Reminna I. Immunopathogenetic Features of Neonatal Pneumonia

The thesis research is devoted to the study of immunopathogenetic features of neonatal pneumonia on the basis of analysis of the causes of their occurrence at birth and in the dynamics of the early neonatal period, the results of modern methods of research, diagnosis, differential diagnosis, and prognosis. Retrospective analysis of 348 clinical records of all newborns hospitalized in the Department of Anaesthesiology and Neonatal Intensive Care during 2013 showed that 11.8% of patients in the Department of Anaesthesiology and Neonatal Intensive Care were colonizated with opportunistic agents when being admitted to a hospital. These were mostly full-term newborns (71.4%). A week later another 18.1% of the patients who stayed at the Department of Anaesthesiology and Neonatal Intensive Care had positive results of bacterial inoculation for flora, which was regarded as hospital colonization. These were mostly premature newborns (61.9%) with opportunistic pathogens. Pathogens of hospital infections were mostly identified either in stool culture (49.5%) or in intubation tubes (26.3%). Based on the prospective study of 74 newborn infants with pneumonia, it was found that the body weight of newborns of Group I was significantly lower (2680±86,35) g than of children in a control group (3313±108,34) g, p<0,05. Children with congenital pneumonia (11.6% and 39.6% at the first minute of life, 4.6% and 13.9% at the fifth minute of life) were more likely to have a poor Apgar score (<4 points and 4-6 points) than children with acquired pneumonia (9.7% and 19.3% at the first minute of life, 6.5% and 6.5% at the fifth minute of life), p <0, 05. We noted a direct correlation of the average force rs=0.4 between TLR2 and IL-10 indices among children of Group II, p<0.05. We also established reliable direct correlation of the average force (rs=0.3; rs=0.3) between TLR2 and IL-1 β, TLR2 and IL-10 in the blood serum of newborn infants of Group I who had received artificial ventilation, p<0.05 and a reliable direct strong connection (rs=0.8) between TLR2 and IL-10 in the blood serum of children in Group II who had also received artificial ventilation, p<0.05. We established high sensitivity (87%) and rather high specificity (80%), accuracy (85%), and high prognostic value of positive and negative results of TLR2 and IL-1β, IL-10 in blood serum with the help of ROC-analysis. TLR2 ≥ 0.64 ng/ml value in the blood serum of newborn babies measured in the first days of their life is a diagnostic test for acquired pneumonia. The content of IL-1β in the blood serum of newborn babies in the first days of their life ≥ 9,2 pg/ml indicates acquired pneumonia The content of IL-10 in the blood serum of newborn babies in the first days of their life equal to ≥ 12,1 pg/ml testifies of acquired pneumonia.