal-specific consensus definition for sepsis. Crit Care Med. 2014; 20: 1-6.
 
[2]  Sallab SE, Abdel-Hady H, Abu-Hashim E, Matter M. Implications of nitric oxide and carbon monoxide in neonatal sepsis. J Med Sci. 2002; 2(4): 177-81.
 
[3]  Hollenberg SM, Cinel I. Bench-to-bedside review: Nitric oxide in critical illness - update 2008. Critic Care. 2009;13:218-27.
 
[4]  Leal YA, Álvarez-Nemegyei J, Velázquez JR, Rosado-Quiab U, Diego-Rodríguez N, Paz-Baeza E, et al. Risk factors and prognosis for neonatal sepsis in southeastern mexico: Analysis of a four-year historic cohort follow-up. BMC. 2012;12:48-57.
 
[5]  Satar M, Özlü F. Neonatal sepsis: a continuing disease burden. Turkish J Pediatr. 2012; 54: 449-57.
 
[6]  Kurosawa DJ, Osuchowki MF, Valentine C, Kurosawa S, Remick DG. The pathogenesis of sepsis. Ann Rev Pathol Mech Dis. 2011; 6: 19-48.
 
[7]  Shi Y, Li HQ, Shen CK, Wang JH, Qin SW, Liu R, et al. Plasma nitric oxide levels in newborn infants with sepsis. J Pediatr. 1993; 123: 435-38.
 
[8]  Ramachandran G. Gram-positive and gram-negative bacterial toxins in sepsis. Virulence. 2014;5(1):213-8.
 
[9]  Wink DA, Hines HB, Cheng RYS, Switzer CH, Flores-Santana W, Vitek MP, dkk. Nitric oxide and redox mechanisms in the immune response. J Leukoc Biol. 2011;89:873-91.
 
[10]  Levett DZ, Fernandez BO, Riley HL, Martin DS, Mitchell K, Leckstrom CA, dkk. The role of nitrogen oxides in human adaptation to hypoxia. Scientific Report. 2011. Available in http:\\www.nature.com.
 
[11]  Mathur V, Satrawala Y, Rajput MS, Vishvkarma A, Shah TD. Physiological and pathophysiological functions of nitric oxide. Der Pharmacia Lettre. 2010, 2(2): 244-57.
 
[12]  Fortin CF, McDonald PP, Fulo T, Lesur O. Sepsis, leukocytes, and nitric oxide (NO): an intricate affair. Shock. 2010;33(4):1-9.
 
[13]  Spasojević I, Obradović B, Spasić S. Bench-to-bedside review: neonatal sepsis –redox processes in pathogenesis. Crit Care. 2012; 221(16): 1-10.
 
[14]  Nicolette NB, Jo W, Muloiwa R, James N. Presentation and outcome of tuberculous meningitis among children: Experiences from a tertiary children’s hospital. Afr Health Sci. 2014; 14(1): 143-9.
 
[15]  Duke T, South M, Stewart A. Activation of the L-arginine nitric oxide pathway in severe sepsis. Arch Dis Child 1997; 76: 203-9.
 
[16]  Mahmoud AT, Tawfik MA, Alshafey MK, Hak SM. Study on nitric oxide level in septicemic neonates. Menoufia Med J. 2014; 27: 474-77.
 
[17]  Ibraheem MF. Neonatal bacterial sepsis: Risk factors, clinical features and short term outcome. Fac Med Baghdad. 2011; 53(3): 1-4.