الفهرس 
Neonatal sepsisOnly 14 pages are availabe for public view
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Abstract
Sepsis is a significant cause of morbidity and mortality in the newborn, particularly in preterm, low birth weight infants, despite advances in neonatal care, infections remain common and sometimes life-threatening in neonates admitted to the neonatal intensive care unit (NICU). Bacterial sepsis is a life threatening crisis with high mortality and morbidity in neonates. Diagnosis of sepsis is still a challenge Due to non-specific clinical presentation. It can be diagnosed by blood culture but it is time consuming. Reliable marker is needed for the diagnosis of neonatal sepsis so that early treatment can be initiated. Various cytokines, chemokines, acute phase reactants, cell surface markers and interferons have been evaluated to find out the effective marker for early diagnosis of neonatal sepsis. Neonatal sepsis may be categorized as early-onset or late-onset. Of newborns with early-onset sepsis, 85% present within 24 hours, 5% present at 24-48 hours, and a smaller percentage present within 48-72 hours. Onset is most rapid in premature neonates. This study aimed to detect the levels of IL-6, CRP and HS-CRP in clinically suspected cases of neonatal sepsis. Evaluation and analysis of the above parameters as early markers of neonatal sepsis. This study was conducted at the pediatric department of zagazig university hospitals and the clinical pathology department of zagazig university hospitals. We concluded 60 neonates in our study of which 40 were considered Cases upon clinical suspection and 20 were considered controls of the case group we divided cases upon blood culture results to probable sepsis group with – ve blood culture and +ve clinical signs and sure sepsis group with +ve culture and clinical signs. In our study we found that IL-6 at a cut off value of 187.5Pg/ml had sensitivity of 87.5% and specificity of 63.6% with a negative predictive value of 93.3% On the other hand HS-CRP at a cut off value of 3.3 Mg/L had a higher sensitivity but a lower specificity at 100% and 47.7% repectively. CRP showed higher specificity than HS-CRP and IL-6 with 61.7% with a negative predictive value of 90% A combination of IL-6 and CRP showed improvement of sensitivity to 100% and a negative predictive value of 100% and is more cost effective than the combination of IL-6 and HS-CRP which showed similar sensitivity and negative predictive value but showed less specificity. The diagnosis of neonatal sepsis is still a difficult approach that needs the clinical suspection and with the abscense of a sure marker CRP still the most used marker in our practice but it is noticed that its better in serial measurements and it lacks specificity and sensitivity in early stages of neonatal sepsis so a comination with IL-6 will improve the accuracy and early prediction of neonatal sepsis. Blood culture is still the gold standard of neonatal sepsis but it has the drawbacks of time consumption and the frequent use of empirical antibiotic may alter the results. Finally we recommend the use of IL-6 as both predictive and prognostic factor in diagnosis of neonatal sepsis with the combination of IL-6 and CRP to be our go to laboratory investigation in clinically suspected neonatal sepsis.