SEPTIC SCREEN AS A DIAGNOSTIC TOOL FOR NEONATAL SEPSIS : AN AUDIT

Sanjay Choudhary; Neeru Malik; Pawan Verma; Neelu Madan; Nivedita Sarda; Anupa Singhal

Volume : VIII, Issue : XII, December - 2018

SEPTIC SCREEN AS A DIAGNOSTIC TOOL FOR NEONATAL SEPSIS : AN AUDIT

Sanjay Choudhary, Neeru Malik, Pawan Verma, Neelu Madan, Nivedita Sarda, Anupa Singhal

Abstract :

Background Neonatal sepsis is a leading cause of neonatal morbidity and mortality in India. Early diagnosis of neonatal sepsis is difficult due to subtle and non specific signs symptoms and symptoms . Blood culture which is the gold standard for diagnosis takes at least 48 hours and may give a false negative report particularly with prior antibiotic use. It was endeavoured to evaluate septic screen as a diagnostic marker for neonatal sepsis.

Material and Methods This was an observational cross sectional prospective study conducted on 500 neonates admitted to the nursery of Dr. Baba Saheb Ambedkar Hospital, with clinical features of sepsis. Following investigations were done as part of septic screen :Total Leukocytes Count,Absolute Neutrophil Count,Immature to Total neutrophil Ratio,m–ESR and C–Reactive Protein.Blood culture was done in each case.All neonates were managed as per standard ICU protocol.Septic screen was considered postive if the result of two or more parameters were positive and the result was compared with blood culture which is the gold standard for diagnosis.Data was analysed using SPSS Statistical Software Version 15.0.

Result In our study out of the five septic screen parameters, TLC, ANC, m–ESR and CRPwere found to be predictive of definitive blood culture positive (P<0.05) .CRP was the best predictor of neonatal sepsis( P<0.001). The sensitivity of a positive septic screen was 100% while specificity was 28.6% positive predictive value of 34.3% and negative predictive value of 100% .

Conclusion In view of the high morbidity and mortality asociated with neonatal sepsis, septic screen with its 100% sensitivity is a useful diagnostic marker. CRP is the septic screen parameter which is most predictive of sepsis in the neonate.