{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,11]],"date-time":"2026-02-11T12:58:58Z","timestamp":1770814738626,"version":"3.50.1"},"reference-count":48,"publisher":"Archives of Pathology and Laboratory Medicine","issue":"8","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2009,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    <jats:italic>Context.<\/jats:italic>\n                    \u2014Early diagnosis of neonatal sepsis is mandatory. Various markers are used to diagnose the condition.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:italic>Objective.<\/jats:italic>\n                    \u2014To evaluate the diagnostic value of various clinical data and hematologic parameters, such as total leukocyte count, absolute neutrophil count, immature to total neutrophil ratio, and soluble E-selectin (sE-selectin) in identification and outcome of neonatal sepsis.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:italic>Design.<\/jats:italic>\n                    \u2014Newborn infants with a clinical diagnosis of sepsis in the neonatal intensive care unit at Mansoura University Children's Hospital during the period between July 2007 and December 2007 were eligible for study. In addition, 30 healthy neonates were included in the study. Complete hematologic and microbiologic laboratory investigations were performed, and serum E-selectin was measured.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:italic>Results.<\/jats:italic>\n                    \u2014Plasma sE-selectin levels were significantly higher (\n                    <jats:italic>P<\/jats:italic>\n                    &lt; .001) in infected infants (mean [SD], 156.9 [77.0] ng\/mL) than in noninfected (mean [SD], 88.8 [47.1] ng\/mL) and healthy infants (mean [SD], 8.67 [3.74] ng\/ mL). Infants with gram-negative sepsis had higher sE-selectin levels than did those with gram-positive sepsis (\n                    <jats:italic>P<\/jats:italic>\n                    = .04). C-reactive protein was the best laboratory test for diagnosis of neonatal sepsis, with an overall sensitivity and specificity of 86% and 97%, respectively. Performing sE-selectin with C-reactive protein or immature to total ratio tests increased the specificity, but reduced the sensitivity, of the tests for the determination of neonatal sepsis. Plasma sE-selectin levels were higher in nonsurvivors than in survivors (\n                    <jats:italic>P<\/jats:italic>\n                    = .01) and were higher in those with hemodynamic dysfunction than in those without hemodynamic dysfunction (\n                    <jats:italic>P<\/jats:italic>\n                    &lt; .001).\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:italic>Conclusions.<\/jats:italic>\n                    \u2014We conclude that plasma sE-selectin levels are elevated in neonatal sepsis. Significant elevation was associated with gram-negative sepsis. Plasma sE-selectin had low diagnostic value when used alone or in combination with other tests; however, it can be used as a prognostic indicator for the outcome of neonatal sepsis.\n                  <\/jats:p>","DOI":"10.5858\/133.8.1291","type":"journal-article","created":{"date-parts":[[2021,2,12]],"date-time":"2021-02-12T10:46:35Z","timestamp":1613126795000},"page":"1291-1296","source":"Crossref","is-referenced-by-count":20,"title":["Evaluation of Microbiologic and Hematologic Parameters and E-Selectin as Early Predictors for Outcome of Neonatal Sepsis"],"prefix":"10.5858","volume":"133","author":[{"given":"Maysaa","family":"El Sayed Zaki","sequence":"first","affiliation":[{"name":"From the Departments of Clinical Pathology (Dr Zaki) and Pediatric Medicine (Dr El Sayed), Mansoura University, Mansoura, 65, Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hesham","family":"El Sayed","sequence":"additional","affiliation":[{"name":"From the Departments of Clinical Pathology (Dr Zaki) and Pediatric Medicine (Dr El Sayed), Mansoura University, Mansoura, 65, Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"3906","reference":[{"issue":"2","key":"i1543-2165-133-8-1291-b1","series-title":"Clin Perinatol","first-page":"361","article-title":"Clinicopathologic approach to the diagnosis of neonatal sepsis.","volume":"18","author":"Gredes, J. S.","year":"1991","unstructured":"Gredes, J. S.