Detection of sepsis in neonate using neutrophil VCS parameters on beckman coulter LH750 haematology analyser (method introduction and optimisation in haematology laboratory at royal north shore hospital)

Abstract

Identifying neonates at high risk of serious bacterial illness and who therefore require empiric antimicrobial therapy is a challenging problem facing paediatricians in their practice. The blood tests that are traditionally used to detect sepsis in infants besides the cultures include white cell count, neutrophils count and inflammatory markers [C-reactive protein (CRP)]. Despite their common use, observational studies report that these markers have poor sensitivity and specificity for identifying bacteraemia. Quantitative determination of neutrophil VCS parameters by the Beckman Coulter Automated haematology analyser is a new marker and has been shown to be a reliable indicator for acute bacterial infection in several studies. We retrospectively analysed a large dataset of 200 neonates (less than 3 months of age) and their VCS positional parameters MNV (mean neutrophil volume) and NDW (neutrophil distribution width) with the usual laboratory markers to detect infection that includes CRP, manual band count and absolute neutrophils count (ANC). The patients were divided into three categories, those who demonstrated evidence of bacterial infection with positive culture, raised inflammatory markers (ANC, CRP), or with no evidence of infection. In the next 3 months, the data will be analysed to determine sensitivity and specificity and the results will be presented.