Kajal Basavaraj Punyashetty1, Tejeshwini Patil2
Neonates are uniquely susceptible to overwhelming bacterial infections. It is very essential to diagnose the sepsis in early phase and it is also important to rule out sepsis to prevent irrational use of antibiotics. Though blood culture is considered as gold standard, it is time consuming with limitation in preterm and has high false negative rates. For the same reason, several rapid haematological tests are done as part of sepsis screen for early diagnosis of neonatal sepsis.
The study was done to establish the role of haematological parameters like Total Leucocyte Count (TLC), Absolute Neutrophil Count (ANC), Immature to Total Neutrophil ratio (I/T ratio), Platelet count, C – Reactive Protein (CRP), Micro-Erythrocyte Sedimentation Rate (m-ESR), either alone or in combination as reliable indicators of septicaemia in clinically suspected neonates.
A prospective study of 100 neonates clinically suspected as having sepsis, who were admitted to NICU, Navodaya Medical College, Hospital and Research Centre, Raichur were included. The above haematological parameters were evaluated and statistically analysed.
Among 100 neonates, only 42 cases were positive for blood culture and were considered true positives. Haematological parameters like TLC, I/T ratio, CRP showed high sensitivity, specificity, positive predictive value and negative predictive value as individually or in combination. ANC and micro-ESR showed low sensitivity but high specificity. Results were promising when tests were done in combination using haematological scoring system.
Irrespective of blood culture-positivity, evaluation of haematological parameters aid in early diagnosis and provide a rational basis for therapy and management of neonatal sepsis.