scholarly journals Evaluation of screening of neonatal sepsis

2018 ◽  
Vol 5 (2) ◽  
pp. 580
Author(s):  
Kartik R. ◽  
Sahana Manjunath ◽  
Prathiba Doddabasappa ◽  
Malavika J.
Keyword(s):  
Blood Culture ◽  
Early Diagnosis ◽  
Sensitivity And Specificity ◽  
Neonatal Sepsis ◽  
Maximum Sensitivity ◽  
Total Leucocyte Count ◽  
Mortality And Morbidity ◽  
Protein Assay ◽  
Sepsis Screen ◽  
Culture Negative

Background: Neonatal sepsis is an important cause of neonatal mortality and morbidity. Early diagnosis of sepsis is difficult due to its non- specific clinical presentation. The gold standard for diagnosis is blood culture, which is obtained in only 25%-40% of cases and requires 48-72 hours. There is a need for a sepsis screen for early diagnosis of septicemia and identification of culture negative cases. The objective of the study was to study the role of sepsis for early diagnosis of septicaemia and identification of culture negative cases and to compare the rapid diagnostic tests with blood culture singly and in combinations for specificity and sensitivity.Methods: 60 cases of suspected septicemia were studied. Total leucocyte count, bandforms peripheral smear examination, C-reactive protein assay, micro-ESR, and blood culture study was investigated. Results: Study revealed that CRP had maximum sensitivity while band neutrophil ratio had balanced sensitivity and specificity. In the two tests, CRP with PS/BF had balanced sensitivity and specificity. In the three tests combination, CRP with TC with micro-ESR had balanced sensitivity and specificity in proven sepsis, While CRP with BF with micro-ESR had balanced sensitivity and specificity in most probable sepsis cases.Conclusions: Neonatal sepsis has vague signs and symptoms, so high index of suspicion helps in arriving early diagnosis and management. CRP had maximum sensitivity in the individual tests. Using either two tests (CRP + PS/BF) or three tests (CRP + Micro ESR + BF/TC) most of the sepsis cases could be identified and sepsis negative cases can be ruled out. Sepsis screen is helpful in avoiding overuse of antibiotics.

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 Role of Sepsis Screening in early diagnosis of Neonatal Sepsis

2017 ◽  
Vol 7 (1) ◽  
pp. 1103-1110 ◽  
Author(s):  
A Lakhey ◽  
H Shakya
Keyword(s):  
Blood Culture ◽  
Early Diagnosis ◽  
Neonatal Sepsis ◽  
Signs And Symptoms ◽  
Statistical Correlation ◽  
Clinical Syndrome ◽  
Total Leukocyte Count ◽  
Invaluable Tool ◽  
Sepsis Screen ◽  
Sepsis Screening

Background: Neonatal sepsis, a clinical syndrome of bacteremia with systemic signs and symptoms of infection in the first 4 weeks of life is a major cause of morbidity and mortality in newborn inborn. Early diagnosis is critical, as sepsis can progress more rapidly in neonates than in adults. An attempt was made to establish correlation between early neonatal sepsis screening & blood culture in neonates presenting with features of sepsis. The aim of this study is to assess the usefulness of sepsis screen in early diagnosis of neonatal septicemia.Materials and Methods: The study was done in Kist medical college and hospital, Nepal from October 2015 to October 2016.  Statistical correlation between early indicators of sepsis screen & blood culture (considered as gold standard) was established in clinically suspicious cases of neonatal sepsis. Results: Out of 150 cases studied, 72 were culture positive. CRP (77.8%) and immature: total neutrophils ratio (73%) showed highest sensitivity. CRP (66.7%), I/T ratio (61.5%) and micro ESR (60.2%) showed highest specificity. Positive predictive value was highest for CRP (68.2%) followed by I/T ratio (63.8%) and corrected total leukocyte count (56.2%)Conclusion: Serum CRP is the most sensitive marker of sepsis. Use of peripheral smear study and CRP can be implicated effectively as a sepsis screen for early diagnosis of neonatal sepsis. The combination of parameters yielded better results than single tests and proved to be an invaluable tool for early diagnosis of neonatal sepsis. 

