Plasma D-dimer level in early and late-onset neonatal sepsis

Table 1 The control and patients' demographic and clinical and laboratory data

		Control group (n = 30)	EOS group (n = 30)	LOS group (n = 30)	t/Z	P value
Age (mean ± SD, d)		2.10 ± 0.8	2.47 ± 0.57	12.47 ± 4.03	147.024	0.001
Weight (mean ± SD, g)		2.98 ± 0.4	2.85 ± 0.41	2.95 ± 0.3	0.895	NS
Male: Female		0.9:1	0.87: 1	1.5:1	0.356	NS
% of cesarean section		23 (76.7%)	22 (73.3%)	21 (70%)	0.381	NS
PROM		0	6 (20%)	0
Risk factors (invasive procedure)	UVC	0	4 (13.3%)	0		0.001
	ETT	0	5 (16.7%)	4 (13.3%)		0.001
	UVC + ETT	0	7 (23.3%)	13 (43.3%)		0.001
	None	100%	14 (46.7%)	13 (43.3%)		0.001
Respiratory distress		0	27 (90%)	23 (77%)	1.920	NS
Apnea		0	3 (10%)	3 (10%)	FE	NS
Cyanosis		0	10 (33.3%)	14 (46.7%)	1.111	NS
Positive Gerdes score (≥ 2)		0	22 (73.3%)	19 (63.3 %)	38.258	0.001
Thrombocytopenia		2 (6.7%)	22 (73%)	12 (40%)	6.787	0.009
CRP (mg/dL)		4 ± 2	57.53 ± 38.82	65.47 ± 39.62	0.783	NS
D-dimer (mg/L)		0.60 ± 0.70	1.48 ± 1.44	2.27 ± 1.86	10.512	0.001
Hospital duration		0	21.6 ± 10	22 ± 9	0.051	NS
Mortality		0	9 (30%)	11 (36.7%)	0.300	NS

ETT: Endotracheal intubation; PROM: Premature rupture of membranes; UVC: Umbilical vein catheterization; NS: Not significant.

Table 2 Microbial profile in the patients' groups

		EOS group (n = 30)	LOS group (n = 30)	Total (n =60)	t	P value
Gram-negative bacteria	Total	21 (70.0%)	28 (93.3%)	49 (81.67%)	2.3	< 0.01
	Klebsiella	15 (50%)	20 (67%)	35 (58%)	1.3	NS
	E. coli	4 (13.30%)	1 (3.3%)	5 (8.33%)	-1.4	NS
	Acinetobacter	2 (6.66%)	4 (13.30%)	6 (10%)	0.85	NS
	Serratia	0%	1 (3.3%)	1 (1.66%)
	Pseudomonas	0%	2 (6.66%)	2 (3.33%)
Gram-positive bacteria	Total	8 (26.7%)	2 (6.7%)	10 (16.7%)	-2.07	< 0.01
	Group B Streptococcus	5 (16.60%)	0%	5 (8.33%)
	CoNS	2 (6.66%)	1 (3.3%)	3 (5%)	-0.6	NS
	Enterococcus	1 (3.3%)	0%	1 (1.66%)
	MRSA	0%	1 (3.3%)	1 (1.66%)
Candida		1 (3.3%)	0%	1 (1.66%)

EOS: Early-onset sepsis; LOS: Late-onset sepsis; E. coli: Escherichia coli; CoNS: Coagulase-negative staphylococci; MRSA: Methicillin-resistant Staphylococcus aureus; NS: Not significant.

Table 3 Comparing D-dimer and C-reactive protein levels according to the isolated organisms

Organism		D-dimer (mean ± SD)	CRP (mean ± SD)
Gram-negative bacteria	E. coli	1.3 ± 0.81	44.2 ± 4.3
	Klebsiella	2.0971 ± 1.98916	71.1 ± 3.9
	Acinetobacter	2.1333 ± 1.63	37.7 ± 3.4
	Pseudomonas	1.95 ± 0.92	64.0 ± 5.65
	Serratia	1.8 ± 0.4	99.0 ± 0.79
Gram-positive bacteria	Group B Streptococcus	1.6 ± 10.6	39.7 ± 2.5
	CoNS	1.3 ± 0.51	53.7 ± 2.7
	MRSA	1.2 ± 0.60	58.0 ± 8.2

CRP: C-reactive protein; E. coli: Escherichia coli; CoNS: Coagulase-negative staphylococci; MRSA: Methicillin-resistant Staphylococcus aureus.

Table 4 Correlation between D-Dimer and other variables

Variables	D-dimer
	R	P value
Hemoglobin	-0.246	0.0201
Platelets	-0.228	0.0311
CRP	0.249	0.0181
Duration of the hospital stays	0.4	0.0011
Mortality	0.43	0.0011

¹Significant.

CRP: C-reactive protein.

Table 5 Recipient observer characteristics curve results for D-dimer to diagnose neonatal sepsis

ROC curve results	The area under the curve	P value	Cut off point	Sensitivity	Specificity
D-dimer (mg/L)	0.822	0.001	0.75	72.7%	86.7%

ROC: Receiver operating characteristic.