\n          \n          Clinicopathologic approach to the diagnosis of neonatal sepsis.\n          Clin Perinatol\n          1991. 182:361\u2013381."},{"issue":"1","key":"i1543-2165-133-8-1291-b2","series-title":"Turk J Pediatr","first-page":"7","article-title":"Role of procalcitonin, C-reactive protein, interleukin-6, interleukin-8, and tumor-necrosis factor- alpha in the diagnosis of neonatal sepsis.","volume":"49","author":"Kocbas, E.","year":"2007","unstructured":"Kocbas, E., A.Sarikeioglu, N.Aksaray, G.Seydaoglu, Y.Seyhun, and A.Yaman. Role of procalcitonin, C-reactive protein, interleukin-6, interleukin-8, and tumor-necrosis factor- alpha in the diagnosis of neonatal sepsis.Turk J Pediatr2007. 491:7\u201320."},{"issue":"3","key":"i1543-2165-133-8-1291-b3","series-title":"Pediatr Infect Dis J","first-page":"244","article-title":"Epidemiology of neonatal infections: experience during and after hospitalization.","volume":"22","author":"Sinha, A.","year":"2003","unstructured":"Sinha, A., D.Yokoe, and R.Platt. Epidemiology of neonatal infections: experience during and after hospitalization.Pediatr Infect Dis J2003. 223:244\u2013251."},{"issue":"6","key":"i1543-2165-133-8-1291-b4","series-title":"J Perinat Med","first-page":"479","article-title":"The predictive value of C-reactive protein and I\/T-ratio in neonatal infection.","volume":"20","author":"Krediet, T.","year":"1992","unstructured":"Krediet, T., L.Gerards, A.Fleer, and G.van Stekelenburg. The predictive value of C-reactive protein and I\/T-ratio in neonatal infection.J Perinat Med1992. 206:479\u2013485."},{"issue":"2","key":"i1543-2165-133-8-1291-b5","series-title":"Eur J Pediatr","first-page":"138","article-title":"Comparison of C-reactive protein and white blood cell count with differential in neonates at risk for septicemia.","volume":"154","author":"Berger, C.","year":"1995","unstructured":"Berger, C., J.Uhelinger, D.Ghelfi, N.Blau, and S.Fanconi. Comparison of C-reactive protein and white blood cell count with differential in neonates at risk for septicemia.Eur J Pediatr1995. 1542:138\u2013144."},{"issue":"2","key":"i1543-2165-133-8-1291-b6","series-title":"Acta Pediatr","first-page":"221","article-title":"Role of cytokines (interleukin-1 beta, 6, 8, tumor necrosis factor-alpha, and soluble receptor of interleukin-2) and C-reactive protein in the diagnosis of neonatal sepsis.","volume":"92","author":"Reyes, C. S.","year":"2003","unstructured":"Reyes, C. S., F.Garcia-Munoz, D.Reyes, G.Gonzalez, C.Dominguez, and E.Domenech. Role of cytokines (interleukin-1 beta, 6, 8, tumor necrosis factor-alpha, and soluble receptor of interleukin-2) and C-reactive protein in the diagnosis of neonatal sepsis.Acta Pediatr2003. 922:221\u2013227."},{"issue":"3","key":"i1543-2165-133-8-1291-b7","series-title":"Eur J Pediatr","first-page":"205","article-title":"Elevated gene expression of interleukin-8 in cord blood as a sensitive marker for neonatal infection.","volume":"159","author":"Berner, R.","year":"2000","unstructured":"Berner, R., B.Tuksen, A.Clad, J.Forster, and M.Brandis. Elevated gene expression of interleukin-8 in cord blood as a sensitive marker for neonatal infection.Eur J Pediatr2000. 1593:205\u2013210."},{"issue":"3","key":"i1543-2165-133-8-1291-b8","series-title":"Arch Dis Child Fetal Neonatal Ed","first-page":"F221","article-title":"Diagnosis of late onset neonatal sepsis with cytokines, adhesion molecule, and C-reactive protein in preterm very low birth weight infants.","volume":"77","author":"Ng, P. C.","year":"1997","unstructured":"Ng, P. C., S. H.Cheng, and K. M.Chui. et al. Diagnosis of late onset neonatal sepsis with cytokines, adhesion molecule, and C-reactive protein in preterm very low birth weight infants.Arch Dis Child Fetal Neonatal Ed1997. 773:F221\u2013F227."},{"issue":"6283","key":"i1543-2165-133-8-1291-b9","series-title":"Nature","first-page":"425","article-title":"Adhesion receptors of the immune system.","volume":"346","author":"Springer, T. A.","year":"1990","unstructured":"Springer, T. A.\n          \n          Adhesion receptors of the immune system.\n          Nature\n          1990. 