الفهرس 
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Abstract
Sepsis is defined as ‘the presence probable or documented of infection together with systemic manifestations of infection’. Sepsis arises when the body’s response to an infection injures its own tissues and organs, potentially leading to death or significant morbidity, however SIRS is an inflammatory state affecting the whole body It is the body’s response to an infectious or noninfectious insult.
In the present work we conducted an observational study on adherence to discriminate between systemic inflammatory response and sepsis in critically ill patients by using infection probability score.
Infection Probability Score contained of 6 distinct variables and varied from 0 to 26 points (0-12 for heart rate, 0-2 for temperature, 0-1 for respiratory rate, 0-6 for C-reactive protein, 0-3 for white blood cell count,0-2 for Sequential Organ Failure Assessment score). The best predictors for infection were heart rate and C-reactive protein, while respiratory rate was found to have the poorest predictive value.
One hundred patients selected from different intensive care units from Alexandria University hospitals and Hepatology intensive care unit in Alexandria fever hospital who conformed to the criteria of bacterial sepsis at the time point of admission to the ICU were included in this study.
Ten mL of blood were collected from each patient and were inoculated into an aerobic culture bottle for culture and sensitivity and samples were processed in Bact/ALERT 3D automatic system at 35°C for at least seven days.
In this study, 52(52%) of sepsis cases were females and 48 (48%) were males. Women have a higher incidence of severe sepsis .
Elder patients were twice as likely to have comorbid conditions. Therefore, advancing age is a significant risk factor for the sepsis incidence, and this is described in part by the comorbid conditions presence.
Prolonged hospital stay in ICUs is considered a specific risk factor for infection. In this study, patients stayed in the ICU with a mean of 9 days and a maximum of 15 days .
A higher rate of admission for medical reasons than surgical reasons was reported by this study in which 88% of sepsis cases were admitted to the ICU for medical reasons, while only12% were admitted after surgical interventions.
In this study gastrointestinal infections were the most common source of infection in 56% of cases, followed by bloodstream infection in 44% of cases, respiratory infections in 25% of cases, urinary tract infection in 13% .
As regards infection probability score >14 was in 51% of cases and < 14 was in 49%. The IPS remained below the cut-off value (14) in non-infected patients. This means that 51% of patient proved to have infection according to IPS score. However, infection was detected in 78% of cases using blood culture and in 22% of cases there was no growth.
In this study, staphylococci was found to be the most common causative agent of sepsis detected in 50% of cases , Escherichia coli in19 %, Klebsiella in18%, Proteus in 16% and Candida was detected in only 2% of cases
To our knowledge there isn’t any other score has been developed to forecast infection in adult ICU patient. The helpfulness of the IPS is to help clinicians evaluate the possibility of infection .In the population that we studied ,infection was present 78.0% of patients, and, in these conditions, the positive predictive value was higher than negative predictive value.