Hematological scoring system as an early diagnostic tool for neonatal sepsis

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

doi:10.14238/pi55.6.2015.315-21

Cited by 3 publications

(3 citation statements)

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“…Degenerative changes like cytoplasmic vacuolization and toxic granules of neutrophils are due to continuous stimulation of neutrophils production resulting in rapidly maturing neutrophils. 14 Sensitivity and specificity of the degenerative changes of our study was similar to study done by Aparna and Tussar. 5,11 Thrombocytopenia (platelets count <1,50,000/µl) in sepsis is due to increased platelets destruction, sequestration secondary to infections and reduced megakaryocyte production to damaging effect of endotoxin.…”

Section: Discussionsupporting

confidence: 90%

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Validity of Hematological scoring system in diagnosis of neonatal sepsis at Birat Medical College Teaching Hospital

Bhattarai,

Singh,

Sedhain

et al. 2024

Birat J. Health Sci.

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Introduction: Newborns are vulnerable to infections. Timely diagnosis of neonatal sepsis can avoid major morbidity and mortality. Neonates with sepsis present with non-specific signs and symptoms. Timely diagnosis is important. Though blood culture is gold standard, it consumes time. Hematological scoring system (HSS) using hematological parameters can be effective in early diagnosis of sepsis. Objectives: To evaluate the effectiveness (Sensitivity, specificity, Positive Predictive value (PPV), Negative Predictive value (NPV) of HSS and their individual parameters in diagnosis of neonatal sepsis. Methodology: This was the cross-sectional study done at tertiary care hospital for period of six months. Neonates with clinical suspicion of sepsis were included in the study. Blood was drawn from neonate in two vials, one was sent for culture and other for calculation of hematological parameters as per Rodwell Hematological scoring system. Diagnostic study parameters were calculated. Result: Total of 143 neonates clinically suspected of sepsis were included in the study with 83 having positive blood culture. Highest sensitivity (86.7%) was recorded for Total Polymorph neutrophil (PMN) while highest specificity (93.3) and PPV (81.8) for I: T PMN ratio. A sensitivity of 67.5% and specificity of 91.7% was seen along with PPV of 91.8% and NPV of 67.1% with HSS greater than or equal to 5. Conclusion: HSS of greater than or equal to 5 can be considered to be the reliable screening tool for diagnosis of sepsis.

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Section: Discussionsupporting

confidence: 90%

“…15 14 Sepsis markers like CRP, cytokines and prolactin will give better results if combined together but these are expensive and not available at every health care centre. 14…”

Section: Discussionmentioning

confidence: 99%

Validity of Hematological scoring system in diagnosis of neonatal sepsis at Birat Medical College Teaching Hospital

Bhattarai,

Singh,

Sedhain

et al. 2024

Birat J. Health Sci.

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“…6 Even though blood culture is gold standard test for diagnosing sepsis, the procedure is expensive, time consuming as it takes 48-72 hours, has low yield due to insufficient sample volumes, intermittent or low-density bacteraemia, or suppression of bacterial growth by earlier (i.e., intrapartum) antibiotic administration. [17][18][19] Moreover the technique demands a well-equipped laboratory which is not available in most of the community hospitals. [20][21][22] In the recent past, various markers which are both sensitive and specific like ELISA methods, prolactins, haptoglobins, interleukins, molecular analysis by polymerase chain reaction (PCR) for bacterial DNA etc.…”

Section: Resultsmentioning

confidence: 99%

Diagnostic utility of haematological parameters and C-reactive protein in early detection of neonatal septicaemia in developing countries