scholarly journals Neonatal Sepsis-Culture Positive Sepsis Vs Clinical Sepsis

2017 ◽  
Vol 6 (1) ◽  
pp. 1362
Author(s):  
Purbasha Ghosh ◽  
Rabindra Nath Misra ◽  
Retina Paul
Keyword(s):  
Risk Factors ◽  
Staphylococcus Aureus ◽  
Blood Culture ◽  
Neonatal Sepsis ◽  
Gold Standard ◽  
Methicillin Resistance ◽  
High Morbidity ◽  
Sepsis Screen ◽  
Culture Positive ◽  
Culture Negative

<p><strong>Background</strong>: The incidence of sepsis is increasing globally, with high morbidity and mortality. Diagnosis of neonatal sepsis is still a clinical and laboratory challenge. Though blood culture is gold standard, it sometimes gives false negative result. So, judgement of clinical condition along with various investigations is important.</p><p><strong>Objectives</strong>: To find out the risk factors associated with neonatal sepsis, to isolate&amp;amp;identify the pathogens from various clinical specimens and to find out antimicrobial susceptibility of the pathogens.</p><p><strong>Material and methods</strong>: Blood culture, sepsis screen, haematological&amp;amp;biochemical markers, cerebrospinal fluid (CSF) study, radiology, MRSA (methicillin resistance Staphylococcus aureus) surveillance were carried out in this study. Some samples were processed in BacT/ALERT-3D system (BioMerieux ) and identified by VITEK-2 (BioMerieux). Epi Info Software system was used to calculate statistics.</p><p><strong>Results</strong>: One seventy (65.9%) were culture positive and 88 (34.1%) were culture negative out of 258 clinically suspected cases. Methicillin sensitive Staphylococcus aureus (MSSA) 66 (38.82%) was the commonest organism. Among 88 culture negative cases, 38(43.2%) babies were two or more sepsis screen tests positive, 40(45.5%) culture negative babies were with risk factors and 5(5.7%) had radiological evidence of pneumonia.</p><p><strong>Conclusion</strong>: The clinical diagnosis of it remains difficult as the symptoms are nonspecific. So, blood culture is mandatory. Other diagnostic tests also help in this situation. Blood culture is still the "Gold standard" for the diagnosis of septicaemia in neonates, but culture negativity cannot exclude the sepsis as a whole.</p>

scholarly journals Comparison between sepsis markers and blood culture in diagnosis of neonatal sepsis: a prospective study

2017 ◽  
Vol 5 (4) ◽  
pp. 1662
Author(s):  
Vijay Baburao Sonawane ◽  
Nitin Mehkarkar ◽  
Sonali Gaikwad ◽  
Nitin Kadam
Keyword(s):  
Blood Culture ◽  
Neonatal Sepsis ◽  
Gold Standard ◽  
Predictive Accuracy ◽  
Statistical Correlation ◽  
Diagnostic Process ◽  
Mortality And Morbidity ◽  
Sepsis Screen ◽  
A Prospective Study ◽  
Sepsis Detection

Background: Neonatal septicaemia is one of the commonest causes of neonatal mortality and morbidity. Accurate and timely diagnosis of neonatal sepsis remains a major challenge to the pediatricians and neonatologists. In the present study, correlation between sepsis screening and blood culture in neonate presenting with features of sepsis is done to accelerate the diagnostic process and blood culture (considered gold standard) was evaluated as marker for sepsis detection and its effectiveness was compared with other septic markers.Methods: In present study, we emphasize to study early indicators of sepsis screen and their statistical correlation with blood culture (considered as gold standard).Results: As any sepsis screen parameters showed little correlation with blood culture, yet on combination it was found that specificity and positive predictive accuracy increased while sensitivity decreased them individual tests. Also combination of tests yield better results than single tests.Conclusions: The combination of sepsis makers yielded diagnostic results than single tests and proved to be an invaluable aid for early diagnosis of neonatal sepsis.

