الفهرس 
Material and methodsOnly 14 pages are availabe for public view
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Abstract
Conclusion
from this study we conclude the following:
• Infection in the neonate presents a diagnostic dilemma as the
clinical presentation is non specific and there is no single reliable
test for the early confirmation of definite sepsis.
• The lack of specificity of careful clinical and laboratory
examination in detecting neonatal sepsis presents a daunting
problem to clinicians. Because undiagnosed sepsis can lead to
rapid deterioration and death, and because isolation of the
causative organism from blood samples is insensitive and can take
up to 48 hours, antibiotics are administered to neonates on the basis
of nonspecific findings. As a result, considerable over
hospitalization, overuse of antibiotics, and other inefficiencies are
accepted as the only means to reduce the morbidity and mortality
rates for neonatal sepsis. The increase pressure for cost
containment and improved efficiency of medical care has sparked a
renewed interest in methods that will improve the sensitivity and
specificity of the diagnosis.
• Nosocomial infections playa very important role in the etiology of
neonatal sepsis in our nurseries. Strict infection control procedures
should be followed with stress on regular checkups and cultures
from workers on neonatal units.
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Conclusion
• C-reactive protein should not be checked as a routine part of a
septic screen in neonates, it may be helpful in excluding infection
in some cases of sepsis if normal levels are obtained 24-48 hours
after the onset of symptoms. It should therefore be considered in
cases in which diagnosis of sepsis is unclear, and where negative
cultures may not give sufficient reassurance to discontinue
antibiotics.
• As shown in our studies, the consecutive determination of IL-6
shows the real significance of this acute-phase protein in the
clinical management of systemic infection, we have shown that IL-
6 is very early marker in the diagnosis of neonatal infection. Also
differential blood count is very sensitive test but its specificity for
neonatal infection is low., on admission, CRP is less sensitive but
specific Parameter, thus in the clinical setting the combination of
CRP and IL-6 may be the ideal tool for the early diagnosis of
neonatal sepsis.
• In this study, G-CSF, when used as a marker of sepsis, identified
the vast majority of neonates with positive blood culture.
• Soluble CD14 is present in serum, it acts as a co-ligand for LPS
leading to activation of vascular endothelial cells and other cells
with the release of cytokines that playa very important role in the
pathogenesis of sepsis, soluble CD14 levels are increased in
newborns with proven sepsis.