scholarly journals Hematological scoring system as an early diagnostic tool for neonatal sepsis

2016 ◽  
Vol 55 (6) ◽  
pp. 315
Author(s):  
Fathia Meirina ◽  
Bidasari Lubis ◽  
Tiangsa Sembiring ◽  
Nelly Rosdiana ◽  
Olga Siregar
Keyword(s):  
Platelet Count ◽  
Blood Culture ◽  
Diagnostic Tool ◽  
Neonatal Sepsis ◽  
Scoring System ◽  
Leucocyte Count ◽  
Degenerative Changes ◽  
Total Leucocyte Count ◽  
Diagnostic Study ◽  
Early Diagnostic

Background Sepsis was the leading cause of death in babies by30%-50% in developing countries. Early diagnosis of neonatalsepsis is still a difficult problem because of clinical features are notspecific. Blood culture is the gold standard, but it takes several daysand is expensive. The hematological scoring system (HSS) consistsof hematologic parameters (leucocyte count, polymorphonuclear(PMN) cells, degenerative changes, and platelet count) for earlydiagnosis of neonatal sepsis.Objective To measure HSS as an early diagnostic tool for neonatalsepsis.Methods A cross sectional study was conducted in March toJune 2013. Samples were collected by consecutive sampling.Fourty neonates suspected sepsis in neonatology unit H. AdamMalik Hospital, Medan, North Sumatera, underwent routineblood count, blood culture, and peripheral blood smear. Eachhematologic parameters were analysed using the HSS of Rodwellet al. The hematologic parameters were total leucocyte count, totalPMN cells, total PMN immature, I:T PMN ratio, I:M PMN ratio,degenerative changes, and platelet count. The total value revealedHSS score. Diagnostic study parameters were calculated.Results Ten of fourty neonates had sepsis based on blood culture􀁕􀁈􀁖􀁘􀁏􀁗􀁖􀀑􀀃􀀷􀁋􀁈􀀃􀀫􀀶􀀶􀀃􀁖􀁆􀁒􀁕􀁈􀀃􀂕􀀗􀀃􀁋􀁄􀁇􀀃􀁖􀁈􀁑􀁖􀁌􀁗􀁌􀁙􀁌􀁗􀁜􀀃􀀛􀀓􀀈􀀏􀀃􀁖􀁓􀁈􀁆􀁌􀁉􀁌􀁆􀁌􀁗􀁜􀀃􀀜􀀓􀀈􀀏􀀃with positive predictive value (PPV) 73%, negative predictivevalue (NPV) 93%, ROC curve showed cut off point 0.902 (95%CI 0.803 to 1.0).Conclusion 􀀶􀁆􀁒􀁕􀁈􀀃􀀫􀀶􀀶􀀃􀂕􀀗􀀃􀁆􀁒􀁘􀁏􀁇􀀃􀁅􀁈􀀃􀁘􀁖􀁈􀁇􀀃􀁄􀁖􀀃􀁄􀁑􀀃􀁈􀁄􀁕􀁏􀁜􀀃􀁇􀁌􀁄􀁊􀁑􀁒􀁖􀁗􀁌􀁆􀀃tool for neonatal sepsis.

scholarly journals Procalcitonin as a diagnostic tool for bacterial neonatal sepsis

2015 ◽  
Vol 55 (5) ◽  
pp. 268
Author(s):  
Nely Nelly ◽  
Guslihan Dasa Tjipta ◽  
Hakimi Hakimi ◽  
Bugis Mardina Lubis
Keyword(s):  
Blood Culture ◽  
Diagnostic Tool ◽  
Neonatal Sepsis ◽  
Predictive Value ◽  
Gold Standard ◽  
Diagnostic Study ◽  
Bacterial Sepsis ◽  
Quick Method ◽  
Reactive Protein ◽  
Early Diagnostic

Background Bacterial sepsis is the main cause of morbidity and mortality in neonates. Early diagnosis and appropriate treatment can reduce the mortality rate. Blood culture is the gold standard for diagnosis of bacterial sepsis, but it requires 3-5 days for results. Since the disease may progress rapidly in neonates, a faster diagnostic test is needed. Measurement of procalcitonin levels may be a quick method to diagnose bacterial sepsis in neonates. Some studies found the sensitivity of procalcitonin to be between 92-100%. Objective To assess the use of procalcitonin as an early diagnostic tool for bacterial neonatal sepsis. Methods This diagnostic study was conducted from October 2011 to February 2012. Forty-three neonates in the Perinatology Unit at H. Adam Malik Hospital were suspected to have bacterial sepsis. They underwent routine blood counts, blood cultures, as well as C-reactive protein and procalcitonin measurements. Subjects were collected by consecutive sampling. The gold standard of sepsis was based on any microorganism found in blood culture. Results Of 43 neonates, 36 neonates had bacterial sepsis. We found that procalcitonin sensitivity was 100%, specificity 85.71%, positive predictive value 97.29% and negative predictive value 100%. The ROC curve showed a cut-off point of 0.929 (95%CI 0.713 to 0.953). Conclusion Procalcitonin is useful as an early diagnostic tool for bacterial neonatal sepsis.

