Diagnosis Of Early-onset Neonatal Sepsis Research Articles

Soluble TREM-1 is not a useful biomarker in the diagnosis of early-onset neonatal sepsis.

Aim: Sepsis remains a significant cause of morbidity and mortality in neonates. We aimed to investigate the use and reliability of the soluble triggering receptor expressed on myeloid cells (sTREM-1) biomarker for suspected early onset of neonatal sepsis (EONS).Materials & methods: 52 patients with suspected EONS and 30 healthy newborns were analyzed for sTREM-1 and other biomarkers.Results: It revealed that elevated levels of C-reactive protein (CRP), neutrophil (%), red cell distribution width (RDW), neutrophil/lymphocyte ratio (NLR) and lactate, as well as decreased lymphocyte (%) were statistically significant for EONS. However, there was no statistically significant difference in sTREM-1 levels between the groups.Conclusion: Although no significant difference in sTREM-1 levels was found between the groups, further research involving repeated measurements and larger sample sizes is necessary to evaluate its practical utility in clinical settings.

Role of ratios of neutrophil and monocyte to lymphocyte and red cell distribution width to platelet in the detection of early onset neonatal sepsis in comparison with serum C-reactive protein

Introduction and Aim: Early onset neonatal sepsis (EONS) is a preventable cause of neonatal mortality and morbidity. Blood culture, the current gold standard has a turn-around time of 48 to 72 hours and high false negatives. Thus, there is a need for reliable biomarkers for its early detection. The present study aims to find the utility of ratios derived from components of complete blood count in detecting EONS. Materials and Methods: The laboratory investigations of neonates with and without clinical sepsis were recorded using purposive convenience sampling technique. The total leucocyte count, absolute neutrophil count, C-reactive protein (CRP) and ratios of blood counts were compared by Mann Whitney test. Their performance was then analysed by receiver operating characteristic analysis. Results: A total of 196 neonates aged 0 to 3 days were considered for the study, out of which 98 cases were study group. Serum CRP and red cell distribution width to platelet (RPR) ratios were found to have statistical significance, albeit low sensitivity and specificity in detection of EONS. Positive correlation of RPR was found with CRP (p value=0.001). The area under the curve for CRP and RPR was 0.661 and 0.628 respectively. However, there was no statistical significant difference in neutrophil and monocyte to lymphocyte ratios between the study and comparative groups. Conclusion: In the background of low yield of culture positivity and its longer turnaround time, RPR can be used as a reliable biomarker in the diagnosis of EONS in conjunction with CRP.

A study of elevated red cell distribution width (RDW) in early-onset neonatal sepsis

BackgroundNeonatal sepsis is a serious infection occurring within the first 28 days of life. It is a significant cause of mortality and morbidity. Red cell distribution width (RDW) is estimated within the standard CBC profile and considered a simple tool for the diagnosis of neonatal sepsis without additional cost. Our aim in this study is to investigate the potential role of red cell distribution width (RDW) in the diagnosis of early-onset neonatal sepsis (EONS). The aim of our study is to detect the role of red cell distribution width (RDW) in the diagnosis and prognosis of early-onset neonatal sepsis (EONS).ResultsThis case-control study was conducted at the NICU of Beni-Suef University Hospital and revealed that RDW% was highly significantly higher among cases than among controls (16.65 ± 4.28, 11.13 ± 0.62, respectively); regarding the severity of neonatal sepsis, we divided our cases into three groups (sepsis group includes 21 neonates, severe sepsis group includes 31 neonates, and septic shock group includes 48 neonates), there were statistically significant differences between the three groups (sepsis, severe sepsis, and septic shock) regarding RDW (15.15 ± 1.65, 16.78 ± 2.01, 17.02 ± 2.02, respectively) as P value (0.027).ConclusionThis study revealed that RDW is associated with the diagnosis and prognosis of early-onset neonatal sepsis, so further study is needed to prove causation as it is being simple, less expensive, available, and easily repeated as it is routinely done with CBC, so it will be a good indicator for prognosis of neonatal sepsis.

