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Category: Volume 06 Issue 02 February 2018
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Title: Role of Sepsis Screening in Early Diagnosis of Neonatal Sepsis

Authors: Dr Priyanka Bhardwaj, Dr (Brig) Vinod Raghava, Dr Uma Sharma

 DOI:  https://dx.doi.org/10.18535/jmscr/v6i2.196

Abstract

Introduction: Neonatal sepsis, a clinical syndrome of bacteremia with systemic signs and symptoms of infection in the first 4 weeks of life is a major cause of morbidity and mortality in newborn. Early diagnosis is critical, as sepsis can progress more rapidly in neonates than in adults. An attempt was made to establish correlation between early neonatal sepsis screening & blood culture in neonates presenting with features of sepsis. The aim of this study is to assess the usefulness of sepsis screen in early diagnosis of neonatal septicemia.

Materials and Methods: The study was done in SGT Medical College and Hospital, Gurugram from January 2016 to January 2017. Statistical correlation between early indicators of sepsis screen & blood culture (considered as gold standard) was established in clinically suspicious cases of neonatal sepsis.

Results: Out of 100 cases studied, 38 were culture positive. Markers like CRP (77.8%) and ratio of immature cells versus total neutrophils (I/T ratio) (73%) showed highest sensitivity. CRP (66.7%), band forms and I/T ratio (61.5%) showed highest specificity. Positive predictive value was highest for CRP (68.2%) followed by I/T ratio (63.8%) and corrected total leukocyte count (56.2%).

Conclusion: Serum CRP is the most sensitive marker of sepsis. Use of peripheral smear study and CRP can be implicated effectively as a sepsis screen for early diagnosis of neonatal sepsis. The combination of parameters yielded better results than single tests and proved to be an invaluable tool for early diagnosis of neonatal sepsis.

Keywords: Blood culture; CRP, I/T ratio; Band forms; Neonatal sepsis; Sepsis screening.

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Corresponding Author

Dr Priyanka Bhardwaj

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