Assessment of Sepsis Markers in Patients Admitted to the Pediatric Intensive Care Unit in Medical Tobruk Center

• Munira A Hamad

  Faculty of medical Sciences University of Tobruk, Tobruk, Libya

  Author

• Amane S yousi

  Faculty of medical Sciences University of Tobruk, Tobruk, Libya

  Author

Background: sepsis and septic shock continue to be a major cause of mortality and morbidity in infant and children worldwide. Objective: To study morbidity and identify the causes of neonatal sepsis among newborn babies. methods: A descriptive case series hospital-based study was conducted from registration files in the neonatal intensive care unit and 123 newborns admitted to neonatal intensive care in Tobruk medical center from January 2024 to November 2025. Result: in our study, the studied cases (n = 123). The findings show a predominance of males (61.0%) compared to females (39.0%), Regarding age the wide range (0.03–15 months) and relatively high standard deviation (2.31) suggest variability in age, but the low median confirms that the majority are clustered in early infancy, Hemoglobin levels showed a mean of 13.0 g/dl, which is generally within the normal and elevated hemoglobin levels among some cases, . The mean CRP level (19.41 mg/dl) with a large standard deviation (28.90) and a wide range (0.17–144.0) reflects considerable variability in inflammatory response. conclusion: These findings emphasize the importance of close biochemical monitoring in infants with inflammatory or infectious conditions to prevent complications and guide appropriate management.

Abdel-Hakeem GL, Shehata NM, et al .(2019). Cord Blood Interleukin-6 as a Predictor of Early Onset Sepsis in High-Risk Neonates. Annals of Neonatology Journal.1(2):37–48.

Aleem S. (2019). When to Include a Lumbar Puncture in the Evaluation for Neonatal Sepsis. Neo Reviews.;20(3):e124–e134.

Benitz WE, etal (2010)Adjunct Laboratory Tests in the Diagnosis of Early-Onset Neonatal Sepsis. Clin Perinatol.;37(2):421–438.

Bizzarro MJ,et al 2005. Seventy-five Years of Neonatal Sepsis at Yale: 1928–2003. Pediatrics. ;116(3):595–602.

Born S, et al.(2021).Epidemiology of Sepsis Among Children and Neonates in Germany: Results From an Observational Study Based on Nationwide Diagnosis-Related Groups Data Between 2010 and 2016. Crit Care Med. 2021;49(7):1049–1057.

Chen J, et al.2023). Meta-analysis of the Role of Neutrophil to Lymphocyte Ratio in Neonatal Sepsis. BMC Infect Dis. ;23(1):837.

Cortese F, et al.(2016). Early and Late Infections in Newborns: Where Do We Stand? A Review. Pediatr Neonatol.;57(4):265–273.

Devkota K, Kanodia P,et al .(2024). Sepsis Among Neonates Admitted to a Neonatal Intensive Care Unit in a Tertiary Care Centre. JNMA.;62(270):76–78.

Ershad M, et al . (2019 )Neonatal Sepsis. StatPearls Publishing.

Escobar GJ, et al, (2000). Neonatal Sepsis Workups in Infants ≥2000 Grams at Birth: A Population-Based Study. Pediatrics;106(2):256–263.

Fernandes ND,et al (2024). Congenital Herpes Simplex..

Fleischmann-S, et al.(2018). The Global Burden of Paediatric and Neonatal Sepsis: A Systematic Review. Lancet Respir Med. ;6(3):223–230.

Fleischer E, Neuman MI, et al.(2019). Cerebrospinal Fluid Profiles of Infants ≤60 Days of Age With Bacterial Meningitis. Hosp Pediatr.;9(12):979–982.

Gabay C, Kushner I. 1999.Acute-Phase Proteins and Other Systemic Responses to Inflammation. N Engl J Med.;340(6):448–454.

Gordon A, Isaacs D(.2006). Late-Onset Neonatal Gram-Negative Bacillary Infection in Australia and New Zealand: 1992–2002. Pediatr Infect Dis J.;25(1):25–29.

Harrison ML, et al (2024).. Beyond Early- and Late-Onset Neonatal Sepsis Definitions: What Are the Current Causes of Neonatal Sepsis Globally? Pediatr Infect Dis J;43(12):1182–1190.

Islam K, et al. (2023). 14-Day Antibiotic Therapy for Culture-Positive Neonatal Sepsis. J Trop Pediatr.;69(6).

Islam F, Afroze S, et al (2025). Clinical Profile and Immediate Outcomes of Suspected Neonatal Sepsis in a Tertiary Care Hospital. Northern International Medical College Journal.;16(1):734–739.

Jethani S, et al (2022). Diagnostic Utility of Combined Immature and Total Neutrophil Counts Along With C-Reactive Protein in Early Detection of Neonatal Sepsis. Ann Med Surg. ;77:103589.

Kariniotaki C, et al.(2025) Neonatal Sepsis: A Comprehensive Review. Antibiotics (Basel). ;14(1).

Kawakita T, 2016. Neonatal Complications Associated With Use of Fetal Scalp Electrode. BJOG.;123(11):1797–1803.