scholarly journals Role of Serial C-reactive Protein (CRP) in Relation to Total Leucocyte Count, Platelet Count & Blood Culture for early Diagnosis of Neonatal Septicemia in Developing Countries

2015 ◽  
Vol 32 (2) ◽  
pp. 61-65
Author(s):  
Chiranjib Barua ◽  
Md Nurul Anwar ◽  
Md Shahidullah ◽  
Shahadat Hossain ◽  
Sharmila Barua ◽  
...  
Keyword(s):  
Developing Countries ◽  
Blood Culture ◽  
Early Diagnosis ◽  
Neonatal Sepsis ◽  
Leucocyte Count ◽  
Control Group ◽  
Total Leucocyte Count ◽  
C Reactive Protein ◽  
Neonatal Septicemia ◽  
Reactive Protein

Neonatal septicemia is a clinical syndrome of systemic illness accompanied by bacteremia occuring in the first 28 days of life. Neonatal septicemia is one of the major causes of neonatal death in developing countries. Early diagnosis and treatment can prevent neonatal mortality and morbidity. The present study includes: 1) usefulness of CRP (C-reactive protein), Total Leucocyte Count, Platelet Count and Blood Culture in early diagnosis of Neonatal Sepsis, 2) significance of serial CRP in diagnosis of neonatal sepsis. 3) the prognostic value of CRP in neonatal sepsis. This is a prospective study done in neonatal ward, Chittagong Medical College Hospital and carried out from January 2008 to January 2011. Sample size was 300. One hundred fifty neonates with suspected sepsis as cases and 150 healthy babies as control were enrolled in this study. Seventy two percent of cases neonates were preterm and low birth weight. Common risk factors for neonatal septicemia which were identified in this study; preterm (72%), low birth weight (72%), premature rupture membrane (60%), chorioamnionitis (26%) and maternal urinary tract infection (16%) . Out of 150 cases of suspected neonatal sepsis total 80.7%% had raised CRP, in initial sample 70.39% were CRP positive and in 2nd sample additional 9.31% case were CRP positive . In control group 91% were CRP negative. CRP was positive in 100% of culture proven sepsis. Sensitivity of CRP was 80.67% and specificity of CRP was 76.44%. Leucocytosis was observed in 7% of cases and leucopenia was found in 11% of cases. In 82 % cases leucocyte count was found normal. In control group, 95% had normal leucocyte count and 5% had leucocytosis but no leucopenia. Sensitivity of leucocyte count was 18% and specificity was 20.68%. Thrombocytopenia was found in 28% of case group. Out of 150 cases only 15.33% yielded growth of organisms in blood culture. Klebsiella was the most common pathogen isolated which was followed by E.coli and Strph. aureus. Sensitivity of blood culture was 15.33% and specificity was 100% Therefore serial CRP can be taken as alternative method for diagnosis of neonatal sepsis specially in developing countries where blood culture is not readily available.J Bangladesh Coll Phys Surg 2014; 32: 61-65

scholarly journals Hematological scoring system as an early diagnostic tool for neonatal sepsis

2015 ◽  
Vol 55 (6) ◽  
pp. 315-321
Author(s):  
athia Meirina ◽  
Bidasari Lubis ◽  
Tiangsa Sembiring ◽  
Nelly Rosdiana ◽  
Olga R. Siregar
Keyword(s):  
Diagnostic Tool ◽  
Neonatal Sepsis ◽  
Scoring System ◽  
Early Diagnostic

Diagnostic Accuracy of Increased Total Leucocyte Count (TLC) And Decreased Absolute Neutrophil Count (ANC) For Diagnosis Of Neonatal Sepsis Taking Culture Sensitivity As Gold Standard

2021 ◽  
Vol 17 (1) ◽  
pp. 08-11
Author(s):  
Ayesha Khanum ◽  
Saima Farhan ◽  
Sundus Arshad ◽  
Arsala Rashid ◽  
Ambreen Kashif ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Absolute Neutrophil Count ◽  
Neutrophil Count ◽  
Neonatal Sepsis ◽  
Leucocyte Count ◽  
Trisodium Citrate ◽  
Health Condition ◽  
Preterm Neonates ◽  
Total Leucocyte Count ◽  
Culture Sensitivity

