الفهرس 
Sepsis of neonatesOnly 14 pages are availabe for public view
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Abstract
Neonatal septicemia remains a major cause of morbidity and mortality in the neonatal period. This study was done in The Neonatal Intensive Care Unit of Benha University Hospital from June 2011 to February 2012 to clarify the role of highly sensitive CRP (hs-CRP) and serum intercellular adhesion molecule-1 (s.ICAM-1) in diagnosis of neonatal septicemia compared to other more established measures as CRP, I/T blood culture. Our study was carried out on 50 newborns divided into 3 groups: Group (Ia): Septicemic full term and preterm newborn (n = 30). Group (Ib): Septicemic full term and preterm newborn after 2 weeks of antimicrobial therapy (n = 30). Group (II): Healthy full term and preterm newborn (n = 20) as controls. Each of the studied newborns was subjected to history taking, clinical examination and laboratory investigations including CBC, CRP, blood culture, I/T , s.ICAM-1 and hs-CRP. Serum levels of hs-CRP and s.ICAM-1 were measured before and after antimicrobial therapy in septicemic group (n = 30) and were compared with other and haematological parameters. In our study there was positive correlation between both hs-CRP and s.ICAM-1 with qualitative CRP at the start and after 2 weeks of antimicrobial therapy. Our study revealed that 100% of cases with positive blood cultures had positive hs-CRP and s.ICAM-1. In our study, it has proven that both hs-CRP and s.ICAM-1 have a significant role in differentiation between early-onset and late onset sepsis which remains challenging problem. Our study revealed that serum levels of hs-CRP and s.ICAM-1 were higher in group Ia (septicemic group at start) than group Ib (septicemic group after 2 weeks of antimicrobial therapy) and group II (controls). In our study hs-CRP at a cut off value 2.5mg/l and s.ICAM-1 at a cut off value 275ng/ml had sensitivity 83% and 86%, specificity 100% and 100%, positive predictive value 100% and 100%, negative predictive value 80% and 74% and diagnostic accuracy 63.6% and 86.9% respectively. We suggest that serum levels of hs-CRP and s.ICAM-1 are elevated during infection and can be used as diagnostic marker for neonatal septicemia.