Introduction: Neonatal sepsis is the most common cause of morbidity and mortality during 
the neonatal period. Presepsin (P-SEP) is a truncated variant of soluble CD14. Pathogens 
stimulate P-SEP shedding from the surface of various immune cell types. Aim of the work:
to evaluate the accuracy of presepsin as a novel biomarker for bacterial infection diagnosis 
and correlate its level with blood culture, CRP and procalcitonin (PCT) levels. Methods: This 
was a comparative prospective study included eighty neonates admitted to NICU. They were 
divided into two major groups: Group I: it included twenty full term neonates; infants who 
are born after 37 completed weeks. Group II: it included sixty preterm neonates; infants who 
are (<37 completed weeks of gestation), it was classified into three subgroups; Group II A 20 
Low birth weight neonates: 1501- 2500 gm., Group II B 20Very low birth weight neonates: 
1001-1500 gm., Group II C 20 Extremely low birth weight neonates: 500-1000 gm. Results:
P-SEP 2 levels were higher in sepsis group than in non-sepsis group. No significant difference 
in levels of P-SEP 1 was found between the two groups. Presepsin showed more diagnostic 
accuracy than PCT in diagnosis of sepsis: the best cut-off value for Presepsin was 485pg/ml, 
with 97.8% sensitivity and 94.1% specificity. There were statistically significant positive 
correlations between P-SEP 2, PCT and CRP. Conclusion: Serum presepsin has superior 
accuracy than procalcitonin in diagnosis of neonatal sepsis. Recommendation: Presepsin can 
be used as a diagnostic and prognostic marker for neonatal sepsis.