Objective: To find diagnostic accuracy of increased total leucocyte count (TLC) and decreased absolute neutrophil count (ANC) for diagnosis of neonatal sepsis taking culture and sensitivity as gold standard.Methodology: Samples was collected from all the neonates with suspicion of sepsis admitted to neonatal due to severe bad health condition in the Children Hospital, Lahore. Parents were informed for consent. Total 3.5 cc sample was drawn by venipuncture.2.0 cc in CBC voil containing trisodium citrate, this sample was sent to CBC lab for automated CBC on sysmex KX-21 analyzer and peripheral smear. 1.5 cc was taken in specialized containers for blood culture and was sent to microbiology lab. Neonatal sepsis on TLC, ANC and blood count were be recorded. Patients of sepsis was managed as per hospital protocol. Data was analyzed using SPSS.Results: Neonates in this study was at mean age of 3.86±1.81 days. There was almost equal number of males and females neonates. Male were 155(51.7%) and female babies 145(48.3%). It was noted that 182(60.7%) babies were on term while 118(39.3%) were preterm neonates in this study. Neonatal sepsis was positive on TLC in 101(33.7%) cases. in 115(38.3%) on ANC.It was noted that sensitivity of the TLC was 71% while specificity was 66% with a diagnostic accuracy of 68%. On the other and, ANC sowed a sensitivity as 65%, specificity as 56% and diagnostic accuracy of 65%.Conclusion: Conclusively, TLC and ANC is not a good marker for the taking a neonate for the consideration of neonatal sepsis.

scholarly journals Statistical validity of interleukin-6 as a biomarker for the diagnosis of early-onset neonatal sepsis

2012 ◽  
Vol 3 (1) ◽  
pp. 5 ◽  
Author(s):  
Sriparna Basu ◽  
Shashikant Dewangan ◽  
Shampa Anupurva ◽  
Ashok Kumar
Keyword(s):  
Risk Factors ◽  
Blood Culture ◽  
Cord Blood ◽  
Interleukin 6 ◽  
Neonatal Sepsis ◽  
Early Onset ◽  
Diagnostic Marker ◽  
Statistical Validity ◽  
Sepsis Screening ◽  
Early Diagnostic

Use of empirical antibiotics in neonates with risk factors of early-onset neonatal sepsis (EOS) is a common practice. A laboratory parameter is needed to help in the accurate diagnosis of EOS to avoid unnecessary use of antibiotics. The aim of this prospective observational cohort study was to compare the statistical validity of cord blood interleukin-6 (IL-6) with conventional sepsis screening as an early diagnostic marker for EOS. Eighty-seven neonates with antenatal risk factors for sepsis were followed up for 72 h for the development of EOS. Cord blood was collected for measurement of IL-6 concentrations. Blood culture and conventional sepsis screening (total leukocyte count, absolute neutrophil count, C-reactive protein and micro-erythrocyte sedimentation rate) were sent for analysis soon after delivery. The study group comprised of symptomatic neonates with positive blood culture (n=36). An equal number of gestational-age matched asymptomatic neonates without risk factor of sepsis served as controls. Statistical validity of IL-6 was compared with sepsis screening parameters as the diagnostic marker for EOS. Gram negative organisms were the predominant cause of EOS. The most commonly isolated organism was <em>Acinetobacter baumanii</em>. The sensitivity and specificity of IL-6 with a cut-off value of 40.5 pg/mL and area under curve of 0.959 were 92.3 and 90.48%, respectively. In contrast, the sensitivity and specificity of different parameters of sepsis screening ranged from 37.5-68.75% and 47.95-57.35%, respectively. In conclusion, cord blood IL-6 can be used as a highly sensitive and specific early diagnostic marker of EOS at a cut-off concentration of 40.5 pg/mL.

scholarly journals A Study on Haematological Profile in Clinically Suspected Cases of Neonatal Sepsis

2020 ◽  
pp. 97-101
Author(s):  
S. R. Upadhey ◽  
Avinash M. Mane ◽  
Atul B. Hulwan ◽  
Rohit S. Kadam ◽  
Dhirajkumar Mane
Keyword(s):  
Blood Culture ◽  
Early Diagnosis ◽  
Observational Study ◽  
Neonatal Sepsis ◽  
Scoring System ◽  
Cost Effective ◽  
Clinical Findings ◽  
Culture Positivity ◽  
Blood Culture Positivity ◽  
Haematological Profile

The present study was a two year observational study of haematological profile in clinically suspected cases of neonatal sepsis. Study analyzed the haematological findings according to Rodwell’s haematological scoring system in neonates clinically suspicious of having sepsis. It included 108 neonates admitted in NICU of our hospital during the study period of June 2015 to May 2017. According to clinical findings, Rodwell’s hematological score and blood culture positivity 108 neonates were divided into three groups; proven sepsis, probable sepsis and no sepsis. Study show that Rodwell’s haematological scoring system is a simple, quick, cost effective tool which can be used as screening test for early diagnosis of neonatal sepsis.

