Background: One of the major challenges in intensive care unit (ICU) patients is sepsis. The incidence of sepsis in patients admitted to the ICU has been reported from 13. 6-39. 3%. Many factors affect patient mortality, including acute phase proteins such as albumin. Methods: The present study was a retrospective study in which patients with a diagnosis of sepsis referred to Golestan Hospital in Ahvaz from March to August were collected. In the present study, patients with sepsis admitted to the ICU who did not show improvement for more than 7 days were evaluated for length of hospital stay, survival and the relationship with albumin levels. During the study, albumin was checked every 72 hours and its validation was done. Based on albumin levels less than 2. 6, they were treated with albumin. The patients who did not have an increase in the level of albumin remained in the study. Results: 124 patients including 64 women (51. 6) and 60 men (48. 4) with a mean age of 66. 4±, 15. 4 were included in the study. The mean duration of hospitalization was 31. 4±, 18. 9 days, in which 24 patients (19. 4%) died and 100 patients (80. 6%) were discharged. Age, albumin and protein levels were associated with disease prognosis (P<0. 001). Also, the duration of hospitalization in the deceased patients was longer than the recovered patients (27. 7±, 25 vs. 32±, 17. 1) (P=0. 04). After further investigations, it was found that there is no difference between the deceased people (66±, 15. 7) and the recovered people (67. 7±, 14. 1) (P=0. 7). Conclusion: The results of the present study showed that albumin has a direct effect on the severity of sepsis and this issue affects older patients more. Therefore, it is recommended that albumin be considered as a risk factor and one of the influential factors in choosing the best treatment strategy, which is associated with a reduction in mortality, hospitalization and treatment costs.

Background: Sepsis is defined as systemic reactions against infection. Some risk factors of sepsis in infants are as follows: premature new born, PROM, maternal fever, chorioamnionitis, etc. Sepsis is categorized as early (within 7 days from birth) or late (day 8th to 28th) Objectives: In this study, the most common clinical manifestations and laboratory findings of sepsis in neonates and infants who were brought to Baqiyatalah hospital or Najmieh hospital between 1380 and 1384.Material and Methods: In this cross-sectional study, 140 neonates and infants were investigated with a mean age of 6.83 days ranging from 1 to 28 days. Results: According to this study, the prevalence of early sepsis was 85.6% and the most common manifestations were poor feeding (51.5%), lethargy (43.4%) and hyporeflexia (40.6%). Chief laboratory findings were positive blood culture (15.4%), positive CSF culture (2.2%), positive urine culture (13.3%), high ESR (7.9%), positive CRP (6.8%), neutropenia (2.9%), leucocytosis between 20,000 and 40,000 (2.1%), leucopenia (0.7%) and thrombocytopenia less than 100,000 (21%) which are in line with global statistics in most cases. Since sepsis is a major cause of infant mortality in the world, timely diagnosis and treatment as well as improving perinatal and infantile care can increase infants’ survival.

Background: Early detection of neonatal sepsis and categorization of patients based on clinical severity is not yet effectively achieved. Some hematological parameters are used to formulate a hematological scoring system (HSS) and a modified hematological scoring system (MHSS) to diagnose neonatal sepsis. A promising biomarker: Presepsin, or Soluble Cluster of Differentiation 14 SubType (sCD14-ST), is a proteolysis product of CD14 produced after immune activation during infections. The purpose of this research is to assess the performance of both hematological sepsis scores and serum presepsin level in neonatal sepsis and compare them to C-reactive protein (CRP) as diagnostic tools and predictors of mortality. Materials and Methods: This case-control study comprised two groups, one group comprised 51 neonates who were further subgrouped into suspected & proved sepsis, along with 30 uninfected neonates as the control group. Both groups were subjected to the calculation of HSS and MHSS, serum presepsin levels, CRP measurement, and blood culture and assessed for clinical severity and mortality. Results: Hematological sepsis scores and presepsin levels were significantly higher in the sepsis group (P <0. 001). Presepsin showed the best diagnostic performance at > 0. 5 ng/ml (AUC 0. 979,sensitivity of 94. 1% and specificity of 100%). While HSS and MHSS at a cutoff value > 1 achieved comparable specificity, lower sensitivity, 72. 6% for the former and 76. 5% for the later was noted. Presepsin also was significantly higher in the dead group (P<0. 004) with the best predictive performance over CRP at cutoff value >1. 9 ng/ml (AUC 0. 838,sensitivity of 85. 7% and specificity of 79. 6%). Conclusion: Hematological sepsis scores and presepsin were useful diagnostic tools in neonatal sepsis, with presepsin as a good predictor of mortality comparable to CRP.

Sepsis is the most common cause of neonatal mortality. As per National Neonatal-Perinatal Database (NNPD), 2002-2003, the incidence of neonatal sepsis in India was 30 per 1000 live births. Signs and symptoms of sepsis are nonspecific; therefore empirical antimicrobial therapy is promptly initiated after obtaining appropriate cultures. The early manifestations of neonatal sepsis are vague and ill-defined. Novel approaches in the diagnosis of neonatal sepsis include heart rate analysis on ECG, and colorimetric analysis of skin color. Although blood culture is the gold standard for the diagnosis of sepsis, culture reports are available only after 48-72 hours. In this era of multidrug resistance, it is mandatory to avoid unnecessary use of antibiotics to treat non-infected infants. Thus, rapid diagnostic test (s) that include Interleukien-6 (IL-6), neutrophil CD64 index, procalcitonin and nucleated RBC count– and differentiate the infected infants from the non-infected, particularly in the early neonatal period– have the potential to make a significant impact on neonatal care. The aim of this review is to specify the diagnostic criteria, treatment guidelines, and a summary of recent diagnostic tests of sepsis, along with the preventive measures.