الفهرس 
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Abstract
Neonatal sepsis is an infection involving an infant during the first 28 days of life. The infection may involve the infant globally or may be limited to just one organ (such as the lungs with pneumonia). It may be acquired prior to birth (intrauterine sepsis) or after birth (extrauterine sepsis).
The clinical signs of neonatal sepsis are nonspecific and associated with other neonatal diseases, such as (RDS), metabolic disorders, intracranial hemorrhage, and a traumatic delivery; it includes respiratory, cardiac, metabolic, neurological, GIT and general signs.
This study was carried out to evaluate the value of pro-adrenomedullin measurement in sepsis and its possible correlation with other traditional marker as C-reactive protein in this disorder.
Our prospective study had been carried out on a sample of neonate infants admitted to the neonatal intensive care unit of Beni-suef University hospital and Beni-suef general hospital. It was conducted on 30 neonates with confirmed Sepsis and 15 normal healthy neonates as control group.
Our patients were classified into:
1. Patient group: 30 cases (newborns have clinical picture suggesting neonatal sepsis with positive acute phase reactant and positive blood culture (confirmed cases).
2. Control group: 15 cases (healthy newborns).
All of our cases subjected to careful history taking (personal, antenatal, natal and postnatal, day of symptoms begin) to catch up any risk factor for neonatal sepsis either fetal, maternal or delivery.
Full clinical examination to all cases was followed for early detection of neonatal sepsis including cardiac, respiratory, neurological, GIT and general or systemic manifestations that suspect sepsis.
Also laboratory investigations including CBC (total leucocytic counts, neutrophil counts, immature/total ratio, and platelets counts), blood culture, CRP and pro-adrenomedullin (by ELISA technique) were done for either patient &control cases.
There were no statistically significant differences between the two studied groups regarding gestational age, sex, age of presentation, PROM, maternal fever and mode of delivery (CS vs. ND) and temprature
There were statistically significant differences between the two studied groups regarding birth weight, heart rate, respiratory rate, platelets count, haemoglobin and total leucocytic count.
The most frequent clinical presentations were poor moro reflex, poor sucking, lethargy followed by apnea and signs of respiratory distress.
The most frequently cultured organism was klebsiela followed by E.coli, Acinetobacter and enterococci.
There was a significant increase in patients versus control groups regarding the mean value of CRP.
There was a significant increase in patients versus control groups regarding the mean value of pro-adrenomedullin.
from this study, we conclude that Pro-ADM is a novel marker that can be used especially for diagnosis of neonatal sepsis and its use combination with conventional acute-phase reactants may be more useful in diagnosis of neonatal sepsis.
from this study, we recommend thatMore studies are needed to detect the diagnostic value of pro-ADM for neonatal sepsis in preterm babies in comparison with full term ones, also further studies are needed to highlight the value of proadrenomedullin in the prognosis of neonatal sepsis by taking serial samples.