THE VALIDITY OF HEMATOLOGIC MARKERS FOR DIAGNOSIS OF NEONATAL SEPSIS

Abstract

Abstract

Objective:  To determine the validity of haematologic markers for sepsis screen (absolute neutrophil count (ANC), immature/total leukocytes ratio (I:T), platelets count (PC), C-reactive protein (CRP) and serum ferri-tin), both individually and in combination for early diagnosis of neonatal sepsis.

Methodology:  This cross – sectional analytical study was conducted in Neonatal Section of Paediatric Medicine Unit II, Mayo Hospital Lahore for one year. One hundred neonates presenting with clinical sepsis were included through non-probability, purposive sampling after written informed consent. Blood sample was collected for full hematologic screening as mentioned above along with blood cultures. Data was entered and analyzed using SPSS Version 17.

Results: There were 68 male and 32 females including 31 preterm and 69 term neonates. 45 neonates were < 1 day age, 40 neonates 1 – 10 days age, 15 neonates 11 – 30 days age. Mean weight of study cases was 2.35 ± 0.69 Kg. Sensitivity, specificity and diagnostic accuracy of ANC were 77.3%, 100% and 90%, for I/T ratio were 81.8%, 81.4% and 81%, for CRP were 75%, 83.9% and 80%, for platelet count were 84.1%, 71.4% and 77%, for serum ferritin were 88.6%, 69.6% and 78% respectively. Sensitivity, specificity and diagnostic accuracy of combination of SF + I:T was 81.8%, 82.1% and 82%, for combination of SF + ANC + I:T were 93.2%, 71.4% and 81% for combination of SF + CRP + I:T were 93.2%, 67.9% and 79%, for combination of SF + I:T + PC were 90.9%, 58.9% and 73%, for combination of SF + CRP + ANC were 95.5%, 69.6% and 81%. Sensitivity, specificity and diagnostic accuracy of combination of all markers were 90.9%, 76.8% and 83% respectively.

Conclusion:  Results of our study showed that we can safely rely on hematologic markers for confirmation of neonatal sepsis both singly and in combination. We suggest that these tests may help to diagnose neonatal sepsis earlier.

Key Words:  Neonatal Sepsis, Diagnostic accuracy, Lethargy, Prolong rupture of membrane, Temperature instability, Hematologic markers.