Comparative evaluation of C-reactive protein, blood gas pH, and lymphocyte profiles in differentiating neonatal sepsis from hyperbilirubinemia-associated leukocytosis: A retrospective cohort study at Al-Jalaa Maternity Hospital, Libya

Narjes Mabrouk  El Osta; Abdulmonam  Elmuzoughi; Mohamed  Algazere; Fathi  Alshourif; Ayad Abud

doi:10.51984/yt67hy91

Authors

Narjes Mabrouk El Osta Department of Medical Laboratory Sciences, Faculty of Medical Technology, University of Tripoli, Tripoli
Abdulmonam Elmuzoughi Department of Medical Laboratory Sciences, Faculty of Medical Technology, University of Tripoli, Tripoli
Mohamed Algazere Department of Medical Laboratory Sciences, Faculty of Medical Technology, University of Tripoli,
Fathi Alshourif Department of Medical Laboratory Sciences at the Faculty of Medical Technology, University of Tripoli,
Ayad Abud Department of Medical Laboratory Sciences, Faculty of Medical Technology, University of Tripoli,

DOI:

https://doi.org/10.51984/yt67hy91

Keywords:

Antimicrobial stewardship, Blood gas, Hyperbilirubinemia, Leukocytosis, Neonatal sepsis

Abstract

Differentiating neonatal sepsis from non-infectious leukocytosis in jaundiced newborns is difficult and may promote unnecessary antibiotic use. This retrospective cohort study evaluated C-reactive protein (CRP), blood gas pH, and absolute lymphocyte count in 135 neonates admitted to Al-Jalaa Maternity Hospital, Tripoli, from March to October 2025. The cohort included isolated sepsis (n = 96), sepsis with jaundice (n = 35), and isolated hyperbilirubinemia with automated leukocytosis (n = 4). Groups were compared using Kruskal-Wallis and Dunn-Bonferroni tests. Isolated jaundice showed markedly higher automated white blood cell counts than isolated sepsis (52.78 ± 0.20 vs. 17.01 ± 7.22 × 10⁹/L; P = 0.0031), but normal CRP (5.00 ± 0.00 mg/L), physiological pH (7.42 ± 0.00), and preserved lymphocytes (9.41 ± 0.42 × 10⁹/L). This group had no mortality and shorter hospitalization despite universal antibiotic exposure. A combined CRP-pH-lymphocyte profile may distinguish true sepsis from non-infectious or spurious leukocytosis and support antimicrobial stewardship.

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Author Biographies

Narjes Mabrouk El Osta, Department of Medical Laboratory Sciences, Faculty of Medical Technology, University of Tripoli, Tripoli

Narjes Mabrouk El Osta is an assistant lecturer in the Department of Medical Laboratory Sciences (physiology specialization) at the Faculty of Medical Technology, University of Tripoli.
Personal Characteristics:

Narjes M. A. El Osta is an Assistant Lecturer at the Department of Medical Laboratory Sciences, Faculty of Medical Technology, University of Tripoli, Libya. She holds a Master's degree (physiology specialization) and serves as the principal investigator and academic supervisor of this study. Her research interests focus on neonatal hematology, clinical biochemistry parameters, and personalized phytotherapy. In this work, she designed the research protocol, supervised the retrospective data collection at Al-Jalaa Maternity Hospital, conducted the data analysis, and drafted the final manuscript.
Abdulmonam Elmuzoughi, Department of Medical Laboratory Sciences, Faculty of Medical Technology, University of Tripoli, Tripoli

Abdulmonam Elmuzoughi is an undergraduate student at the Department of Medical Laboratory Sciences, Faculty of Medical Technology, University of Tripoli, Libya. He participated in this study as a research assistant responsible for the retrospective collection, review, and organization of neonatal clinical records and laboratory data from Al-Jalaa Maternity Hospital archives.
Mohamed Algazere, Department of Medical Laboratory Sciences, Faculty of Medical Technology, University of Tripoli,

Mohamed Algazere is an undergraduate student at the Department of Medical Laboratory Sciences, Faculty of Medical Technology, University of Tripoli, Libya. He participated in this study as a research assistant responsible for the retrospective collection, review, and organization of neonatal clinical records and laboratory data from Al-Jalaa Maternity Hospital archives.
Fathi Alshourif, Department of Medical Laboratory Sciences at the Faculty of Medical Technology, University of Tripoli,

Dr. Fathi Mohamed Al-Shuwayrif is an Assistant Professor of Hematology and Head of the Department of Medical Laboratory Sciences at the Faculty of Medical Technology, University of Tripoli, Libya. He is a senior specialist in clinical hematology and blood disorders, with extensive experience in supervising academic research and laboratory training. In this study, he provided expert guidance on analyzing blood data and investigating blood count abnormalities in newborns.
Ayad Abud, Department of Medical Laboratory Sciences, Faculty of Medical Technology, University of Tripoli,

Dr. Ayad Abud is a lecturer at the Department of Medical Laboratory Sciences, Faculty of Medical Technology, University of Tripoli, Libya. He actively contributes to teaching and research within the health and medical sciences sector. In this study, he served as a co-author, participating in the intellectual review, data validation, and the final refinement of the manuscript.