Blood culture positivity for the diagnosis of neonatal sepsis: Is it always necessary

Abstract

Neonatal sepsis is the third leading cause of neonatal mortality and an estimated 3 million newborns suffer from sepsis globally every year. Early diagnosis and treatment will go a long way in reducing the load. However, there is a lack of consensus on the definition and the accepted criteria for diagnosis of neonatal clinical sepsis in practice and research. The objective of this study was to assess the risk factors and laboratory parameters used in diagnosis of neonatal sepsis. A retrospective case control study was conducted among neonates admitted in the NICU. Blood parameters including total leukocyte count, immature/total neutrophil ratio, and C-reactive protein along with blood culture results were analyzed along with neonatal demographics and obstetric history. Although I/T ratio and CRP showed significant correlation with neonatal sepsis, positive blood culture results were found in 8.3% of the cases only. Hence the evaluation for presence of non-bacterial pathogens is an important consideration for a definition of neonatal sepsis and in particular, clinical sepsis.