Diagnostic Values of Platelet to Lymphocyte Ratio and Neutrophil to Lymphocyte Ratio in the Early Diagnosis of Early-Onset Neonatal Sepsis in Full-term Newborns

Diagnostic Values of Platelet to Lymphocyte Ratio and Neutrophil to Lymphocyte Ratio in the Early Diagnosis of Early-Onset Neonatal Sepsis in Full-term Newborns

Cord blood inflammatory markers for the diagnosis of early-onset neonatal sepsis

Objective: The present study was design to screen early-onset neonatal sepsis using cord blood inflammatory markers. Additionally, the study compared suitable inflammatory markers for septic screen using cord blood. Study Design: This single-centre observational study included neonates suspected of early onset neonatal sepsis having gestational age >28 weeks and weight >1000gm, delivered at a Tertiary Care Centre. Cord blood was collected immediately after birth (0 hour) and clinical parameters (i.e., C-reactive protein (CRP), interleukin 6 (IL-6), procalcitonin, blood culture) as well as haematological parameters (i.e., absolute neutrophil count (ANC), white blood cell count (WBC)) associated with early-onset neonatal sepsis were examined. Results: The study included 44 neonates of mean gestational age of 36.1 ± 3.2 weeks. Receiver operating characteristic curve (ROC) for sepsis markers showed that procalcitonin demonstrated the highest sensitivity and specificity of 90.9% and 100%, respectively; AUC of 0. 966 (95% CI, 0.862-0.998, p <0.001) with cut off ≤0.48. IL-6 significantly predicted early-onset neonatal sepsis with an AUC of 0.965 (95% CI, 0.861-0.997, p <0.001); optimum cut off ≤ 6.4pg/ml with sensitivity and specificity of 90.9% and 95.5%, respectively.

Comparative assessment of umbilical cord blood with peripheral venous blood using hematological scoring system as an early predictive screening method for the detection of early-onset neonatal sepsis in the tertiary care center of Central India

Background: Sepsis is one of the major causes of neonatal morbidity and mortality. Early recognition and diagnosis of early-onset neonatal sepsis (EONS) is difficult because of the variable and non-specific clinical presentation of this condition. Hence, there is a need for early predictive screening method for EONS. Aims and Objectives: To compare the umbilical cord blood Haematological Scoring System (HSS) with peripheral venous blood as an early predictive screening method for detection of EONS. Materials and Methods: 100 inborn neonates with two or more risk factors for EONS, chosen by sequential sampling method were included in this prospective analytical study. Blood samples were collected from the umbilical cord and peripheral vein analyzed for hematological parameters, sepsis screen, and peripheral smear for HSS of Rodwell et al., send for blood culture. Blood cultures were performed as gold standard for diagnosing neonatal sepsis and sepsis screen was done to corroborate the diagnosis of neonatal sepsis. Results: Of 100 neonates, 21 belongs to sepsis; 14 to probable sepsis; 65 to no sepsis. HSS in umbilical cord blood (UCB) had Sensitivity-74.28%, Specificity-92.30%, PPV-83.87%, NPV-86.95% and HSS in PVB had Sensitivity-62.85%, Specificity- 87.69%, PPV-75.86%, NPV-81.69%. Conclusion: HSS score in UCB can be used as a simple, quick, cost-effective, and readily available screening test with decent sensitivity and high specificity, for the detection of EONS.

Early-Onset Neonatal Sepsis: Role of C-Reactive Protein, Micro-ESR, and Gastric Aspirate for Polymorphs as Screening Markers.

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.

Role of Serum Apelin in the Diagnosis of Early-Onset Neonatal Sepsis.

