Haematological Scoring System: An Early Predictor of Newborn Sepsis as Compared to Blood Culture at tertiary care centre

Abstract

Background: Newborn sepsis is a clinical syndrome characterised by infection-related signs and symptoms in the first month of life, with or without bacteraemia. Sepsis is defined by the Brazilian Health Surveillance Agency (ANVISA) as a systemic reaction with at least two or more of the following signs and symptoms: thermal instability, bradycardia, apnea, intolerance, worsening of respiratory discomfort, hypoactivity and lethargy. Materials and Methods: This cross-sectional study was conducted in the Bal Chikitsalaya, M. B. Government Hospital, Udaipur (Rajasthan). A total of 100 sample sizes were included in between 6-month periods from March 2019 to August 2019. Blood culture reports were compared to haematological scoring parameters, C-reactive protein (CRP) levels, and other factors. Results: 27% of the 100 cases under investigation had positive blood cultures. There were 65% male. 35% of neonates had very low birth weights and 60% were premature. 74% of cases of septicemia had an early onset, compared to 26% of cases with a late onset. In 37.1% of cases, klebsiella was the most frequent organism identified, followed by E. coli and Coagulase Positive Staphylococcus. It has a higher sensitivity and a lesser specificity. The PPV range of the haematological grading criteria was 47% to 65%. C-reactive protein has extremely high sensitivity (81.5%) and extremely low specificity (9.6%), respectively. Conclusion: The early diagnosis of newborn sepsis can be made with the help of the Haematological Scoring System (HSS), which is a rapid, easy-to-use, readily accessible, bedside, cost-effective diagnostic. As opposed to blood cultures, haematological scoring factors are effective early diagnostic and treatment tools. Since the indicators have excellent sensitivity and specificity, antibiotics can be administered to asymptomatic patients with negative culture results. The accuracy of the sepsis diagnosis is improved.