3466283:425\u2013434."},{"issue":"4","key":"i1543-2165-133-8-1291-b10","series-title":"J Inflamm","first-page":"212","article-title":"Levels of soluble adhesion molecules and cytokines in patients with septic multiple organ failure.","volume":"46","author":"Endo, S.","year":"1996","unstructured":"Endo, S., K.Inada, and Y.Yamada. et al. Levels of soluble adhesion molecules and cytokines in patients with septic multiple organ failure.J Inflamm1996. 464:212\u2013219."},{"key":"i1543-2165-133-8-1291-b11","series-title":"Crit Care Med","first-page":"S302","article-title":"Markers of endothelial damage in organ dysfunction and sepsis.","volume":"30","author":"Reinhart, K.","year":"2002","unstructured":"Reinhart, K., O.Bayer, F.Brunkhorst, and M.Meisner. Markers of endothelial damage in organ dysfunction and sepsis.Crit Care Med2002. 30:(5)(suppl). 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Diagnostic value of leukocyte indices in late neonatal sepsis.Pediatr Infect Dis J1994. 135:409\u2013410."},{"key":"i1543-2165-133-8-1291-b14","series-title":"Am J Respir Crit Care Med","first-page":"938","article-title":"Antibody to E- and l-selectin does not prevent lung injury or mortality in septic baboons.","volume":"157","author":"Carraway, M. S.","year":"1998","unstructured":"Carraway, M. S., K. E.Welty-Wolf, and S. P.Kantrow. et al. Antibody to E- and l-selectin does not prevent lung injury or mortality in septic baboons.Am J Respir Crit Care Med1998. 157:(3, pt 1). 938\u2013949."},{"issue":"3","key":"i1543-2165-133-8-1291-b15","series-title":"Acta Pediatr","first-page":"274","article-title":"Infections in neonates delivered at term are associated with increased serum levels of ICAM-1 and E-selectin.","volume":"86","author":"Austgulen, R.","year":"1997","unstructured":"Austgulen, R., K. J.Arntzen, P. E.Haereid, S.Aag, and H.Dollner. Infections in neonates delivered at term are associated with increased serum levels of ICAM-1 and E-selectin.Acta Pediatr1997. 863:274\u2013280."},{"issue":"12","key":"i1543-2165-133-8-1291-b16","series-title":"J Clin Epidemiol","first-page":"11251","article-title":"Early diagnostic markers for neonatal sepsis: comparing C-reactive protein, interleukin-6, soluble tumor necrosis factor receptors and soluble adhesion molecules.","volume":"54","author":"Dollner, H.","year":"2001","unstructured":"Dollner, H., L.Vatten, and R.Austgulen. 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Soluble E-selectin is found in supernatants of activated endothelial cells and is elevated in the serum of patients with septic shock.J Immunol1993. 1502:633\u2013654."},{"key":"i1543-2165-133-8-1291-b19","series-title":"Arch Dis Child","first-page":"417","article-title":"Diagnostic markers of infection: comparison of procalcitonin with C reactive protein and leukocyte count.","volume":"81","author":"Hatherill, M.","year":"1999","unstructured":"Hatherill, M., S. M.Tibby, K.Sykes, C.Turner, and I. A.Murdoch. Diagnostic markers of infection: comparison of procalcitonin with C reactive protein and leukocyte count.Arch Dis Child1999. 81:417\u2013421."},{"issue":"5","key":"i1543-2165-133-8-1291-b20","series-title":"J Pediatr Child Health","first-page":"459","article-title":"Utility of hematological parameters and C-reactive protein in the detection of neonatal sepsis.","volume":"38","author":"Manucha, V.","year":"2002","unstructured":"Manucha, V., U.Rusia, M.Sikka, M. M.Faridi, and N.Madan. Utility of hematological parameters and C-reactive protein in the detection of neonatal sepsis.J Pediatr Child Health2002. 385:459\u2013564."},{"issue":"4","key":"i1543-2165-133-8-1291-b21","series-title":"Pediatrics","first-page":"927","article-title":"Early clinical markers for the development of bronchopulmonary dysplasia: soluble E-selectin and ICAM-1.","volume":"102","author":"Ramsay, P. L.","year":"1998","unstructured":"Ramsay, P. L., E. O.Smith, S.Hegemier, and S.Welty. Early clinical markers for the development of bronchopulmonary dysplasia: soluble E-selectin and ICAM-1.Pediatrics1998. 1024:927\u2013932."