Rapid diagnostic tests in neonatal septicemia.

Abstract

Fifty clinically suspected cases of septicemia and 10 healthy neonates (controls) were studied. 58% of the cases were males and 52% were less than a week old. Blood culture was positive in 48% of cases among which Gramnegative bacilli predominated (71% of culture positive cases). C-reactive protein (CRP) test, total leukocyte count, ratio of band cells to total polymorphonuclear cells, buffy coat smear examination for organisms, and gastric aspirate cytology for polymorph % were the rapid diagnostic tests performed. Our study revealed that CRP is the most useful single test with a high degree of sensitivity (83%), specificity (42%) and positive predictive accuracy (57%). The best combination of tests was CRP and gastric aspirate cytology with a sensitivity of 83%, specificity of 76% and positive predictive accuracy of 48%. These tests can be performed rapidly and do not require special laboratory equipment. These could help to differentiate infected neonates from non-infected ones, thereby reducing mortality and preventing antibiotic misuse.