Evaluation Of Hematological Parameters In Early Onset Neonatal Sepsis
EONS: Evaluation Of Hematological Parameters
Keywords:
C Reactive Protein, EONS, Hematological ParameterAbstract
Background & Objective : Diagnosis of early onset neonatal sepsis (EONS) is always a challange to the neonatologists. So, the study evaluate role of hematological parameters in diagnosis of EONS in a teaching hospital of eastern India. Methods: Newborn, age less than 72hours, associated with risk factors or clinical diagnosis of sepsis, admitted between March 2011 and February 2013 was enrolled in this study. They were subjected to blood culture and various sepsis screen parameters like C-Reactive Protein, micro-erythrocyte sedimentation rate (Micro ESR), total leukocyte count (TLC), Immature to Total Neutrophil ratio (I:T ratio) and platelet count. Sensitivity, specificity, positive predictive value(PPV), negative predictive value (NPV) as well as P value of all the parameters were calculated considering blood culture as ‘gold standard’ for sepsis. Result: Among 238 clinically suspected cases of early onset neonatal sepsis, blood culture was positive in 90(37.8%) cases of which Klebsiella pneumoniae (45.71%) was the predominant organism. Positive CRP and Micro ESR were the most useful tests for sepsis with a high specificity of 91.89% and 90.54% respectively but sensitivity of any one was not satisfactory. Negative predictive value of the CRP, micro- ESR, I:T ratio ranges between 90.07% and 81.99% . In relation to sepsis alteration in hematological parameters were found statistically significant (P value <0.05).Conclusion: The value of the hematological tests could be used satisfactorily to rule out EONS and withheld unnecessary antibiotic treatment. Thus the tests aids in management of EONS while waiting for culture report.
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