Heba Ezzat Hashem is MB BCh Faculty of Medicine at Ain Sham University, Egypt. She is a senior resident doctor at Department of Clinical and Chemical Pathology, Faculty of Medicine, Ain Shams University, Egypt.


Background: Neonatal sepsis represents a diagnostic burden problem by showing minimal initial nonspecific manifestations. The clinical course can be fulminate and fatal if treatment is not commenced promptly. It is therefore crucial to establish early diagnosis and initiate adequate therapy. Blood culture takes up to 7 days for results and may be inconclusive, thus there is an urgent need for a specific accurate marker for early diagnosis. The challenge of biomarker identification is reflected by the fact that over 3000 sepsis biomarker studies last years. Neutrophil CD64, CD11b, monocyte CD14 and presepsin showed particular promise in this aspect.

Aims: In this study we assessed the utility of all mentioned markers as an early predictive and monitoring marker and the best panel of markers that can achieve the highest diagnostic performance in this disease.

Methods: Our study conducted over 9-months and included a total of 84 sepsis evaluations, neonates classified into three groups: Documented sepsis group, Clinical sepsis group and Control group. Blood samples were collected for hs-CRP, CBC, nCD64, nCD11b, m CD14, presepsin and blood culture.

Results: A statistically significant difference in levels of nCD64, presepsin and mCD14 was found in sepsis groups than in control group; however nCD64 achieves the highest diagnostic performance than the other biomarkers. Combination of 2 markers achieves the highest diagnostic and prognostic performance over a single hematological parameter.

Conclusions: We can conclude that nCD64% represent the best early predictor and monitoring marker that can be incorporated in the routine daily work in NICU.