Evaluation of simple hematological screen for early diagnosis of neonatal sepsis

This prospective study was undertaken in Dhaka Shishu Hospital from 15th March 2005 to 15th October 2006 to evaluate the role of simple hematological test for early diagnosis of neonatal sepsis. Eighty suspected cases of septicaemia admitted in neonatal ward of Dhaka Shishu Hospital were included in this study. Patients those who had history of perinatal asphyxia, infant of diabetic mother, congenital cyanotic heart disease etc. were excluded from the study. Thirty neonates without sign symptoms of septicaemia admitted for other causes like jaundice, feeding problems etc. were taken as a control group. After taking informed consent data were collected in structured questionnaire. Following laboratory investigations like total WBC count, differential count, absolute neutrophil count, band cell count, platelet count, CRP, blood culture were done. Micro-ESR was done as bed side test. Immature and total neutrophil ratio (I/T ratio) detected from total neutrophil and band form count. Patients with positive blood culture were categorized as definite sepsis. Patients with negative blood culture but abnormal hematological report suggestive of sepsis were categorized as probable sepsis. Those who had no signs of sepsis were categorized as control group. Absolute neutrophil count (ANC) had low sensitivity (13%) but Micro-ESR, CRP, I/T ratio, platelet count had moderately high sensitivity and specificity. These simple hematological screen are useful marker for early diagnosis of neonatal sepsis.