Kh.S. KHAYERTYNOV¹, V.A. ANOKHIN¹, I.G. MUSTAFIN¹, S.V. BOICHUK¹, G.R. KHASANOVA¹, S.A. LYUBIN²

¹Kazan State Medical University of the Ministry of Health of the Russian Federation, Kazan

²City Children’s Hospital No. 1, Kazan

Сontact details:

Khayertynov Kh.S. — PhD (medicine), Associate Professor of the Department of Children’s Infections

Address: 49 Butlerov Str., Kazan, Russian Federation, 420012, tel. +7-903-342-96-27, e-mail: khalit65@rambler.ru

The research objective was to determine the severity of immunosuppression in neonates with various forms of sepsis.

Material and methods. The indicators of innate and adaptive immunity were studied in 36 neonates with sepsis. Studies were conducted in the initial period of the disease. Blood levels of neutrophils, lymphocytes, monocytes and subpopulations of lymphocytes were evaluated: CD3, CD4 +, CD8 + and CD19 + lymphocytes. In 16 cases, there was an early onset of sepsis, in 20 – the late onset of sepsis. In 18 neonates pneumonia developed, in 12 – enterocolitis, in 2 – pneumonia and enterocolitis, in 4 – purulent meningitis. The etiology of neonatal sepsis was established in 8 cases (22%). In seven neonates microorganisms were isolated from the blood: in four cases – K. pneumoniae, in one case – S. aureus, S.auricularis and S. similans, in one child (with purulent meningitis) – St. agalactiae. The control group consisted of 17 healthy neonates.

Results. It was found that the initial period of neonatal sepsis occurs against the background of inhibition of cellular immunity, which was manifested by a significant decrease in the number of CD3 + lymphocytes in the blood, as well as subpopulations of CD4 + and CD8 + lymphocytes (p <0.05). The greatest changes were recorded in a subpopulation of CD4 cells, the values of which were 3 times lower relative to the control. It was found that the likelihood of immunosuppression in neonates with enterocolitis was significantly higher compared with neonates who had pneumonia (p <0.05).

Conclusion. In neonatal sepsis the inhibition of cellular immunity is noted. The most pronounced level of immunosuppression in neonatal sepsis is observed in neonates with enterocolitis. Immunosuppression in neonatal sepsis can serve as an indication for the treatment with lymphopoiesis stimulating drugs.

Key words: neonatal sepsis, lymphocytes, immunosuppression.

(For citation: Khayertynov Kh.S., Anokhin V.A., Mustafin I.G., Boichuk S.V., Khasanova G.R., Lyubin S.A. Immunosuppression in neonatal sepsis. Practical Medicine. 2019. Vol. 17, № 5, P. 165-169)

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