Title: Haematological Parameters in Neonatal Sepsis
Authors: Dr Abhilasha Garg, Dr Chandan Kr. Agrawal, Dr Narendra Mogra, Dr Pooja Kanwat, Dr Abha Patni
DOI: http://dx.doi.org/10.18535/jmscr/v3i10.61
Background: In neonatal sepsis, the haematological screening parameters and Creactive protein (CRP) have wide variations in performance. Objective: To evaluate the performance of haematological screening parameters and CRP in blood culture positive neonatal sepsis. Methods: This prospective study was done over a period of one year. Blood samples from 100 clinically suspected neonatal septicemia cases were subjected to aerobic culture and Sepsis screen tests like C-Reactive protein, micro-ESR, total WBC count, Absolute neutrophil count, Immature/Total neutrophil count (I/T) ratio, Immature/mature neutrophil count (I/T) ratio and platelet count. The culture results werecorrelated with the Sepsis screen tests. Results: Of the 100 cases studied, 26%were blood culture positive. 72%were males. 56%were preterm and 40% were very low birth weight neonates. Early onset septicemia was more common, seen in 68% of cases than late onset septicemia (22.4%) cases. E. Coli was the commonest organism isolated in 38.46% of cases followed by klebsiella pneumoniae & staphylococcus aureus. Among the haematological parameters, the positivity was best with ANC & I/T Ratio (84.61%) and the least with platelet count (73.07%). Any 2 or more parameters were positive in 96.15% of the subjects. Conclusion: The sepsis parameters in predicting neonatal septicemia clinically needs further evaluation. Blood culture remains the gold standard for the diagnosis of neonatal septicemia. Combination of two or more sepsis screen parameters has better results in diagnosing neonatal septicemia compared to a single test while awaiting the blood culture results. Keywords: Blood culture, Neonatal septicemia, Sepsis screen. 1. Aggarwal R, Sarkar N, Deorari AK, Paul VK: Sepsis in the newborn. Indian J Pediatr 2001; 68: 1143-1147. 2. Varsha, Rusia U, Sikka M, Faridi MM, Madan N: Validity of hematologic parameters in identification of early and late onset neonatal infection. Indian J Pathol Microbiol 2003; 46:565-8. 3. Mehr S and Doyle LW. Cytokines as markers of bacterial sepsis in newborn infants: a review. Pediatr Infect Dis J 2000; 19: 879-887. 4. Rodwell RL, Leslie AL, Tudehope Dl: Early diagnosis of neonatal sepsis using a Haematological scoring system. J Pediatr, 1988; 112:161-6. 5. Khair KB,Rahman MA,Sultana T,Roy C, Rahman MQ, Shahidullah M, Ahmed AN: Role of hematologic scoring system in early diagnosis of neonatal septicaemia. BSMMU J 2010; 3(2): 62-67. 6. Manroe BL, Weinberg AG, Rosenfeld CR, Browne R. The neonatal blood count in health and disease. I. Reference values for neutrophilic cells. J Pediatr 1979; 95:89-98. 7. National Neonatal-Perinatal Database-2000. National Neonatology Forum, India. 8. Sriram R. Correlation of Blood culture results with the Sepsis score and the Sepsis screen in the diagnosis of Neonatal Septicemia. Int J Biol Med Res. 2011; 2(1): 360-368. 9. Bhat R & Rao A: The performance of haematological screening parameters and CRP in earlyonset neonatal infections. Journal of clinical & diagnostic research 2010; 4(6): 3331-3336. 10. Jaswal RS, Kaushal RK, Goel A, Pathania K. Role of Creactive protein in deciding duration of antibiotic therapy in neonatal septicemia. Indian Pediatr. 2003; 40:880-883. 11. Sharma M, Goel N, Chaudhary U, Aggarwal R, Arora DR. Bacteraemia in Children. Indian J Pediatr. 2002 Dec; 69(12): 1029-32. 12. Benitz WE, Han MY, Madan A, Ramachandra P. Serial serum C-reactive protein levels in the diagnosis of neonatal infection. Pediatrics 1998; 102:e41. 13. Gerdes JS and Polin R. Early Diagnosis and Treatment of Neonatal Sepsis. Indian J Pediatr. 1998; 65(1): 63-78.Abstract
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