776 DIAGNOSTIC SPECIFICITY OF WHITE BLOOD COUNTS IN SEPTICEMIA AT BIRTH

Abstract

To determine the value of white cell counts in early diagnosis of bacteremia on the first day of life, we made retrospective analysis of 3 groups cared for in our intensive care nursery. The septic group had positive blood cultures from 2 separate venipunctures on admission. One control group was minimally ill on admission, never cultured, and required only observation. Another control group was critically ill infants with negative blood cultures who died within 72 hours. All appropriate infants who had admission CBC's during 1973-77 were included. There was no difference among the groups in weight or gestational age. Values are mean (range). *p=.001 compared to septic 11 of the 26 septic infants had white counts <5000; which is below the range of controls. Mortality in these 11 was 63%, and was 60% in the 15 septic infants with normal white counts. As a group, infants septic on the first day had leukopenia; neutropenia and lymphopenia were equally seen. Platelet counts were indeterminate. Leukopenia at birth strongly suggests sepsis rather than a non-infectious stress, but does not predict mortality, and 56% of septic infants are not leukopenic.