Our results suggested that C1236T polymorphism in ABCB1 gene was associated with steroid resistance. A higher proportion of SR children had C1236T TT genotype and T allele, these patients may require other therapeutic strategies.

16S rRNA gene amplification by real time PCR and sequence analysis could be served as ideal and reliable genetic-based methods to diagnose and rule out sepsis with provision of additional data that cannot be obtained by routine laboratory tests with a shorter turnaround time than those with culture-based protocols.

Sepsis is a life-threatening condition associated with high morbidity and mortality rates among neonates. Clinical diagnosis is limited due to the neonates’ unspecific signs and symptoms as well as the long time required to obtain the blood culture results. Consequently, there is an urgent need for new biomarkers to early diagnose neonatal sepsis. We aimed to evaluate Neutrophil Gelatinase-Associated Lipocalin (NGAL) diagnostic performance to detect neonatal sepsis. We enrolled 30 neonates with sepsis admitted to the neonatal intensive care units and 30 age- and sex-matched healthy neonates recruited from the neonatal outpatient clinic during their routine follow-up visits. We measured NGAL levels by sandwich enzyme-linked immunosorbent assay, the C-reactive protein (CRP) with nephelometry technique using BN II nephelometer, and the complete blood count by Mindray BC-6800 analysers. NGAL, CRP, TLC, haemoglobin, and platelet levels showed significant differences between cases and control (all p < .001). Of the 30 neonates with sepsis, 17 neonates (56.7%) survived. At 0 h, the NGAL level showed no statistically significant difference between the non-survivors and survivors’ groups; however, after 96 h, NGAL was significantly higher in the non-survivors group ( p ˂ .001). Our diagnostic analysis showed that NGAL levels have strong discrimination power to early differentiate neonates with sepsis; at the 475.00 pg/ml cut-off value, NGAL showed both sensitivity and specificity of 100% with an area under curve of 100%. Conclusion: Our study suggests that NGAL could be a promising biomarker for neonatal sepsis detection. Further studies with larger sample sizes and survival analysis are warranted to confirm this finding and to clarify the efficacy of NGAL in survival prediction. Key findings NGAL level was high in neonates with sepsis NGAL level was high in non-survived neonates NGAL could be a promising diagnostic marker for sepsis

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Background: Meningitis is a life-threatening inflammatory disease of the meninges. If not treated, bacterial meningitis can lead to brain swelling, permanent disability, coma and even death. To reduce the morbidity and mortality related to bacterial meningitis, it is important to differentiate septic meningitis from aseptic meningitis during the acute phase of the disease. Objectives: To evaluate the role of serum procalcitonin (PCT) in the differential diagnosis of septic and aseptic meningitis and to evaluate serum procalcitonin as a prognostic marker for meningitis severity and the success of meningitis treatment plan. Methodology: This study was conducted on total number of 63 subjects that were subdivided into three groups, 25 patients with septic meningitis (groupI), 20 patients with aseptic meningitis (group II) and 18 age and sex matched subjects without CNS diseases as control (group III). All subjects were subjected to full history taking, clinical examination and laboratory investigations. Serum PCT was measured for all the study subjects using ELISA method. Results: Serum PCT at cut off level >0.180 ng/dL clearly distinguished patients with meningitis from control group (P-Value <0.001) while at cut off level >0.492 ng/dL differentiate patients with septic meningitis from those with aseptic meningitis with 100% sensitivity and specificity (P-Value <0.001). All cases that had bad outcome had higher level of PCT than cured cases even after treatment. The most frequently detected organisms in septic meningitis group were St. pneumoniae (28%), Staph. aureus (16%), K.pneuominae (16%), E. coli (12%) and N. meningitides (8%). About 85% of isolated Enterobacteriaceae species were potential ESβLs-producers. 25% of K. pneumoniae isolates were MβLs-producing, E.coli was 100% sensitive to Carbapenems group and Amikacin while K.pneumoniae showed only 75% sensitivity to Carbapenems group and 100% of S. aureus isolates were MRSA. Sensitivity to the new therapeutic drugs was 100% for linezolid and teicoplanin for S. aureus and St. pneumonia. The most frequently detected organisms in aseptic meningitis were Cryptococcus neoformans (5%) and Herpes simplex 1/2 viruses (10%). Conclusion: Serum PCT level can be used as a diagnostic and prognostic marker in patients with meningitis. It can also differentiate between septic and aseptic meningitis

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