Background: Neonatal sepsis is defined as a systemic inflammatory response elicited by blood-stream infection. It is associated with high morbidity and mortality, especially during the first 28 days of life [neonatal period], particularly in resource limited settings.
Aim of work: The aim of the work was to evaluate serum level of carnitine in neonate with sepsis. In addition, to study the relation between L-carnitine concentration with birth data and the presence of neonatal sepsis.
Subjects and methods: This was a case control study, which was conducted at Al-Azhar University Hospital [New Damietta; Egypt]. It included 60 neonates, 30 with neonatal sepsis [the sepsis group], and 30 without sepsis [control group]. All were carefully evaluated by neonatal and maternal history taking, clinical examination and laboratory workup. Serum-L-carnitine was measured and values were compared between groups and correlated with other variables. The predictive power of L-carnitine in diagnosis sepsis and prediction of its associated mortality was calculated.   
Results: L-carnitine levels were significantly reduced in sepsis than healthy controls [3.6±0.99 vs. 15.3±2.1 mg/l]. Serum carnitine less than 4.69 had a significant value for sepsis prediction with sensitivity of 90%, specificity of 70% and area under curve of 0.83. In addition, serum carnitine less than 2.97 had a significant value for prediction of mortality [sensitivity of 80%, specificity of 89% and area under curve equal 0.86]. sepsis associated mortality was 16.7%. Finally, there was moderate negative significant correlation between serum carnitine with C-reactive protein [r=-0.68] and total leucocyte count [r=-0.44]; while, there was mild positive significant correlation between serum carnitine and birth weight [r=-0.26] and hemoglobin [r=0.27].   
Conclusion: L-carnitine is significantly reduced in neonatal sepsis and it can be used as predictor for neonatal sepsis and sepsis-related mortality.