title: Validity of hematologic parameters in identification of early and late onset neonatal infection.
abstract: This study was designed to evaluate the utility of hematological parameters and C-reactive protein (CRP) to formulate a sepsis screen to detect sepsis in early and late onset infection. Hundred and fifty neonates clinically suspected of bacterial infection, based on risk factors and/or clinical features were selected for the study. Blood was collected by venipuncture at the time of admission in all neonates. A total leukocyte count (TLC), differential leukocyte count (DLC), its derivatives [Total neutrophil count (TNC or T), ratio of immature to total neutrophil count (I/T), ratio of immature to mature neutrophil count (I/M)] and CRP were obtained. TLC = 10x10(9)/L, TNC = 8x10(9)/L, I/T = 0.16, I/M = 0.25 and CRP = 0.6 mg/dl were found to be good parameters in detection of sepsis. During the first three days of life leukopenia, neutropenia, elevated I/T ratio, elevated I/M ratio and CRP were good diagnostic aids while after 3 days of life CRP was the best single test. This emphasizes use of multiple indicators for detection of sepsis. Using these parameters a sepsis screen was formulated which detected >90% of proven early and late onset sepsis suggesting that other neonates with positive sepsis screen but blood culture negativity may have been truly infected.
authors.affiliation: Department of Pathology, University College of Medical Sciences & G.T.B Hospital, Shahdra, Delhi.
authors.lastname: Varsha
authors.forename: Usha
authors.initials: U
authors.lastname: Rusia
authors.forename: Meera
authors.initials: M
authors.lastname: Sikka
authors.forename: M M A
authors.initials: MM
authors.lastname: Faridi
authors.forename: Nishi
authors.initials: N
authors.lastname: Madan
mesh_terms: D017668:Age of Onset; D002097:C-Reactive Protein / Q000032:analysis; D016022:Case-Control Studies; D006801:Humans; D007231:Infant, Newborn; D007958:Leukocyte Count; D011446:Prospective Studies; D012307:Risk Factors; D018805:Sepsis / Q000097:blood* / Q000175:diagnosis*
chemical_list: D002097:C-Reactive Protein