scholarly journals Role of procalcitonin in early diagnosis of neonatal sepsis

2017 ◽  
Vol 4 (2) ◽  
pp. 383 ◽  
Author(s):  
Fareedul Hasan ◽  
Shamshad A. Khan ◽  
Maharoof M. K. ◽  
Niyaz Muhammed
Keyword(s):  
Blood Culture ◽  
Early Diagnosis ◽  
Neonatal Sepsis ◽  
Predictive Value ◽  
Clinical Signs ◽  
P Value ◽  
Gastric Aspirate ◽  
College Hospital ◽  
Mortality And Morbidity ◽  
Early Onset Sepsis

Background: Neonatal sepsis is the most common cause for neonatal mortality and morbidity in India, Therefore it is essential that we diagnose early onset sepsis using clinical signs and symptoms and rapid diagnostic techniques and start appropriate treatment without any delay. Various diagnostic tests that differentiate infected and non-infected neonates particularly in the first few days of life can potentially make significant impact on the neonatal care.Methods: This was a hospital based clinical prospective study, done in the NICU department of pediatrics at Yenepoya medical college hospital, from January 2013 to December 2013. Sample size in this study was 50. All consecutive neonates fulfilling the inclusion and exclusion criteria were subjected to investigations like serum Procalcitonin, CRP, Total count, Gastric aspirate, Peripheral smear and Blood culture before starting treatment with antibiotics. Positive blood culture was taken as proven sepsis. The results obtained from our study parameters were statistically compared with cases of proven sepsis. Results: In our study 16(32%) out of 50 neonates had proven sepsis. In comparison to the other  markers of neonatal sepsis Elevated levels of serum Procalcitonin was found to be the most sensitive test with sensitivity of 100%, specificity of 50%, positive predictive value of 48.5%and negative predictive value of 100% and with a very highly significant p value of <0.001.Among the levels of PCT moderately elevated (2-10ng/dl) had sensitivity of 100%, specificity of 84.5%, PPV of 62.5% and NPV of 100% and highly elevated (>10ng/dl) had sensitivity of 100%, specificity of 80%, PPV of 75% and NPV of 100%.Conclusions: The use of procalcitonin in the diagnosis of neonatal sepsis has proved to be very useful compared to other regular sepsis markers. Procalcitonin performs better than CRP in the diagnosis of neonatal infection. Serum Procalcitonin levels >2 ng/dl has got a better sensitivity; PPV and NPV thus help us not only in the early diagnosis and also in the prognosis of the treatment and helps us in guiding in reducing the unwanted usage on antibiotics.

scholarly journals Role of serum procalcitonin as a marker for diagnosing neonatal sepsis

2019 ◽  
Vol 6 (5) ◽  
pp. 1991
Author(s):  
Haniya Jafar ◽  
Jyotsna Agarwal ◽  
Raj Kumar Kalyan ◽  
Shruti Radera ◽  
Sheetal Verma ◽  
...  
Keyword(s):  
Blood Culture ◽  
Neonatal Sepsis ◽  
Acute Phase Reactant ◽  
Total Leucocyte Count ◽  
Significant Burden ◽  
Near Term ◽  
Sepsis Screen ◽  
Low Sensitivity ◽  
Sensitivity Specificity

Background: Neonatal sepsis is a continuing problem causing significant burden on health care, especially in developing world. As blood culture has low sensitivity in diagnosis of neonatal sepsis, strong clinical suspicion along with combination of different laboratory tests is required. The data available for extensively studied acute phase reactant, procalcitonin (PCT) remains controversial. This study was done to assess role of PCT alone and in combination with different tests for diagnosing neonatal sepsis.Methods: Blood samples of 275 neonates (>35 weeks of gestation) admitted to NICU, with suspicion of neonatal sepsis were collected for bacterial culture, serum procalcitonin level and sepsis screen (CRP, mESR, I/T ratio, Total Leucocyte Count, Absolute Neutrophil Count).Results: Blood culture was positive in 30.5% of enrolled neonates. At a cut-off value of 0.5 ng/ml the sensitivity, specificity, PPV, NPV of serum PCT in neonatal sepsis cases was 73.8%, 47.1%, 48%, 80.4% respectively. Serum PCT was found raised in 60 (48.8%) clinically suspected cases of neonatal sepsis where sepsis screen and blood culture both were negative, also it was not raised in 17 (32.7%) of clinically suspected cases of septicemia where both blood culture and sepsis screen were positive. Amongst other individual tests, CRP was found to have best sensitivity (79.7%) and NPV (85%) followed by PCT (73.8% and 80.4%) while best specificity was found for I/T ratio (93.7%) followed by mESR (89%) for diagnosis of neonatal sepsis with positive blood culture. Best NPV was seen for combination of PCT+CRP+I/T ratio (95.6%) for the suspected cases of neonatal sepsis.Conclusions: Thus, we conclude that serum PCT can play a useful role when combined with other test markers but may not find its way as a sole diagnostic marker for diagnosing neonatal sepsis in term/near term babies.

