الفهرس 
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Abstract
Pediatric sepsis continues to have a tremendous impact worldwide. Sepsis is the leading cause of death worldwide in the pediatric population resulting in an estimated 7.5 million deaths annually. It encompasses the top four causes of childhood mortality as reported by WHO. Early recognition of sepsis and initial management in the outpatient and hospital wards are essential for preventing progression to more severe forms. Defining sepsis in the pediatric patient is made more difficult due to age specific vital signs, and their tremendous physiologic reserve which often masks the seriousness of their condition. Pediatric severe sepsis is defined as (1) two or more systemic inflammatory response syndrome criteria (2) confirmed or suspected invasive infection, and (3) cardiovascular dysfunction, acute respiratory distress syndrome, or two or more organ dysfunctions.
Systemic inflammatory response syndrome (SIRS), a clinical syndrome following inflammation, is characterized by tachycardia, tachypnea, fever, and leukocytosis. In the intensive care unit (ICU), over 50% of patients show symptoms of SIRS during their hospital stay. SIRS can be attributed to sepsis or to a non-infectious inflammatory stimulus, like polytrauma, surgery, pancreatitis, or burns. It is vital to discriminate between non-infectious SIRS and sepsis since timely treatment with antibiotics is lifesaving in case of sepsis. Clinically, it is hard to distinguish non-infectious SIRS from sepsis, and current diagnostic tools like microbiologic cultures take time and have low sensitivity. Additional diagnostic tools are needed to differentiate between SIRS with and without infection.
Circulating biomarkers might help understand the underlying inflammatory mechanisms in patients with sepsis and select the most appropriate monitoring strategies and treatment. A wealth of biomarkers have been investigated and some of them, such as C-reactive protein (CRP) and procalcitonin, are routinely used in clinical practice.The innate immune response plays a central role in response to infections, with neutrophils representing the most important cells involved in this process. MPO is highly abundant in neutrophils accounting for ” ” " ~ " ” ”5% of the protein content by dry mass, and together with other released proteins is responsible for pathogen elimination. The aim of our study is to determine role of MPO as a biomarker in early diagnosis of sepsis in PICU and its prognostic value as a biomarker for mortality.
We conducted a prospective case control observational study at PICU at Beni-Suef University Hospital from September 2020 till September 2021. The study included 48infant with sepsis and another 30 healthy as a control group. All participations subjected to the following:full history taking, full clinical examination and laboratory investigations as CBC, CRP, blood culture & sensitivity, liver functions, serum creatinine and plasma levels of MPO. Patients group was followed up for manifestations of sepsis, SIRS and sever sepsis. Patients with sever sepsis were assessed by another sample to follow up the plasma level of MPO.
We found significantly higher levels of MPO in patients with sepsis (79.75± 34.08 mU/ml ) and sever sepsis(111.70± 26.50mU/ml) compared to control group(39.99± 5.69mU/ml ) .