A Study of Hematological Changes in Neonatal Sepsis

Abstract

Background: Neonatal sepsis is one of the major causes of morbidity and mortality in the newborn. Early diagnosis and treatment are crucial in the management of neonatal sepsis. Blood culture, the gold standard, takes long time and lack sensitivity. Hematological sepsis score is a simple score obtained by combining routinely available tests and is rapid, non-expensive and has shown good correlation with blood culture. With this background the study was carried out to evaluate hematological changes in neonatal sepsis and to analyse the diagnostic utility of hematological scoring system (HSS) and its correlation with C-reactive protein and blood culture in neonatal sepsis. Methods:The study included 200 neonates admitted to Neonatal Intensive Care Unit with clinical suspicion of neonatal sepsis. CBC, Peripheral blood smear, CRP and Blood culture were obtained from all the neonate. Hematological sepsis score was calculated, and its sensitivity and specificity were obtain using blood culture as gold standard.Result: We screened 200 neonates with suspected neonatal sepsis. Blood culture was positive in 101 (50.5%) and HSS score >2 was found in 80 (40%) neonates. CRP and HSS had sensitivity of 84.15% and 72.27% and specificity of 68.68% and 92.92% respectively. Conclusion:Our study shows that HSS had fairly good sensitivity and specificity for neonatal sepsis screening and HHS can be utilized for neonatal sepsis screening.

Utility of Hematological Parameters in Early Diagnosis of Neonatal Sepsis in Comparison to C-Reactive Protein

“…In our study, we found that among the various hematological parameters analyzed, I:T ratio was a better predictor of neonatal sepsis. Similar results were noted in other studies conducted by Nayana and Sreenivas, 11 Nayak et al, 12 and Makadia and Shah 13 ( Table 2 ).…”

“…In this study, CRP had a sensitivity of 47.1%, specificity of 75.9%, NPV of 87.5%, and a PPV of 28.6%. These results are comparable with Nayak et al The discordance on comparing with study performed by Makadia and Shah 13 , Jeyaganguli et al, 14 and Saboohi et al 15 may be due to variation in selected study population.…”

“…These results are comparable with studies performed by Nayak et al 12 and Makadia and Shah. 13 In this study, HSS had a sensitivity of 64.7%, specificity of 15.7%, NPV of 68.4%, and a PPV of 13.6%. The obtained sensitivity and NPV of HSS are comparable with similar other studies performed on neonatal sepsis by Nayak et al 12 and Makadia and Shah.…”

“…The obtained sensitivity and NPV of HSS are comparable with similar other studies performed on neonatal sepsis by Nayak et al 12 and Makadia and Shah. 13…”