Evaluation of Haematological Profile in Early Diagnosis of Clinically Suspected Cases of Neonatal Sepsis

Early diagnosis of neonatal septicemia is difficult due to lack of specific clinical and laboratory findings. Blood culture is considered gold standard for the diagnosis, but is very time consuming. Hence most of the paediatricians administer antibiotics at the least suspicion of sepsis. To overcome this, several rapid haematological tests have been evaluated for their usefulness in rapid diagnosis of neonatal sepsis. Objective behind the study was to establish the role of haematological parameters (Total Leucocyte Count, Absolute Neutrophil Count, Immature to Total Neutrophil Ratio, Platelet count, C-Reactive Protein and Micro Erythrocyte Sedimentation rate), as a reliable indicator of septicemia alone and in combinations in neonates with suspected sepsis. A prospective study of haematological parameters of 120 neonates with clinically suspected sepsis was performed. These parameters were evaluated statistically based on the standard reference values. TNR was the best individual test with the highest sensitivity, specificity, positive and negative predictive value. ANC and CRP were only beneficial to rule out the sepsis. TLC, Micro ESR and Platelet count when used alone were neither helpful for confirming sepsis nor beneficial to exclude sepsis. Results were promising when these tests were used in combinations. The combination of I: TNR+ ANC+ CRP and I: TNR+ ANC+ CRP+ ESR gave the best test results. The most useful combination was of 5 tests (I: TNR+ ANC+ CRP+ ESR+ Platelet count). It is concluded that the different permutation and combinations of haematological parameters act as a rapid adjunct to diagnose and exclude neonatal sepsis.