Utility of Sepsis Screen in the Early Diagnosis of Neonatal Sepsis
Introduction: Neonatal sepsis could be defined as a clinical entity because of generalized bacterial infection within 28 days of life and showing a positive blood culture. It is probably responsible for 30- 50% of the total neonatal deaths each year. Timely diagnosis of neonatal sepsis is criti...
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| Format: | Article |
| Language: | English |
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JCDR Research and Publications Pvt. Ltd.
2016-07-01
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| Series: | Indian Journal of Neonatal Medicine and Research |
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| Online Access: | http://www.ijnmr.net/articles/PDF/2178/18541_F(P)_PF1(Vsu_Om)_PFA(GH)_PF2(VsuGH).pdf |
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| author | Chandrashekhar P Bhale Apurva Vasant Kale Sachin S Kale Meera Mahajan Smita S Mulay |
| author_facet | Chandrashekhar P Bhale Apurva Vasant Kale Sachin S Kale Meera Mahajan Smita S Mulay |
| author_sort | Chandrashekhar P Bhale |
| collection | DOAJ |
| description | Introduction: Neonatal sepsis could be defined
as a clinical entity because of generalized bacterial
infection within 28 days of life and showing a positive
blood culture. It is probably responsible for 30-
50% of the total neonatal deaths each year. Timely
diagnosis of neonatal sepsis is critical because in
neonates the illness can progress more rapidly than
adults. The blood culture report takes at least 72
hours. Therefore, a simple test with quick availability
of results can be helpful to reduce neonatal morbidity
and mortality.
Aim: To evaluate the utility of sepsis screen in early
diagnosis of neonatal septicemia and to study various
hematological parameters, changes in peripheral
blood smear, evaluate the performance of microerythrocyte sedimentation rate, serum C-reactive
protein and serum direct bilirubin in neonates with
clinical suspicion of sepsis.
Materials and Methods: The present, study was
done in our institute from October 2013 to October
2015. CBC was done on 191 clinically suspected
cases of neonatal sepsis along with Micro ESR,
Serum CRP and direct bilirubin. Differential leukocyte
count, absolute neutrophil count, immature
neutrophils: total neutrophils ratio was done from
Field stained peripheral smears. Blood culture was
done in Microbiology Department. Exclusion criteria
were neonates with major congenital anomalies and
those who have already received antibiotics.
Statistical Analysis: Statistical analysis was done
using SPSS software, version 20th and unpaired ‘t’-
test.
Result: Out of 191 cases studied, 91 were culture
positive. CRP (84.6%) and immature : total neutrophils
ratio(75.8%) showed highest sensitivity, Whereas
absolute neutrophil count(99.0%) along with serum
direct bilirubin (93.0%) and corrected total leucocyte
count (93.0%)showed highest specificity. Positive
predictive value was highest for absolute neutrophil
count (97.5%) and CRP (84.8%).
