الفهرس 
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Abstract
Neonatal sepsis (sepsis neonatorum) is usually defined as an infection occurring in the first 28 days after birth associated with systemic signs of infection. It is considered to be a major cause of morbidity and mortality in newborn infants.
Neonatal sepsis may be early onset, late onset or late-late onset. The most common organism responsible for sepsis are group B –streptococci, E.coli and Listeria monocytogenus. All of which may present as early or late onset sepsis.Neonatal sepsis may be also nosocomial with predominant of Staphylococcus aureus, E.coli, Enterococci and Pseudomonas as a causative agents.
Certain maternal and neonatal risk factor play an important role in occurrence of neonatal sepsis such as (pre-mature rupture of membrane, colonization with group-B- streptococci, urinary tract infection, low birth weight, sex, underlying disability, twins and type of delivery).
Certain preventive measures should be taken to reduce the risk of nosocomial neonatal sepsis as: hand washing, protective clothes, gloves, isolation and sterilization together with education and training the health employee.
Symptoms of neonatal sepsis may be overlapped with other condition as delayed transition or transient tachpnea. Gastrointestinal and respiratory affection may occur as diarrhoea , vomiting, cyanosis and dyspnoea. Neonatal sepsis may be complicated with septic shock, disseminated intravascular coagulopathy and respiratory failure.
Unfortunately, there is no single diagnostic test that can reliably diagnose sepsis in the newborn, therefore many diagnostic tests are utilized to diagnose or confirm sepsis. Amniocentesis (examination of amniotic fluid for white blood cell count, glucose and IL-6) is used in prenatal diagnosis of neonatal sepsis, cordocentesis (examination of cord blood for IL-6, IL-8, circulating gene related peptide) and placental blood sampling.
Postnatal diagnosis of neonatal sepsis include haematological investigations as total leucocytic count, platelet count, CRP and ESR. Immunological investigations as antigen detection tests (latex agglutination, counter immunoelectro-phoresis and PCR), antibodies detection tests.
Recently, detection of cytokines as IL-6, IL-8, IL-1B, IL-2r and tumor necrosis factor) play an important role in early diagnosis of neonatal sepsis.
Moreover detection of pro-calcitonin and neutrophil CD11b are a promising test for exclusion of early onset neonatal sepsis.
Despite these multiple tests, blood culture is considered to be the gold standard for diagnosing neonatal bacterial sepsis.
Recently, molecular techniques such as PCR have been used successfully to identify a wide range of organisms, including bacteria, yeast, viruses and protozoa.
However, culture will not superseded by PCR based testing due to the requirement for purified culture isolates in antimicrobial susceptibility testing, but if the molecular methods could reliably rule out neonatal sepsis in less time than bacterial culture, it would allow the exclusive treatment of neonates wit true infection, thus reducing the use of broad spectrum antibiotics and the potential of infants who are not septic of acquiring drug resistant bacteria.
In the present study, we compare between blood culture method and PCR for detection of neonatal septicaemia as 30 blood specimens were collected from neonates admitted at NICU.
The present work revealed that out of 30 blood samples, 28 (93.3%) were positive by both blood culture and PCR while 2 (6.7%) were negative by both methods with highly significant association between the 2 methods.
Positive PCR cases are undergo sequencing to detect the definite genus of the organism with highly significant association between the result of culture and sequencing.
Despite that, PCR appear to be an excellent diagnostic test choice for a rapid means of ruling out bacterial sepsis and thus reduce the risk of admission at NICU with hazards of broad spectrum antibiotics with emergence of resistant strains. Moreover to decrease the financial burden on the families due to prolonged hospital stay for infants that separate their mothers which may create difficulties in successful bonding and breast feeding.