scholarly journals Evaluation of Hematological Scoring System (HSS) for Early Diagnosis of Neonatal Sepsis

2016 ◽  
Vol 7 (2) ◽  
pp. 135-138
Author(s):  
Mir Mohammad Yusuf ◽  
BH Nazma Yasmeen ◽  
MAK Azad Chowdhury
Keyword(s):  
Blood Culture ◽  
Negative Predictive Value ◽  
Neutrophil Count ◽  
Neonatal Sepsis ◽  
Predictive Value ◽  
Scoring System ◽  
Very Low Birth Weight ◽  
Hematological Parameters ◽  
Hematological Parameter ◽  
Major Health Problem

Background : Neonatal sepsis is a common occurrence and major health problem in Bangladesh and other developing countries, a devastating cause of morbidity and mortality during first 28 days of life.Objective: This study was carried out to evaluate the efficacy of hematological scoring system (HSS) in the early detection of neonatal sepsis.Study period : June 2014 to December 2014(Six months).Methods : This was a prospective study consisting of 218 neonates admitted at Intensive Care Unit (ICU) Dhaka Shishu Hospital who were clinically suspected to have septicaemia. Newborn babies with major congenital anomaly,inborn error of metabolism, severely jaundiced due to blood group incompatibilities or RDS (due to surfactant deficiency) were excluded. The hematological parameter were measured in all cases. Patients were scored according to hematological scoring system (HSS), incorporating increase or decrease in leucocytes count, absolute neutrophil count, immature neutrophil count (e.g. band form), presence of degenerative changes in neutrophil (e.g. toxic granulation, vacuolation). CRP estimation and blood culture were also performed. Blood culture is considered as gold standard for diagnosis of sepsis. Fourteen out of 128 (11%) had culture proven sepsis. They were predominantly preterm and of very low birth weight. Score of 3 was considered as positive.Results : On evaluation of various hematological parameters the HSS was found to have a sensitively of 71%, specificity of 73%, positive predictive value 24%, negative predictive value 95%.Conclusion: HSS is a simple, quick, readily available effective tool to detect early neonatal sepsis. Considering the high sensitivity, specificity, negative predictive value, this study implies that score ³3 were reliable as a screening tool for early neonatal sepsis.Northern International Medical College Journal Vol.7(2) Jan 2016: 135-138

scholarly journals Evaluation of platelet and its indices as a marker of neonatal sepsis: a prospective case control study

2018 ◽  
Vol 5 (5) ◽  
pp. 1898 ◽  
Author(s):  
Ratana Ram Choudhary ◽  
Mohan Makwana ◽  
Harish Kumar Mourya ◽  
Jagdish Dabi ◽  
Kartika Gulati
Keyword(s):  
Platelet Count ◽  
Blood Culture ◽  
Neonatal Sepsis ◽  
Neonatal Morbidity ◽  
Signs And Symptoms ◽  
Control Group ◽  
Case Group ◽  
Platelet Indices ◽  
Sepsis Screen ◽  
Sepsis Screening

Background: Neonatal sepsis is major cause of neonatal morbidity and mortality worldwide. Blood culture and sepsis screening are currently used method, but their utility is limited due to delayed reporting and increased cost. Platelet indices are one such set of parameters which can be helpful in the future diagnosis of neonatal sepsis. This study was aimed to evaluate the significance of platelet indices either alone or in combination with existing sepsis screen as a marker of neonatal sepsis.Methods: Neonates admitted in the neonatal unit of Hospital and showing signs and symptoms of sepsis, and/or born to mothers with risk factor for sepsis were included in this study. Investigations sent for all these neonates included blood culture, sepsis screen (CRP, micro ESR, TLC, ANC, IT ratio) and platelet indices (Platelet count, MPV, PDW).Results: In present study, 81.12% neonates in case group had platelet count less than 1.5lacs/mm3 while in control group 20.91% neonates only had the same. This difference was statistically significant, (p<0.0001). Similarly, 70.91% neonates in case group had MPV more than >10.8 fl whereas in control group only 26.53% neonates had the same, with difference was statistically significant, (p<0.0001) Similarly, 65.81% neonates in case group and 34.69% in control group had PDW more than 19.1fl and this difference was statistically significant, (p=0.0001).Conclusions: High PDW, high MPV and low platelet count are more associated with neonatal sepsis. So, platelet and its indices may be used as a sensitive marker to identify septic babies and it may be combined with existing sepsis screen to specifically exclude non-septic case.

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