Pruthvi D.1, Pavan Ramarao Kulkarni2, Uma Raghavendra Jamkhandi3, Shivakumar Sanganagouda Inamdar4
BACKGROUND
Neonatal septicaemia is a bacterial infection with positive blood culture in first
four weeks of life. The early sepsis screen is vital as it detects earlier and
benefits the clinician to treat the infection reducing neonatal mortality and
morbidity. We wanted to evaluate various haematological screening parameters
and C-reactive protein (CRP) in blood culture positive neonates in sepsis.
METHODS
This prospective study was conducted for a period of one year. Blood samples
from hundred clinically suspected neonatal septicaemia cases were subjected to
aerobic culture and sepsis screen tests like C-reactive protein, erythrocyte
sedimentation ratio (ESR), total WBC count, absolute neutrophil count, immature
/ total neutrophil count (I / T) ratio and platelet count. The culture results were
correlated with the sepsis screen tests.
RESULTS
Of the hundred cases studied, 18 % were blood culture positive and 66 % were
males. Early onset septicaemia was more common, seen in 64 % of cases than
late onset septicaemia (26 %) cases. Staphylococcus aureus was the commonest
organism isolated in 38.46 % of cases followed by Klebsiella pneumoniae & E.
Coli. Among the haematological parameters, the positivity was best with Creactive
protein (94.44 %) followed by immature & mature neutrophil ratio (I /
M) (94.44 %), I / T ratio (88.88 %) and the least with absolute neutrophil count
(66.0 %). Any two or more parameters were positive in 94.44 % of the subjects.
CONCLUSIONS
Sepsis screen has good sensitivity, specificity and is a valuable aid for early
diagnosis of neonatal septicaemia. Sepsis screen is simple, cost effective, less
time consuming and easy to perform. As an individual test C-reactive protein has
shown highest sensitivity, specificity and is a sensitive and responsive indicator
of neonatal sepsis.
