Neonatal sepsis is a major contributing factor for increased mortality and morbidity in the newbron and its successful outcome depends on early detection and prompt institution of an effective antimicrobial therapy. Accurate diagnosis of the
neonatal
septicemia, however, is quite difficult because its early signs and symptoms are rather subtle.
This study was conducted in an attempt to search for useful early markers for the clinical entity A total of 224 newborns, over a 17 month pcriod (1/90 5/91), who were evaluated for probable neonatal sepsis were analysed. The laboratory
parameters
that
showed highest correlation with bacteriologically proves sopsis were as follows: Total WBC counts (<5,000/mm), Band/Total ncutrophils(>0.2), elevated ESR(>15mm/hr), CRP(>6ng/ml).
Of the 224 study subjects, 41 had two or more parameters of which 12 subjects had positive blood cultures(positive predictive value:29%), only 4 of the 183 newborns who had less than 2 parameters had positive blood cultures(false negative:2%).
It is concluded that the presence of two or more of the above parameters can be used as a strong indicator for neonatal sepsis and its sensitivity is 75% while specificity is 86%.
|