Abstract
Introduction Early-onset neonatal sepsis is a major cause of morbidness and death in newborn children. Its timely diagnosis is usually a challenge in developing countries like India. Aim To study the efficacy of C-reactive protein (CRP), micro-ESR, and gastric aspirate for polymorphs in the diagnosis of early-onset neonatal sepsis. Materials and Methods This study included sixty term and preterm children, inborn and referred cases. The children who presented before day seven of life with clinical suspicion of sepsis or who were at high risk of developing sepsis were included. These were further investigated. Significant values for screening tests were taken as C − reactive protein > 0.6 mg/dl, micro-ESR—after 1 hour, fall in the column of blood in capillary tube was measured, and result was taken as mm fall in 1 hr, and gastric aspirate for polymorphs > 5 polymorphs/HPF. Sepsis screen positive result was 2 or more positive tests. The statistical evaluation was done using Fisher, and ANOVA tests using SPSS 20.0 version. Results Sixty children were included in the study with forty as the referred ones. Most of them had tachypnea (45%). CRP showed high sensitivity, whereas micro-ESR and gastric aspirate for polymorphs showed high specificity. Conclusions Neonatal sepsis screening is required for the detection of infection as the blood culture report may not be positive in all the cases, and even if positive, the result takes few hours. CRP showed high sensitivity, whereas micro-ESR and gastric aspirate for polymorphs showed high specificity independently as well as when combined.
Highlights
Early-onset neonatal sepsis is a major cause of morbidness and death in newborn children
60 neonates admitted to the neonatal intensive care unit (NICU) attached to the Department of Pediatrics and Neonatology were enrolled in the study with risk factors and who fulfilled inclusion and exclusion criteria
The most common organism grown in blood culture was Klebsiella in 10 (63.4%), followed by Staphylococcus aureus in 4 (25.0%), and Pseudomonas in 2 (11.6%) neonates
Summary
Early-onset neonatal sepsis is a major cause of morbidness and death in newborn children. Aim. To study the efficacy of C-reactive protein (CRP), micro-ESR, and gastric aspirate for polymorphs in the diagnosis of early-onset neonatal sepsis. The children who presented before day seven of life with clinical suspicion of sepsis or who were at high risk of developing sepsis were included. Neonatal sepsis screening is required for the detection of infection as the blood culture report may not be positive in all the cases, and even if positive, the result takes few hours. Respiratory distress, apneic spells, episodes of bradycardia, feeding intolerance, lethargy, and temperature instability, as well as minor changes on physical examination or in clinical status, are some of the conditions that suggest a possible neonatal infection and need sepsis evaluation. The earlyonset disease can manifest as asymptomatic bacteremia, generalized sepsis, pneumonia, and/or meningitis [2]
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