Sepsis Screen Questioned

PEDIATRICS ◽  
1981 ◽  
Vol 68 (1) ◽  
pp. 153-153
Author(s):  
Patrick R. Murray
Keyword(s):  
Early Diagnosis ◽  
Erythrocyte Sedimentation Rate ◽  
Sedimentation Rate ◽  
Neonatal Sepsis ◽  
Screening Tests ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Erythrocyte Sedimentation ◽  
Leukocyte Counts ◽  
Sepsis Screen

The article by Philip and Hewitt (Pediatrics 65:1036-1041, 1980) on the early diagnosis of neonatal sepsis was interesting, but their conclusions may be misleading. They demonstrated that when at least two of five screening tests were positive (band/total neutrophils, leukocyte counts, latex C-reactive protein, erythrocyte sedimentation rate (ESR), and latex haptoglobin), neonatal sepsis could be accurately predicted in 28 of 30 (93%) infants. Two or more tests were also positive for 43 of 346 (12%) infants without proven sepsis.

To Study the Clinical Profile of Neonatal Sepsis and the Sensitivity of Various Markers of Sepsis Screen

2014 ◽  
Vol 1 (1) ◽  
pp. 19
Author(s):  
Sagar Sonawane ◽  
Milind Suryawanshi ◽  
Priyanka Patil ◽  
Ravindra Sonawane ◽  
M. K. Tolani
Keyword(s):  
Blood Culture ◽  
Positive Blood Culture ◽  
Neonatal Sepsis ◽  
Clinical Manifestations ◽  
Clinical Profile ◽  
Gastric Bleeding ◽  
Automated Method ◽  
Feed Intolerance ◽  
Sepsis Screen ◽  
A Prospective Study

<strong>Objective:</strong> To study the clinical profile of Neonatal Sepsis &amp; the sensitivity of various markers of sepsis screen. <strong>Material &amp; Methods:</strong> This was a prospective study of neonates admitted to our NICU from January 2010 to October 2011 with diagnosis of neonatal sepsis or those who developed sepsis later on during their stay in NICU. All newborns diagnosed as a case of neonatal sepsis, based on clinical features with positive sepsis screen and/or positive blood culture, were included in our study. Blood Culture &amp; Sensitivity was done with conventional non–automated method using Herley’s Broth. <strong>Result:</strong> Common clinical manifestations of Neonatal Sepsis among the study group were Lethargy (96.36%), Tachypnea (92.73%), Refusal to suck/feeding difficulty (76.36%), Delayed CRT, Poor Pulses (74.55%), Sclerema (61.82%), Gastric Bleeding (45.45%) &amp; Feed Intolerance (45.45%). 46 babies had positive sepsis screen (sensitivity 84%), while 27 babies had a positive blood culture (sensitivity 49.09%).

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 Haematological Parameters in Neonatal Sepsis in a Tertiary Care Centre Study

2021 ◽  
Vol 8 (13) ◽  
pp. 751-754
Author(s):  
Pruthvi D ◽  
Pavan Ramarao Kulkarni ◽  
Uma Raghavendra Jamkhandi ◽  
Shivakumar Sanganagouda Inamdar
Keyword(s):  
Blood Culture ◽  
Absolute Neutrophil Count ◽  
Neutrophil Count ◽  
Neonatal Sepsis ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Neonatal Septicaemia ◽  
Sepsis Screen ◽  
Sensitivity Specificity ◽  
Culture Positive

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. KEYWORDS Blood Culture, Neonatal Septicaemia, Sepsis Screen

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