Validity of hematologic parameters in identification of early and late onset neonatal infection.
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.
Varsha
Department of Pathology, University College of Medical Sciences & G.T.B Hospital, Shahdra, Delhi.
Rusia
Usha
U
Sikka
Meera
M
Faridi
M M A
MM
Madan
Nishi
N
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*
D002097:C-Reactive Protein