Conclusion: Serum CRP is the most sensitive
marker of sepsis. Use of peripheral smear study,
serum direct bilirubin and micro ESR together with
CRP can be used effectively as a sepsis screen for
early diagnosis of neonatal sepsis. |
| first_indexed | 2024-12-10T14:20:35Z |
| format | Article |
| id | doaj.art-d54653720cc642d38a96f97304a72a8f |
| institution | Directory Open Access Journal |
| issn | 2277-8527 2455-6890 |
| language | English |
| last_indexed | 2024-12-10T14:20:35Z |
| publishDate | 2016-07-01 |
| publisher | JCDR Research and Publications Pvt. Ltd. |
| record_format | Article |
| series | Indian Journal of Neonatal Medicine and Research |
| spelling | doaj.art-d54653720cc642d38a96f97304a72a8f2022-12-22T01:45:13ZengJCDR Research and Publications Pvt. Ltd.Indian Journal of Neonatal Medicine and Research2277-85272455-68902016-07-0143IO01IO0710.7860/IJNMR/2016/18541.2178Utility of Sepsis Screen in the Early Diagnosis of Neonatal SepsisChandrashekhar P Bhale0Apurva Vasant Kale1Sachin S Kale2Meera Mahajan3Smita S Mulay4Professor, Department of Pathology, M. G. M. Medical College and Hospital, Aurangabad, India.Resident, Department of Pathology, M. G. M. Medical College and Hospital, Aurangabad, India.Associate Professor, Department of Pathology, M. G. M. Medical College and Hospital, Aurangabad, India. Assistant Professor, Department of Pathology, M. G. M. Medical College and Hospital, Aurangabad, India.Professor and Head, Department of Pathology, M. G. M. Medical College and Hospital, Aurangabad, India.Introduction: Neonatal sepsis could be defined as a clinical entity because of generalized bacterial infection within 28 days of life and showing a positive blood culture. It is probably responsible for 30- 50% of the total neonatal deaths each year. Timely diagnosis of neonatal sepsis is critical because in neonates the illness can progress more rapidly than adults. The blood culture report takes at least 72 hours. Therefore, a simple test with quick availability of results can be helpful to reduce neonatal morbidity and mortality. Aim: To evaluate the utility of sepsis screen in early diagnosis of neonatal septicemia and to study various hematological parameters, changes in peripheral blood smear, evaluate the performance of microerythrocyte sedimentation rate, serum C-reactive protein and serum direct bilirubin in neonates with clinical suspicion of sepsis. Materials and Methods: The present, study was done in our institute from October 2013 to October 2015. CBC was done on 191 clinically suspected cases of neonatal sepsis along with Micro ESR, Serum CRP and direct bilirubin. Differential leukocyte count, absolute neutrophil count, immature neutrophils: total neutrophils ratio was done from Field stained peripheral smears. Blood culture was done in Microbiology Department. Exclusion criteria were neonates with major congenital anomalies and those who have already received antibiotics. Statistical Analysis: Statistical analysis was done using SPSS software, version 20th and unpaired ‘t’- test. Result: Out of 191 cases studied, 91 were culture positive. CRP (84.6%) and immature : total neutrophils ratio(75.8%) showed highest sensitivity, Whereas absolute neutrophil count(99.0%) along with serum direct bilirubin (93.0%) and corrected total leucocyte count (93.0%)showed highest specificity. Positive predictive value was highest for absolute neutrophil count (97.5%) and CRP (84.8%). Conclusion: Serum CRP is the most sensitive marker of sepsis. Use of peripheral smear study, serum direct bilirubin and micro ESR together with CRP can be used effectively as a sepsis screen for early diagnosis of neonatal sepsis.http://www.ijnmr.net/articles/PDF/2178/18541_F(P)_PF1(Vsu_Om)_PFA(GH)_PF2(VsuGH).pdfbilirubinc - reactive proteinleukocyte countnewborn |
| spellingShingle | Chandrashekhar P Bhale Apurva Vasant Kale Sachin S Kale Meera Mahajan Smita S Mulay Utility of Sepsis Screen in the Early Diagnosis of Neonatal Sepsis Indian Journal of Neonatal Medicine and Research bilirubin c - reactive protein leukocyte count newborn |
| title | Utility of Sepsis Screen in the Early Diagnosis of Neonatal Sepsis |
| title_full | Utility of Sepsis Screen in the Early Diagnosis of Neonatal Sepsis |
| title_fullStr | Utility of Sepsis Screen in the Early Diagnosis of Neonatal Sepsis |
| title_full_unstemmed | Utility of Sepsis Screen in the Early Diagnosis of Neonatal Sepsis |
| title_short | Utility of Sepsis Screen in the Early Diagnosis of Neonatal Sepsis |
| title_sort | utility of sepsis screen in the early diagnosis of neonatal sepsis |
| topic | bilirubin c - reactive protein leukocyte count newborn |
| url | http://www.ijnmr.net/articles/PDF/2178/18541_F(P)_PF1(Vsu_Om)_PFA(GH)_PF2(VsuGH).pdf |
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