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Background: Neonatal sepsis is the third leading cause of neonatal mortality after prematurity and intrapartum related complications worldwide. The literature regarding the use of Mean platelet volume as a diagnostic tool in neonatal sepsis is scanty.Methods: Prospective case control study in a district hospital. Neonates > 30 weeks gestation admitted to NICU during the study period were included. Neonates who did not have any risk factors for sepsis and did not have a positive blood culture or elevated CRP were categorized as group 1. Neonates who were admitted with risk factors of sepsis but did not have a positive CRP or blood culture positivity were categorized as group 2. Neonates who were admitted as probable sepsis and subsequently developed blood culture or CRP positivity were categorized as group 3.Septic workup was done for all the subjects at admission and at 72 hours after admission. Newborn with congenital anomalies and who were already on antibiotics prior to admission were excluded from the study. Statistical analysis was done using Statistical Package of Social Sciences (SPSS) version 20.0.Results: Total 240 Neonates were included in the study. Elevation of MPV in neonates with sepsis was seen as early as the first sample whereas CRP elevation was seen only on Day 3. Cut off value for Mean Platelet Volume (MPV) was found to be 10.15fl with sensitivity of 84% and specificity of 74%.Conclusions: MPV can be used as a earliest diagnostic marker for prediction of neonatal sepsis and mortality. It can facilitate early initiation of treatment without any additional exposure.
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Background: Neonatal sepsis is a frequent and important cause of morbidity and mortality which accounts for one quarter of neonatal deaths. There are very few studies done in India to evaluate the role of MPV as diagnostic marker of neonatal sepsis.Methods: Prospective case control study in a tertiary care hospital. Neonates > 30 weeks gestation admitted to neonatal intensive care unit during the study period of 1 year with clinically suspected were included in the study. Neonates with Septic screen positive and culture positive sepsis were included in group A and normal neonates were included in Group B. MPV was done for all the subjects and values more than 10.2fl was considered positive. Newborns with congenital anomalies and who were already on antibiotics prior to admission were excluded from the study. Statistical analysis was done using Statistical Package of Social Sciences (SPSS) version 17.0.Results: 106 neonates were included in the study. MPV showed statistically significant difference between the study groups (mean 12.8'1.52, 10.82'1.20 respectively) at a cut of value of 10.2fl and a sensitivity of 93%, specificity of 84 % with a positive predictive value of 83% and negative predictive value of 94%.Conclusions: MPV can be used as an adjuvant marker along with established septic screen to ensure early diagnosis and treatment of neonatal sepsis with no additional expense.
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Aim: The aim of the study is to find out the role of common haematological parameters along with micro-ESR, I/T ratio in diagnosis of neonatal sepsis for initiating early management. Methods: This is a descriptive study consisting of 35 neonates admitted at a sophisticated institute with clinical suspicion of septicaemia along with 40 neonates as the comparison group. The neonatal haematological parameters including total leucocytes count, absolute neutrophil count, immature neutrophil count, I/T ratio, platelet count were measured in all the neonates. Micro-ESR was measured as a bed side test. CRP was also measured using slide agglutination method and the results were compared with turbidimetric method. Blood culture was done as a gold standard test for sepsis. Micro-ESR more than age of the patient in days +3 mm in 1st hour was considered significant for sepsis. I/T ratio more than or equal to 0.2 was considered positive for sepsis. Results: The study revealed that micro-ESR and I/T ratio were significantly higher (p<0.001) in suspected cases of septicaemia as compared to the neonates in the comparison group. Sensitivity and specificity of micro-ESR were 87.09% and 75.0% respectively. Sensitivity and specificity of I/T ratio were 93.54% and 95% respectively. Conclusion: Micro-ESR and I/T ratio can be used effectively as cheap and simple tests to screen for septicaemia in neonate which is possible even in a primary health care centre.