Evaluation of Septic Screen as a Diagnostic Tool for Neonatal Sepsis in a Tertiary Hospital at Mysore

This is a hospital based cross sectional study to evaluate the validity of septic screen in detecting neonatal sepsis conducted over Nov 2012 to Nov 2013. 60 newborns admitted with suspected sepsis on the basis of clinical presentation were enrolled for the study. All the babies underwent septic screen (TLC, ANC, CRP, I/T Ratio, Platelet count and micro ESR) and Blood culture. Septic screen was considered positive if any 2 parameters were abnormal. Using blood culture as gold standard in diagnosing neonatal sepsis, the sensitivity, specificity, PPV and NPV for septic screen were calculated. The study population consisted of more male (40), preterm (41) and LBW babies (42). Nearly 70% of the cases were outborn and only 30% were inborn babies. 54 (90%) were early-onset, only six (10%) were lateonset sepsis. Out of 60 cases, 44 (73.3%) were septic screen positive i.e., two or more parameters were abnormal and 16 (26.7%) were negative. A total of 48 (80%) cases were blood culture proven sepsis and 12 (20%) were negative. 37 (61.2%) cases had positive blood culture and septic screen, only five (8.2%) cases were negative for both. Out of 48 culture positive cases, 11(18.2%) were negative on septic screen and seven (10.2%) septic screen positive cases didn’t grow anything in blood culture. A positive septic screen had sensitivity of 77%, specificity of 41%, PPV of 84% and NPV of 31% when blood culture is considered as gold standard to detect neonatal sepsis.