Role of Haematological Factors in Early Diagnosis of Neonatal Sepsis – A Prospective Study

Abstract

Background: Early onset sepsis is significantly associated with predisposing perinatal risk factors. Various hematological parameters like white blood cell count, absolute neutrophil count, immature to total neutrophil ratio, degenerative changes in neutrophils, platelet count, C -reactive protein and Erythrocyte Sedimentation Rate are good diagnostic tools, which are easily available as rapid screening tests with good sensitivity and negative predictive value. The aim of present study is to evaluate the efficiency of the various blood parameters either alone or in combination in the early diagnosis of the neonatal septicaemia. Methods: The prospective, cross sectional hospital based study conducted over a period of 2 years on 250 newborns. This study was done to find out the predisposing risk factors, utility of sepsis screen to diagnose sepsis that is to evaluate the efficacy of various hematological parameters in diagnosing early onset sepsis. Results: Absolute neutrophil count has 87.5% sensitivity, 83.65% specificity, 51.03% PPV and 79.5% NPV. Platelet count has 93.33% sensitivity, 25% specificity, 25.92% PPV and 93.02% NPV. Creactive protein has 91.45% sensitivity, 85% specificity, 22.05% PPV and 86% NPV. Micro Erythrocyte Sedimentation Rate has 64.44% sensitivity, 51.25% specificity, 20.41% PPV and 76.64% NPV. Conclusion: Various hematological parameters like white blood cell count, absolute neutrophil count, immature to total neutrophil ratio, degenerative changes in neutrophils, platelet count, C-Reactive Protein and Erythrocyte Sedimentation Rate are good diagnostic tools, which are easily available as rapid screening tests with good sensitivity and negative predictive value.

Hematologic Profiles of Ethiopian Preterm Infants With Clinical Diagnoses of Early-Onset Sepsis, Perinatal Asphyxia, and Respiratory Distress Syndrome

“…These tests are easily avail able as rapid screening tests and are reported to have good sensitivity and negative predictive values. 1,2 Hematologic profiles of neonates can be affected by many factors such as complications of prematurity, infection, postnatal fluid shifts, late clamping of the umbilical cord, sampling sites, type of delivery, and the timing of the sample collection. The profile can also be affected by conditions such as hypothermia, asphyxia, and other prematurity related problems.…”

“…These tests are easily available as rapid screening tests and are reported to have good sensitivity and negative predictive values. 1 , 2 …”