Hematological scoring system as an early diagnostic tool for neonatal sepsis

Meirina, athia; Lubis, Bidasari; Sembiring, Tiangsa; Rosdiana, Nelly; Siregar, Olga Rasiyanti

doi:10.14238/pi55.6.2015.05

Cited by 4 publications

(3 citation statements)

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“…28 The HSS more than or equal to 4 was more significant in early diagnosis of neonatal sepsis compared to CRP and procalcitonin level with p=0.001. 29 This was also similar to this study which shows that combination of hematological parameters with 48 hours CRP was good to exclude sepsis ( Table 3 and 6).…”

Section: Discussionsupporting

confidence: 89%

Modified hematological sepsis score: an easy and cost effective measure to combat neonatal septicemia

Varughese

2020

Int J Res Med Sci

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Background: Early diagnosis of neonatal sepsis continues to be a problem because of subtle and non-specific clinical features. Blood culture is the gold standard, but it takes several days and is expensive. The hematological scoring system (HSS) consisting of different blood parameters could be an effective and simple method to help diagnose and treat neonatal sepsis. Aim of the present study was undertaken to highlight the importance of HSS in the early diagnosis and evaluation of neonatal septicaemia.Methods: This was a prospective study done in a peripheral hospital in Kerala. The inclusion criteria involved all inborn babies above 34weeks gestation. Exclusion criteria involved babies with congenital anomalies, congenital heart diseases, pathological jaundice, birth weight less than 2kg and babies requiring NICU admission, 550 babies were included in the study. Cord CRP and 48 hours CRP was taken. At 48 hours, blood samples were also taken for Total count (TC), Absolute Neutrophil Count (ANC), Platelet count, and peripheral smear. Blood culture was taken for babies suspected to have sepsis and started on antibiotics. The screening parameters were assessed for individual performance and in combination.Results: Individually, though parameters like TC, ANC, 48 hrs CRP and platelet count had excellent sensitivity (100%) and NPV (100%), their specificity was low 65%-82%. Degenerative changes showed sensitivity 94.1%, specificity 91% and NPV 99.8%. HSS score >5 and >6 had better specificity and NPV.Conclusions: HSS scoring can be used to safely exclude neonatal sepsis, thus avoiding unnecessary antibiotic exposure in newborns and undue worry for parents.

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Section: Discussionsupporting

confidence: 89%

Modified hematological sepsis score: an easy and cost effective measure to combat neonatal septicemia

Varughese

2020

Int J Res Med Sci

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“…However, most of the infants have not had a fully developed granulopoietic system yet. 22 That fact could be an answer to the low percentage of sepsis neonates who had vacuolization and toxic granule in this study.…”

Section: Discussionmentioning

confidence: 77%

The characteristics of neonatal sepsis in Low Birth Weight (LBW) infants at Sanglah General Hospital, Bali, Indonesia in 2018

Suismaya

Artana

2020

Intisari Sains Medis

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Background: Sepsis is one of the most common causes of mortality and long terms morbidity among infants. It is known to be related to Low Birth Weight (LBW) due to the lack of immunity function to resist the infection. This study aims to identify the characteristics of neonatal sepsis in LBW infants in Sanglah General Hospital.Method: A retrospective cross-sectional study was conducted in the Neonatal Care Unit, Sanglah General Hospital, during January-December 2018 period among 135 neonates. Samples were taken using total sampling for neonates who had LBW and diagnosed with sepsis. Uncompleted data and voluntarily discharge patients were excluded from the study. Data regarding baseline characteristics of respondents, major and minor risk factors, laboratory results of sepsis, as well as blood culture, were analyzed using SPSS version 23 for Windows.Result: Most of respondents were male (54.1%), followed by bodyweight 1,500-2,499 grams (58.5%), and preterm labor (<32 weeks) (86.7%). The average length of stay was 21.30Â±19.28 days. The vast majority of infants diagnosed as Early Onset Sepsis (EONS) (89.6%). Most of the patients had normal leukocyte count (93.3%), neutrophilia (95.6%), low I/T ratio (70.4%), normal platelets (67.4%), and high procalcitonin (98.5%). The blood culture showed the most microorganism was Enterococcus faecalis (6.00%) in gram-positive bacteria.Conclusion: This study found that most of the respondents were male, followed by preterm labor, EONS, normal leukocyte count, low I/T ratio, high procalcitonin, as well as Enterococcus faecalis as the most common gram-positive bacteria.Â

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“…This finding is consistent with that of other studies. [13][14][15][16] In this study, neonates mostly presented with chief complaints of poor feeding (60%) and fever (60%). Studies have suggested that the clinical presentation of neonatal sepsis is quite nonspecific 3,16 and thus clinicians need to be more alert while handling these cases.…”

Section: Discussionmentioning

confidence: 99%

Use of hematological parameters as an early screening tool for neonatal sepsis

et al. 2021

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Background: Neonatal sepsis continues to be a major public health problem in developing countries. Due to the nonspecific clinical manifestations of neonatal sepsis, the longer turnaround time for culture reports, an early diagnostic tool is essential for the initiation of appropriate and timely treatment. Materials and Methods: This is a cross-sectional study of 470 clinically suspected cases of neonatal sepsis admitted in the pediatrics department of B.P. Koirala Institute of Health Sciences, Dharan, Nepal. Following hematological parameters: abnormal total leucocyte count, abnormal total polymorphonuclear count, elevated immature Neutrophils count, elevated immature to total neutrophil ratio, immature to mature neutrophils ratio ≥ 0.3, platelet count ≤ 150,000/mm3, and pronounced degenerative changes in Neutrophils were assessed and a score of 1 was assigned to each as per the hematological scoring system of Rodwell. A score ≥ 3 was considered positive and a score < 3 was considered negative for the diagnosis of sepsis. Blood culture was taken as a gold standard for diagnosis of neonatal sepsis Results: Hematological scoring system had fairly high sensitivity, specificity, NPV, and PPV; i.e. 85.96%, 84.26%, 84.52%, and 85.71% respectively. The diagnostic accuracy of HSS was high (85.1%) in comparison to the maximum diagnostic accuracy of individual hematological parameters, i.e. 74.46% for the total neutrophil count. Conclusions: Hematological scoring system can be used as a convenient and early diagnostic tool against neonatal sepsis in developing countries with a high burden of neonatal sepsis because of its high sensitivity and easy availability.

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Hematological scoring system as an early diagnostic tool for neonatal sepsis

Cited by 4 publications

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Modified hematological sepsis score: an easy and cost effective measure to combat neonatal septicemia

Modified hematological sepsis score: an easy and cost effective measure to combat neonatal septicemia

The characteristics of neonatal sepsis in Low Birth Weight (LBW) infants at Sanglah General Hospital, Bali, Indonesia in 2018

Use of hematological parameters as an early screening tool for neonatal sepsis

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