الفهرس 
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Abstract
N
eonatal sepsis is a clinical syndrome characterized by signs and symptoms of infection with or without accompanying bacteremia, neonatal sepsis is caused by various organisms invading the blood stream, which may be bacterial, viral, fungal, or protozoal.
Blood culture and routine sepsis screening (CRP, total leukocytic count, and platelets count) are the most common used methods. Although blood culture is the gold standard method for diagnosis of bacterial sepsis, at least 24 hours are needed for presumptive diagnosis. As neonates are vulnerable and rapidly deteriorate, rapid laboratory diagnosis and prompt management is required.
Although blood culture is the gold standard for sepsis diagnosis and should be done to all cases suspected with sepsis before starting the antimicrobial treatment, however, studies shows that its sensitivity ranges from 25-45 % of suspected cases.
Thrombocytopenia is a common hematological abnormality in neonates with bacterial sepsis. Larger platelets have more granules; it reveals the presence of inflammatory burden and disease activity in many diseases. In the settings of decreased platelets such as bacterial sepsis, young platelets that are bigger and more active enter the circulation and hence MPV level increases.
Therefore, increased MPV is useful clinically as a marker of production rate and platelet activation.
The auto-analyzers nowadays readily provide platelet indices along with platelet counts without any additional cost. However, these indices are not given proper weightage often.
Lactic acid is the metabolite of the anaerobic oxidation of sugar (glycolysis) and is generated by the skeletal muscle, brain, and red blood cells. It is excreted by the kidney. The normal blood lactic acid (BLA) value in neonates is 1.0-2.0 mmol/l. There have been a few studies conducted on the influence of early stage BLA detection on neonatal bacterial sepsis diagnosis.
In our study we aimed to determine the role of mean platelet volume (MPV) and plasma lactate level in the diagnosis & prognosis of neonatal bacterial sepsis.
During this study 108 clinically septic neonates were enrolled; blood cultures were collected, and blood samples for MPV, CRP, and blood lactic acid were withdrawn.
Septic neonates with positive blood culture were considered cases, while neonates with negative blood culture were considered the controls.
The results obtained from our study showed that, there was no significant difference between cases and controls as regard gender and mortality, however a significant difference was found between cases and controls as regard age of onset of sepsis with P value (0.021), 59.3% of cases had late onset sepsis compared to 37% only of controls.
Our results showed that there was a significant difference between cases and controls as regards MPV, CRP, and lactate with higher mean and median values among cases with P-value 0.001, 0.003, and 0.021, respectively. High blood lactic acid level was found to be highly significant in non- survived neonates when compared to survived ones with p- value 0.001.