الفهرس 
Neonatal SepsisOnly 14 pages are availabe for public view
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Abstract
Neonatal sepsis (NS) remains the most common cause of neonatal mortality and morbidity. Diagnosis of neonatal sepsis remains a challenge as it has subtle and different signs and symptoms at different gestational ages.
Although blood culture is the gold standard in diagnosing NS, the search for other markers of NS with high sensitivity is ongoing to overcome the drawbacks of blood cultures.
Determining the causative organism of neonatal sepsis as soon as possible until blood culture results are available will ease the choice of empiric antibiotic therapy; it will also reduce treatment costs and prevent unnecessary antibiotic use. Also, we believe that the CRP/ Albumin ratio may offer an advantage in clinical practice by its low cost and being readily available.
C-reactive protein levels increase in response to infection and this increase is proportional to infection severity .However, CRP levels in neonates may also increase due to non-infectious causes such as premature rupture of membranes, vaccination, fetal distress, maternal fever, and meconium aspiration. In contrast, albumin is a negative acute-phase reactant released in inflammation. This may be explained by increased catabolism rates in sepsis and redistribution secondary to increased vascular permeability, which causes capillary leakage. The degree of hypoalbuminemia in critically ill patients correlates with the intensity of the inflammatory response triggered by in- fection .Therefore, the difference between CRP and albumin in sepsis is gradually widening. Given that the use of the ratio between CRP and albumin will include minor reductions in albumin values, it will also change without significant difference in albumin values and provide a value that positively correlates with infection, i.e. a high rate indicates a high inflammatory status.
Gram-negative (GN) bacteremia causes a more profound inflammatory response than Gram-positive (GP) bacteremia. Gram-negative infections probably increase TNF-α and IL-1, IL-6, IL-10, and IL-8 production to a higher degree than GP infections.
The aim of our study was to investigate the relationship between CRP/albumin and Gram-negative bacterial sepsis in neonates as amarker in it‘s diagnosis in late onset neonatal sepsis and early initiation of appropriate therapy without waiting for blood culture results.
This prospective observational study was conducted on 207 neonates admitted to neonatal intensive care units (NICU) of Menoufia university hospital in the period from January 2022 to January 2023; with a diagnosis of suspected neonatal sepsis, 83 of whom had blood culture proliferation as proven sepsis and were enrolled. The patients were grouped into two groups based on blood culture results: GPBS and GNBS groups. Twenty two patients had GP bacterial proliferation and 61 had GN bacterial proliferation. The laboratory and demographic features of the patients were obtained from the hospital records.
The GP group compromised 22 newborns; 14 males (63.6%) and 8 females (36.4%), with mean gestational age of (37.4 ± 1.4weeks), mean birth weight of (3.08 ± 0.5), 5 neonates (22.7 %)were delivered vaginally and 17 (77.3 %) were delivered by CS.