الفهرس 
IntroductionOnly 14 pages are availabe for public view
 |  | from | 122 |  |  |
| | | from | 122 | | |
Abstract
Neonatal sepsis is a serious bacterial infection in neonates. With a variable presentation confusing clinicians with other diseases as trauma, tissue damage or even normal birth process. Discriminating neonatal sepsis from other diseases depends mainly on investigations. With blood culture the cornerstone of the investigations.
There is to date neither single biomarker nor combination of biomarkers to surely affirm neonatal sepsis conclusively. With the high mortality especially in preterm infants, searching for the optimal biomarker is still going.
Our study was a case-control study which was conducted upon 80 neonates (40 as cases of neonatal sepsis, 40 as control), both full-term and preterm neonates were included. The septic group was divided into 20 cases with culture positive and 20 cases with clinical sepsis.
The studied group with neonatal sepsis were subjected to complete perinatal history, assessment of gestational age, full physical examination, and, investigations in the form of complete blood count with differential count, serum CRP, salivary CRP, SAA and routine investigations.
While the control group was subjected to complete perinatal history, assessment of gestational age, full physical examination, salivary CRP and SAA.
Salivary CRP samples were collected within 12 hours of serum CRP and analyzed by ELISA. Also, SAA samples were analyzed by ELISA and compared with other biochemical markers of neonatal sepsis.
The mean gestational age of the studied cases was 36± 2.3 and the mean birth weight was 2± 0.65(kg) with 62.5% of them are females.
All cases had late-onset sepsis. Regarding clinical signs of sepsis; 35% of the cases were feverish, 12% had tachycardia, 25% had decreased sucking, 16% had apnea, and 57.5% needed oxygen. As for the outcome, the majority of cases (82.5%) improved while only (17.5%) died.
We found that salivary CRP is detectable in saliva of neonates with sepsis and it had a moderate positive correlation with serum CRP indicating that salivary CRP is a valuable biomarker for detecting abnormal serum CRP levels. Also, salivary CRP was significantly increased in culture-proven group than in the culture-negative group.
Regarding SAA; it was significantly increased in neonates with sepsis than controls. Also, SAA was significantly increased in culture-proven group than in the culture-negative group and showed better results in diagnosing sepsis than serum CRP.
In culture positive septic group; blood culture was found positive in 50% of the septic cases and the most common organism found among septic cases was Klebsiella pneumoniae (30%) while MRSA and Acinetobacter was found in 7.5% for each item separately and only 2 cases had positive Candida Albicans and CONS.