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Neonatal sepsis, one of the main causes of neonatal morbidity and mortality (1), is a complex clinical syndrome occurring in 1-8.6/1000 live births (2) as a result of the systemic inflammatory response to infection during the neonatal period (3). Early onset sepsis (EOS) is defined as sepsis occurring during the first 72 hours of life as a fetal response to an ascending infection (from the birth canal) or to the hematogenous dissemination of a maternal infection (4). Sepsis is a complex condition initiated by a pathogen and mediated by cytokines followed by immune, inflammatory, and coagulation homeostasis disturbances, its evolution being dictated by a complicated balance between pro inflammatory and anti inflammatory factors (5) Most of the short and long-term complications of the neonatal sepsis are strictly related to inflammatory mediators. Neonatal sepsis is associated with a mortality rate that ranges from 13 to 60% (6,7) in spite of improved antibiotic therapy and care and an increased morbidity in survivors. “Suspected sepsis” is one of the most frequently encountered diagnosis in neonatology because: a) a large number of newborns are evaluated for early or late sepsis based on risk factors and for fear of missing a correct diagnosis and a prompt treatment (8); b) in neonates, the clinical signs of infection are not specific, late, and the differential diagnosis with neonatal respiratory distress syndrome, aspiration syndromes, or neonatal maladaptation to extrauterine life is difficult (8-10); c) blood culture the golden standard in neonatal sepsis diagnosis provides late information, has a poor accuracy, and is not universally available (11); and d) we do not have yet an ideal diagnostic tool for neonatal infection (12). Therefore, diagnosis of neonatal sepsis is still a challenge for neonatal medicine. Antibiotic therapy is often initiated based upon clinical suspicion and/or the presence of risk Course Notes

Complete blood count and differential in diagnosis of early onset neonatal sepsis