},{"key":"i1543-2165-133-8-1291-b22","series-title":"J Med Assoc Thai","first-page":"S1151","article-title":"Predictive values of serial C-reactive protein in neonatal sepsis.","volume":"85","author":"Nuntnarumit, P.","year":"2002","unstructured":"Nuntnarumit, P., Pinkaew, and S.Kitiwanwanich. Predictive values of serial C-reactive protein in neonatal sepsis.J Med Assoc Thai2002. 85:(suppl 4). S1151\u2013S1158."},{"issue":"5","key":"i1543-2165-133-8-1291-b23","series-title":"Pediatr Infect Dis J","first-page":"430","article-title":"Utility of complete blood count and blood culture screening to diagnose neonatal sepsis in the asymptomatic at risk newborn.","volume":"22","author":"Ottolini, M. C.","year":"2003","unstructured":"Ottolini, M. C., K.Lundgren, L. J.Mirkinson, S.Cason, and M. G.Ottolini. Utility of complete blood count and blood culture screening to diagnose neonatal sepsis in the asymptomatic at risk newborn.Pediatr Infect Dis J2003. 225:430\u2013434."},{"issue":"1","key":"i1543-2165-133-8-1291-b24","series-title":"Am J Respir Crit Care Med","first-page":"247","article-title":"A dual-binding antibody to E- and l-selectin attenuates sepsis-induced lung injury.","volume":"152","author":"Ridings, P. C.","year":"1995","unstructured":"Ridings, P. C., A. C. J.Windsor, and M. A.Jutila. et al. A dual-binding antibody to E- and l-selectin attenuates sepsis-induced lung injury.Am J Respir Crit Care Med1995. 1521:247\u2013253."},{"issue":"2","key":"i1543-2165-133-8-1291-b1","series-title":"Clin Perinatol","first-page":"361","article-title":"Clinicopathologic approach to the diagnosis of neonatal sepsis.","volume":"18","author":"Gredes, J. S.","year":"1991","unstructured":"Gredes, J. S.\n          \n          Clinicopathologic approach to the diagnosis of neonatal sepsis.\n          Clin Perinatol\n          1991. 182:361\u2013381."},{"issue":"1","key":"i1543-2165-133-8-1291-b2","series-title":"Turk J Pediatr","first-page":"7","article-title":"Role of procalcitonin, C-reactive protein, interleukin-6, interleukin-8, and tumor-necrosis factor- alpha in the diagnosis of neonatal sepsis.","volume":"49","author":"Kocbas, E.","year":"2007","unstructured":"Kocbas, E., A.Sarikeioglu, N.Aksaray, G.Seydaoglu, Y.Seyhun, and A.Yaman. 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S., F.Garcia-Munoz, D.Reyes, G.Gonzalez, C.Dominguez, and E.Domenech. Role of cytokines (interleukin-1 beta, 6, 8, tumor necrosis factor-alpha, and soluble receptor of interleukin-2) and C-reactive protein in the diagnosis of neonatal sepsis.Acta Pediatr2003. 922:221\u2013227."},{"issue":"3","key":"i1543-2165-133-8-1291-b7","series-title":"Eur J Pediatr","first-page":"205","article-title":"Elevated gene expression of interleukin-8 in cord blood as a sensitive marker for neonatal infection.","volume":"159","author":"Berner, R.","year":"2000","unstructured":"Berner, R., B.Tuksen, A.Clad, J.Forster, and M.Brandis. Elevated gene expression of interleukin-8 in cord blood as a sensitive marker for neonatal infection.Eur J Pediatr2000. 1593:205\u2013210."},{"issue":"3","key":"i1543-2165-133-8-1291-b8","series-title":"Arch Dis Child Fetal Neonatal Ed","first-page":"F221","article-title":"Diagnosis of late onset neonatal sepsis with cytokines, adhesion molecule, and C-reactive protein in preterm very low birth weight infants.","volume":"77","author":"Ng, P. C.","year":"1997","unstructured":"Ng, P. C., S. H.Cheng, and K. M.Chui. et al. Diagnosis of late onset neonatal sepsis with cytokines, adhesion molecule, and C-reactive protein in preterm very low birth weight infants.Arch Dis Child Fetal Neonatal Ed1997. 773:F221\u2013F227."},{"issue":"6283","key":"i1543-2165-133-8-1291-b9","series-title":"Nature","first-page":"425","article-title":"Adhesion receptors of the immune system.","volume":"346","author":"Springer, T. A.","year":"1990","unstructured":"Springer, T. 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S302\u2013S312."},{"issue":"4","key":"i1543-2165-133-8-1291-b12","series-title":"Eur J Pediatr","first-page":"331","article-title":"Early diagnosis of septicaemia in the newborn: clinical studies and sepsis score.","volume":"138","author":"Tollner, U.","year":"1982","unstructured":"Tollner, U.\n          \n          Early diagnosis of septicaemia in the newborn: clinical studies and sepsis score.\n          Eur J Pediatr\n          1982. 1384:331\u2013337."