Performance of the Hematological Scoring System for Early Diagnosis of Neonatal Sepsis in a Neonatal Intensive Care Unit of a Developing Country
Infectious Diseases and Tropical Medicine 2017; 3 (4): e429
Topic: Bacterial Infections
Category: Research article
Abstract
Objective: Neonatal sepsis is a common health problem in developing countries. Diagnosis of neonatal sepsis may be difficult as the early signs of sepsis may be subtle; hence, reliable identification of sepsis at an earlier stage is important. Thus, we aimed to assess the performance of the hematological scoring system (HSS) for early detection of neonatal sepsis in our Neonatal Intensive Care Unit (NICU).
Patients and Methods: A cross-sectional study was conducted on 200 neonates admitted to NICU of Suez Canal University Hospital who were clinically suspected to have sepsis. Peripheral blood smears of all newborns have been collected and data were analyzed for neonatal sepsis using HSS, which included six hematological parameters that had an optimum sensitivity and NPV.
Results: A total of 200 babies were evaluated for sepsis, 80 (40%) were proved to be septic by the positive blood cultures. Our study found that the highest sensitivity was recorded for platelet count and degenerative changes in PMN (100% each), while I:T ratio (>0.2) and I:M ratio recorded the highest specificity (96.7% each). Platelet count had the highest NPV (100%). White blood cell count had the highest PPV (90%) and the highest accuracy (92%) in identifying neonates with sepsis. Hematological scoring system ≥ 4 had a sensitivity of 95% and a specificity of 96.7%, PPV 26% and NPV 100%, respectively. ROC curve showed an area under curve (AUC) of 0.954 (95% CI 0.94-1.0).
Conclusions: HSS can be used for diagnosis of neonatal sepsis; HSS ≥ 4 could be used for early diagnosis of neonatal sepsis in our NICU.
Patients and Methods: A cross-sectional study was conducted on 200 neonates admitted to NICU of Suez Canal University Hospital who were clinically suspected to have sepsis. Peripheral blood smears of all newborns have been collected and data were analyzed for neonatal sepsis using HSS, which included six hematological parameters that had an optimum sensitivity and NPV.
Results: A total of 200 babies were evaluated for sepsis, 80 (40%) were proved to be septic by the positive blood cultures. Our study found that the highest sensitivity was recorded for platelet count and degenerative changes in PMN (100% each), while I:T ratio (>0.2) and I:M ratio recorded the highest specificity (96.7% each). Platelet count had the highest NPV (100%). White blood cell count had the highest PPV (90%) and the highest accuracy (92%) in identifying neonates with sepsis. Hematological scoring system ≥ 4 had a sensitivity of 95% and a specificity of 96.7%, PPV 26% and NPV 100%, respectively. ROC curve showed an area under curve (AUC) of 0.954 (95% CI 0.94-1.0).
Conclusions: HSS can be used for diagnosis of neonatal sepsis; HSS ≥ 4 could be used for early diagnosis of neonatal sepsis in our NICU.
To cite this article
Performance of the Hematological Scoring System for Early Diagnosis of Neonatal Sepsis in a Neonatal Intensive Care Unit of a Developing Country
Infectious Diseases and Tropical Medicine 2017; 3 (4): e429
Publication History
Submission date: 20 Sep 2017
Revised on: 09 Nov 2017
Accepted on: 13 Nov 2017
Published online: 14 Dec 2017
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