Diagnostic utility of Haematological scoring system (HSS) with clinicopathological and bacteriological evaluationin early diagnosis of neonatal sepsis

Abstract

Background: Neonatal sepsis is a major cause of mortality with high incidence of 11 to 24.5 per 1000 live births in India. Delay in diagnosis further increases the mortality to 30-40% of total neonatal deaths. Though blood culture is gold standard for diagnosis of neonatal sepsis, it has limitations. The comprehensive Hematologic scoring system (HSS) formulated by Rodwell et al is used for early diagnosis of sepsis. This comprises of Immature/Total neutrophil ratio, Total PMN count, Immature/Mature ratio, Immature PMN count, degenerative changes in PMN, platelet count. Methods: This is a prospective study of haematologic profiles of 333 neonates admitted in neonatal care unit in our institute. Field stained blood smears were examined for HSS. Blood culture was done before administration of antibiotic treatment. Neonates with predisposing perinatal risk factors or if there was clinical suspicion of sepsis were included in this study from Nov 2014 to feb 2016. Result: Of the 303 neonates in the present study, 77 had positive blood cultures, The incidence of septicemia was higher in males (72.7%) than females (27.3%). Majority of the neonates presented with early onset type of sepsis (91%). Elevated I: T ratio and I:M ratio were seen in most cases of septicemia. Conclusion: HSS is the most sensitive indicator of sepsis. Use of HSS by peripheral smear study Blood culture can be used effectively as a sepsis screen for early diagnosis is useful to reduce neonatal morbidity and mortality. DOI: 10.21276/APALM.1504