Kuzniewicz MW, (2017). A Quantitative, Risk-Based Approach to the Management of Neonatal Early-Onset Sepsis. JAMA Pediatr.;171(4):365–371.

Mainichi W,et al.(2022). Role of Complete Blood Cell Count Parameters in the Diagnosis of Neonatal Sepsis. BMC Pediatr.;22:41.

Mirza S A, (2018). Electrolyte Abnormalities in Neonates With Probable and Culture-Proven Sepsis and Its Association With Neonatal Mortality. Coll Physicians Surg Pak. ;28(3):206–209.

Molla A, Albadrani M.(2024). Prevalence and Species Distribution of Neonatal Candidiasis: A Systematic Review and Meta-Analysis. Diseases.;12(7).

Nordberg V, et al.(2021). A Decade of Neonatal Sepsis Caused by Gram-Negative Bacilli. Eur J Clin Microbiol Infect Dis. ;40(9):1803–1813.

Patel U, Patel VK, et al. (2014).To Evaluate C-Reactive Protein and Other Hematological Parameters for Diagnosis of Neonatal Sepsis. Int J Med Res Rev. ;2(4):311–318.

Pong A, Bradley JS.(1999). Bacterial Meningitis and the Newborn Infant. Infect Dis Clin North Am.;13(3):711–733.

Póvoa P, et al .(2005). C-Reactive Protein as a Marker of Infection in Critically Ill Patients. Clin Microbiol Infect.;11(2):101–108.

Puopolo KM, et al .(2018). Management of Neonates Born at ≤34 6/7 Weeks' Gestation With Suspected or Proven Early-Onset Bacterial Sepsis. Pediatrics.;142(6).

Puopolo KM, et al (2018). Management of Neonates Born at ≥35 0/7 Weeks' Gestation With Suspected or Proven Early-Onset Bacterial Sepsis. Pediatrics. ;142(6).

Puopolo KM, et al .(2019) Management of Infants at Risk for Group B Streptococcal Disease. Pediatrics. ;144(2).

Rohatgi S, et al (2017).. Seven Versus 10 Days Antibiotic Therapy for Culture-Proven Neonatal Sepsis. J Paediatr Child Health. ;53(6):556–562.

Rozycki HJ, et al( 1987).. Impaired Sensitivity of a Single Early Leukocyte Count in Screening for Neonatal Sepsis. Pediatr Infect Dis J. ;6(5):440–442.

Sediqi MS.(2023). Prevalence of Pediatric Sepsis in Hospitalized Children of Maiwand Teaching Hospital, Kabul, Afghanistan. BMC Pediatr. ;23(1):1–5.

Shane AL, (2017). Neonatal Sepsis. Lancet. ;390(10104):1770–1780.

Shane AL, Stoll BJ.(2013). Recent Developments and Current Issues in the Epidemiology, Diagnosis, and Management of Bacterial and Fungal Neonatal Sepsis. Am J Perinatol. ;30(2):131–141.

Simonsen KA, (2014). Early-Onset Neonatal Sepsis. Clin Microbiol Rev.;27(1):21–47.

Stoll BJ, Han, et al.(2010). Neonatal Outcomes of Extremely Preterm Infants From the NICHD Neonatal Research Network. Pediatrics;126(3):443–456.

Stoll BJ, Hansen NI, et al.(2011). Early-Onset Neonatal Sepsis: The Burden of Group B Streptococcal and E. coli Disease Continues. Pediatrics.;127(5):817–826.

Stoll BJ, Puopolo KM,, et al.(2020). Early-Onset Neonatal Sepsis 2015–2017, the Rise of Escherichia coli, and the Need for Novel Prevention Strategies. JAMA Pediatr. ;174(7):e200593.

Sullins AK, Abdel-Rahman SM(.2013). Pharmacokinetics of Antibacterial Agents in the CSF of Children and Adolescents. Paediatr Drugs. ;15(2):93–117.

True H, Blanton M,et al .(2022). Monocytes and Macrophages in Pregnancy: The Good, the Bad, and the Ugly. Immunol Rev. ;308(1):77–92.

Van Dyke MK, et al.(2009). Evaluation of Universal Antenatal Screening for Group B Streptococcus. N Engl J Med. ;360(25):2626–2636.

Visser VE, Hall RT. (1979) Urine Culture in the Evaluation of Suspected Neonatal Sepsis. J Pediatr. ;94(4):635–638.

Wynn JL, Wong HR.2010. Pathophysiology and Treatment of Septic Shock in Neonates. Clin Perinatol. ;37(2):439–479.

Yu YQ, et al .( 2022). Etiology, Antimicrobial Resistance, and Risk Factors of Neonatal Sepsis in China: A Systematic Review and Meta-analysis From Data of 30 Years. J Matern Fetal Neonatal Med.;35(25):7541–7550.

Zidan A, et al.2022. Epidemiology of Bacterial Infections in Pediatrics Intensive Care Unit (PICU) at Zagazig University.;88(1):3452–3456.

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