Haematological screening in diagnosis of neonatal sepsis

ABSTRACT

Neonatal sepsis is a clinical syndrome haracterized by bacteremia and clinical symptoms caused micro-organisms or their toxic products Diagnosis is confirmed by growth of micro-organisms in body fluid cultures. When available, blood culture positivity is approximately 40% and takes as long as 48-72 hours. In order to determine the predictive value of simple to performs hematological tests for neonatal sepsis, a prospective randomized study was carried out in 100 neonates who had strong clinical suspicion of sepsis. Thirty normal neonates served as controls Role of TLC, DLC, Absolute Neutrophil Count ANC, IT ratio, platelet counts and degenerative morphological changes was determined. Out of 100 clinically suspected cases, 40 neonates were proved to be septic by blood culture and 60 neonates were of probable sepsis [strong clinical suspicion despite negative culture]. An abnormal ANC was found to be the most sensitive [67%], single parameter for prediction of neonatal sepsis followed by elevated LT ratio and thrombocytopenia Derangement of either ANC or IT ratio had sensitivity of 80% higher sensitivity was found in cases of late onset sepsis. Combination of abnormal ANC and elevated IT ratio scents reasonable as a surrogate parameter for neonatal sepsis especially in the late onset type