Estimation of Parameters of Haematological Scoring System in Early Diagnosis of Neonatal Sepsis

Background: Neonatal septicemia is one of the major factors contributing to high perinatal and neonatal mortality and morbidity. The definite diagnosis of septicemia is made by a positive blood culture which requires a minimum period of 48-72 hours and yields a positive result in 30-70% of cases. Hence there is a critical need for laboratory tests that aid in rapid diagnosis of neonatal sepsis. Materials and Methods: Study was conducted in neonates with suspicion of sepsis admitted to NICU. Prospective study was done for 114 clinically suspected neonatal septicemia cases. Hematological parameters were measured and culture positivity and CRP was taken as the criterion for definitive diagnosis of neonatal septicemia. Results: 59.6% were culture & CRP positive, 67% were male, and 67% were low birth weight neonates (<2.5 kg). Immature PMN cell, Immature: Total Neutrophil Ratio and Immature: Mature Neutrophil Ratio shows highest sensitivity (69%), Total Leucocyte Count shows highest specificity (70%) and Platelet count shows highest predictive values. Conclusion: Hematological parameters are particularly useful in resource poor settings for early screening of septicemia as availability of blood culture is limited and time consuming. Clinical profile of neonates was also useful in screening of infected individuals. So, amalgamation of clinical and hematological parameters is useful in screening as it is simple, quick, cost effective and readily available tool.