2020

IJPO

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Introduction: Septicaemia is one of the major causes of mortality and morbidity during the neonatal period especially in developing countries. Early diagnosis of neonatal sepsis is a diagnostic problem due to non-specific clinical features. Blood culture is the gold standard, but it takes several days and is expensive. Hence there is a critical need for laboratory tests that aid in the rapid diagnosis of neonatal sepsis. Aims and Objectives: To measure the role of Haematological Scoring System and C-reactive protein as an early diagnostic tool for neonatal sepsis. Materials and Methods:This was a prospective study performed on 116 neonates, who were clinically suspected cases of septicaemia, admitted at Neonatal Intensive Care Unit, Yenepoya Hospital, Mangalore. Each hematologic parameter like total leukocyte count, polymorphonuclear neutrophil (PMN) count, immature PMN count, platelet count etc. were analysed in all cases using the Haematological Scoring System (HSS) formulated by Rodwell et al. Blood cultures were performed as a gold standard. C-reactive protein (CRP) was also estimated. Results: Out of 116 neonates, 61(52%) were male neonates and 55(48%) were female neonates. 18(15%) cases were with proven sepsis, 58(50%) cases with probable sepsis and 40(35%) cases were on the safer side. The HSS was found to have a sensitivity of 94.4%, specificity of 75.5%, positive predictive value was 41.4% and negative predictive value was 98.6%. Conclusions: HSS is a rapid, simple and easily affordable screening tool for early detection of neonatal septicaemia. It also provides an effective guideline to make decisions regarding judicious use of antibiotics.

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The Utility of Peripheral Blood Leucocyte Ratios as Biomarkers in Neonatal Sepsis: A Systematic Review and Meta-Analysis

et al. 2022

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BackgroundEarly stage diagnosis of neonatal sepsis (NS) remains a major roadblock due to non-specific symptoms and the absence of precise laboratory index tests. The full blood count is a relatively cheap, universal, and rapid diagnostic test.MethodThis study assessed the diagnostic accuracies of immature-to-total neutrophil ratio (ITR), immature-to-mature neutrophil ratio (IMR), neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR) used in the diagnosis of NS. Included studies were retrieved by searching four major databases and relevant references, and reviewed based on the inclusion/exclusion criteria. Pooled sensitivities and specificities were calculated, I2 was utilized to test for heterogeneity, and the source was investigated via meta-regression analysis.ResultsFinally, 38 studies passed the eligibility criteria. A total of thirty-one studies (6,221 neonates) included data on the ITR, eight studies (1,230 neonates) included data on the IMR, seven studies (751 neonates) included data on the NLR, and two studies (283 neonates) included data on the PLR. The summary sensitivity estimates with 95% confidence interval (CI) for the ITR, IMR, NLR, and PLR tests were, respectively, 0.74 (95% CI: 0.66–0.80), 0.74 (95% CI: 0.54–0.88), 0.73 (95% CI: 0.68–0.78), and 0.81 (95% CI: 0.55–1.00). The summary specificity values for the ITR, IMR, NLR, and PLR tests were 0.83 (95% CI: 0.77–0.87), 0.89 (95% CI: 0.80–0.94), 0.69 (95% CI: 0.57–0.79), and 0.93 (95% CI: 0.81–1.00), respectively. The area under the summary receiver operating characteristic curves for the ITR, IMR, and NLR tests were 0.85 (95% CI: 0.82–0.88), 0.91 (95% CI: 0.88–0.93), and 0.75 (95% CI: 0.71–0.79). The PLR could not be evaluated because only two studies included pertinent data.ConclusionThe NLR test might not be sufficiently accurate in precisely diagnosing NS. The ITR and IMR tests alone can improve the accuracy of NS diagnosis, but the marked heterogeneity and the limited number of studies prevented us from reaching any definitive conclusions. Thus, further studies are warranted to validate these findings.Systematic Review Registration[https://www.crd.york.ac.uk/prospero/], identifier [CRD42021247850].

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Hematological scoring system as an early diagnostic tool for neonatal sepsis

Abstract: Background Sepsis was the leading cause of death in babies by

Cited by 3 publications

References 11 publications

Validity of Hematological scoring system in diagnosis of neonatal sepsis at Birat Medical College Teaching Hospital

Validity of Hematological scoring system in diagnosis of neonatal sepsis at Birat Medical College Teaching Hospital

Diagnostic utility of haematological parameters and C-reactive protein in early detection of neonatal septicaemia in developing countries

The Utility of Peripheral Blood Leucocyte Ratios as Biomarkers in Neonatal Sepsis: A Systematic Review and Meta-Analysis

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