COMPARISON OF THE HEMATOLOGICAL PROFILE, C-REACTIVE PROTEIN AND BLOOD CULTURES FOR THE NEONATAL SEPTICEMIA SCREENING PREVALENT IN THE RAJKOT DISTRICT

B. CHUNDAWAT¹*, N. MAKWANA², Y.S. GOSWAMI³, S. KACKER^4
1RUHS College of Medical Sciences, Rajasthan University of Health Sciences, Jaipur, Rajasthan 302033, India
²GMERS Medical College, Civil Hospital Campus, Gandhinagar, 382012, Gujarat University, Ahmedabad, 380 009, Gujarat, India
³GMERS Medical College, Patan, 364265, Hemchandracharya North University, Patan, 384265, Gujarat, India
⁴RUHS College of Medical Sciences, Rajasthan University of Health Sciences, Jaipur, Rajasthan 302033, India
* Corresponding Author : shubs181011@gmail.com

Received : 01-05-2019     Accepted : 26-05-2019     Published : 30-05-2019
Volume : 11     Issue : 5       Pages : 1557 - 1560
Int J Microbiol Res 11.5 (2019):1557-1560

Keywords : Neonatal sepsis, Hematological scoring system, C - reactive protein, Blood culture
Academic Editor : Dr Manuja Agarwal, Dr Nilofer Khayyam
Conflict of Interest : None declared
Acknowledgements/Funding : Authors are thankful to P.D.U. Government Medical College, Rajkot, 360001, Saurashtra University, Rajkot, 360005, Gujarat, India. Authors are also thankful to GMERS Medical College, Patan, 364265, Gujarat University, Ahmedabad, 380 009, Gujarat, India
Author Contribution : All authors equally contributed

Neonates are easily prone to bacterial infection. Diagnosis of neonatal septicemia may be difficult as the early signs of sepsis may be subtle and different at different gestational ages so difficult to diagnose. The present study was undertaken to assess the significance of the hematological scoring system (HSS) for early detection of neonatal sepsis. The HSS is a simple, quick, cost effective tool which can be used as a screening test for early diagnosis of neonatal sepsis through the blood culture is considered gold standard for diagnosis, result comes after 48-72hrs so a practical septic screen is done. Elevated CRP levels, hematological profile and blood culture all together are required in the combination for the diagnosis of sepsis. Background: Neonatal septicemia is characterized by clinical signs and symptoms accompanied by bacteremia in the 1st month of life. This is because the new-born especially the premature are prone to serious infections by organisms and partly because the signs of these infections may be absent or minimal and hard to detect. Thus, fatal septicemia may occur with little warning. Hence the timely diagnosis of sepsis in neonates is critical as the illness can be rapidly progressive and, in some instances, fatal. There is no specific laboratory test with 100% sensitivity and specificity. Aim: The present study emphasis the role of more than one factor in combination for the diagnosis of the neonatal septicemia. Material and Methods: The 100 clinically suspected cases of Neonatal septicemia had undergone microbiological investigation at Microbiology Department, PDU Gov. Medical College which were attended at Ktch-Nicu, P.D.U Gov. Medical College, Rajkot, Gujarat from August 2012 to November 2012.It is a referral centre receiving samples from primary health centre, community health centre & urban health centre under Rajkot district and postgraduate training institute that provides neonatal care for patients from all Saurashtra & Kutch regions. Patients were seen after the initial clinical diagnosis of sepsis was made with signs of Tachypnea, lethargy, poor cry were the main presenting features followed by refusal to feed, jaundice, abdominal distension, fever, diarrhoea, seizure, hypothermia, conjunctivitis. From the birth upto the age of 5days are included Performed by semi quantitative latex agglutination method. Result: Out of 100(58 male, 42 female) neonates with suspicion of septicemia, 50 weighed between 1500 and 2000 g,40 weighed between 2001-2499 g and 10 neonates weighed >2500 g. 69% (n = 69) presented within 72 hours of life (early onset septicemia) and 31% (n = 31) after 72 hours (late onset septicemia).According to the HSS sepsis confirmed cases are 65(score> 5), probability of sepsis is seen in 18 cases(score 3-5), Sepsis negative cases are 17(score<2). Blood culture positive in 64 cases amongst them in 54 cases had septic score >5, CRP is elevated in 70 cases amongst them 57 cases had septic score >5, I:T ratio >.2 is seen in 62 cases amongst them 48 cases had septic score >5.Sensitivity and specificity of all the parameters were calculated but none of the laboratory test is 100% sensitive and 100% specific. Though the blood culture is gold standard but didn’t prove effective solely. So, all the factors are used in the correlation for the accurate diagnosis of the neonatal septicemia. Even the cost effective hematological septic score is better alternative. Conclusion: For the accurate, rapid and cost-effective diagnosis of the neonatal septicemia, hematological septic score is better alternative. Though the blood culture is the gold standard but none of the laboratory test is 100% sensitive and specific so the combination of HSS, Elevated CRP, blood culture are read together for the diagnosis of the neonatal septicemia.

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