},{"issue":"5","key":"i1543-2165-133-8-1291-b13","series-title":"Pediatr Infect Dis J","first-page":"409","article-title":"Diagnostic value of leukocyte indices in late neonatal sepsis.","volume":"13","author":"Da Silva, O.","year":"1994","unstructured":"Da Silva, O. and O.Hammerberg. 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Early diagnostic markers for neonatal sepsis: comparing C-reactive protein, interleukin-6, soluble tumor necrosis factor receptors and soluble adhesion molecules.J Clin Epidemiol2001. 5412:11251\u201311257."},{"issue":"7","key":"i1543-2165-133-8-1291-b17","series-title":"Arch Dis Child","first-page":"802","article-title":"Complement activation in neonatal infection.","volume":"67","author":"Peakman, M.","year":"1992","unstructured":"Peakman, M., G.Senaldi, G.Liossis, H. R.Gamsu, and D.Vergani. Complement activation in neonatal infection.Arch Dis Child1992. 677:802\u2013807."},{"issue":"2","key":"i1543-2165-133-8-1291-b18","series-title":"J Immunol","first-page":"633","article-title":"Soluble E-selectin is found in supernatants of activated endothelial cells and is elevated in the serum of patients with septic shock.","volume":"150","author":"Newman, W.","year":"1993","unstructured":"Newman, W., D. B.Beall, and C. W.Carson. et al. Soluble E-selectin is found in supernatants of activated endothelial cells and is elevated in the serum of patients with septic shock.J Immunol1993. 1502:633\u2013654."},{"key":"i1543-2165-133-8-1291-b19","series-title":"Arch Dis Child","first-page":"417","article-title":"Diagnostic markers of infection: comparison of procalcitonin with C reactive protein and leukocyte count.","volume":"81","author":"Hatherill, M.","year":"1999","unstructured":"Hatherill, M., S. M.Tibby, K.Sykes, C.Turner, and I. A.Murdoch. Diagnostic markers of infection: comparison of procalcitonin with C reactive protein and leukocyte count.Arch Dis Child1999. 81:417\u2013421."},{"issue":"5","key":"i1543-2165-133-8-1291-b20","series-title":"J Pediatr Child Health","first-page":"459","article-title":"Utility of hematological parameters and C-reactive protein in the detection of neonatal sepsis.","volume":"38","author":"Manucha, V.","year":"2002","unstructured":"Manucha, V., U.Rusia, M.Sikka, M. M.Faridi, and N.Madan. Utility of hematological parameters and C-reactive protein in the detection of neonatal sepsis.J Pediatr Child Health2002. 385:459\u2013564."},{"issue":"4","key":"i1543-2165-133-8-1291-b21","series-title":"Pediatrics","first-page":"927","article-title":"Early clinical markers for the development of bronchopulmonary dysplasia: soluble E-selectin and ICAM-1.","volume":"102","author":"Ramsay, P. L.","year":"1998","unstructured":"Ramsay, P. L., E. O.Smith, S.Hegemier, and S.Welty. Early clinical markers for the development of bronchopulmonary dysplasia: soluble E-selectin and ICAM-1.Pediatrics1998. 1024:927\u2013932."},{"key":"i1543-2165-133-8-1291-b22","series-title":"J Med Assoc Thai","first-page":"S1151","article-title":"Predictive values of serial C-reactive protein in neonatal sepsis.","volume":"85","author":"Nuntnarumit, P.","year":"2002","unstructured":"Nuntnarumit, P., Pinkaew, and S.Kitiwanwanich. Predictive values of serial C-reactive protein in neonatal sepsis.J Med Assoc Thai2002. 85:(suppl 4). S1151\u2013S1158."},{"issue":"5","key":"i1543-2165-133-8-1291-b23","series-title":"Pediatr Infect Dis J","first-page":"430","article-title":"Utility of complete blood count and blood culture screening to diagnose neonatal sepsis in the asymptomatic at risk newborn.","volume":"22","author":"Ottolini, M. C.","year":"2003","unstructured":"Ottolini, M. C., K.Lundgren, L. J.Mirkinson, S.Cason, and M. G.Ottolini. Utility of complete blood count and blood culture screening to diagnose neonatal sepsis in the asymptomatic at risk newborn.Pediatr Infect Dis J2003. 225:430\u2013434."},{"issue":"1","key":"i1543-2165-133-8-1291-b24","series-title":"Am J Respir Crit Care Med","first-page":"247","article-title":"A dual-binding antibody to E- and l-selectin attenuates sepsis-induced lung injury.","volume":"152","author":"Ridings, P. C.","year":"1995","unstructured":"Ridings, P. C., A. C. 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