Thermoregulatory alterations as a marker for sepsis in normothermic premature neonates

To evaluate the core-peripheral temperature alterations as a marker for sepsis in normothermic premature newborns, 50 normal term neonates and 11 preterms with sepsis and 11 normal preterms (controls) were studied. Axillary, rectal and sole temperatures were recorded in all babies using a single mercury-in-glass thermometer by a single observer. There was significant widening of the rectal-sole and axillary-sole temperatures in the preterms with sepsis (p less than 0.001). There was no significant difference (p greater than 0.05) between the axillary and rectal temperatures in the term, normal preterms or those with sepsis. With an overall accuracy of 90.9%, a rectal-sole temperature difference of greater than or equal to 2.3 degrees C (100% sensitivity) or greater than or equal to 3.2 degrees C (100% specificity) is a useful marker to differentiate normothermic preterms with or without sepsis. Using the axillary-sole temperature difference, the respective values were greater than or equal to 2.2 degrees C and greater than or equal to 3.0 degrees C.