VALUE OF MEASUREMENT OF NEUTROPHIL ELASTASE-ALPHA-1 PROTEINASE-INHIBITOR LEVELS IN THE EARLY DIAGNOSIS OF NEONATAL INFECTION

In a case-control study in 398 neonates the value of measuring the lev els of neutrophil elastase-alpha 1 proteinase inhibitor (EPI) for earl y diagnosis of neonatal infection was studied in comparison to the com monly used parameters of leukocyte count, ratio of immature to total g ranulocytes and C-reactive protein levels. Investigations were perform ed on day 1 or day 6 of life. On the basis of the clinical findings pa tients were allocated to one of the three following groups: healthy ne onates (group A), neonates with local infections such as pneumonia or skin infection (group B) or neonates with septicemia as demonstrated b y a positive blood culture (group C). The median EPI levels (with rang e) measured on day 1 were: group A 40 (15-65) mug/l, group B 120 (80-2 60) mug/l, group C 225 (140-355) mug/l. The levels on day 6 were: grou p A 27.5 (5-55) mug/l, group B 105 (65-370) mug/l, group C 182.5 (74-4 50) mug/l. EPI thus discriminated well between healthy neonates and ne onates with infection, but not between neonates with infection and neo nates with septicemia.