Objective:Apelin is a proinflammatory adipocyte-derived factor. The aim of this study was to evaluate the role and significance of serum apelin as a new sepsis marker in the identification of full-term and preterm new-born infants with early-onset sepsis.Material and Methods:This was a case-control study. We included 80 neonates. The cases were divided into 2 groups; neonates with early-onset sepsis and control group with neonates non-sepsis. Apelin was quantified by enzyme-linked immunosorbent assay.Results:There was a significant elevation in the mean values of serum apelin in the early-onset sepsis group (1214.7 ± 273.06 pg/mmol) than in the non-septic neonates 116.27 ± 21.96 pg/mmol (P < .0001). Apelin values were correlated to clinical sepsis and hematological scores as well as C-reactive protein. Serum apelin concentration was significantly higher among culture-positive cases than the culture-negative cases (mean ± SD was 1239.52 ± 268.47 and 929.42 ± 136.97 pg/mmol, respectively, P < .0001). Moreover, the apelin level was higher in non-survivor neonates than in the survivors in the early-onset sepsis group. No significant difference was found between preterm and full-term new-born infants with regard to the apelin values. The best cut-off estimate of apelin to diagnose early sepsis was >178.33 pg/mmol.Conclusion:Apelin may be useful in the diagnosis and prognostic prediction of neonates with early-onset sepsis.

Alpha 1 Acid Glycoprotein as a Marker for Diagnosis of Early-Onset Neonatal Sepsis in Full-term Neonates

Alpha 1 Acid Glycoprotein as a Marker for Diagnosis of Early-Onset Neonatal Sepsis in Full-term Neonates

Дифференцированный подход к диагностике раннего неонатального сепсиса у преждевременно рожденных детей

Актуальность. Ранний неонатальный сепсис остается ведущей причиной заболеваемости и смертности недоношенных детей. Проблема своевременной диагностики обусловливает необходимость внедрения новых эффективных мониторинговых биомаркеров сепсиса новорожденных. Цель: совершенствование диагностики раннего неонатального сепсиса у преждевременно рожденных детей на основании определения диагностической значимости сывороточного уровня sTREM-1, разработка комплексного алгоритма и оценка эффективности подхода. Материалы и методы. Был проведен анализ клинико-лабораторных наблюдений 70 недоношенных детей с ранним неонатальным сепсисом (n = 22) и внутриутробной пневмонией (n = 48) с определением содержания sTREM-1 сыворотки крови. Результаты. У новорожденных с ранним неонатальным сепсисом выявлено достоверное снижение уровня sTREM-1 по сравнению с новорожденными с внутриутробной пневмонией (97,1 ± 4,5 пг/мл против 134,00 ± 7,73 пг/мл). При использовании неоднородной последовательной процедуры Вальда — Генкина установлены ранговые структуры диагностических показателей и разработана эффективная мультимаркерная диагностическая модель. Выводы. Определено, что содержание sTREM-1 в сыворотке крови детей из группы риска реализации внутриутробной инфекции &lt; 148 пг/мл в первые сутки жизни достоверно ассоциируется с неонатальным сепсисом. Использование разработанного мультимаркерного алгоритма способствует совершенствованию диагностики раннего неонатального сепсиса.

Utility of Red Cell Distribution Width (RDW) In Diagnosis and Prognosis of Early-Onset Neonatal Sepsis in Term Neonates

Objective: To assess the increased Red Cell Distribution Width (RDW) in diagnosis and prognosis of early-onset neonatal sepsis in term neonates. Methods: In a prospective, observational study, we enrolled term neonates ( 37 weeks of gestation) clinically suspected for Early-Onset Neonatal Sepsis (EONS) (within 7 days of birth). A cut-off of 18% and above was taken to consider RDW as abnormal or increased. The primary outcome was to assess the relation of increased RDW with in-hospital mortality. The secondary outcome was to determine the diagnostic yield of increased RDW in culture-proven sepsis. Results: In 166 neonates, 60% were males. Increased RDW was seen in 42.42% of neonates and 15.75% of neonates had positive blood culture. Compared to normal RDW, in-hospital mortality was significantly higher in neonates with increased mortality (27.14% vs. 10.52%, respectively; p=0.006). Also, abnormal RDW was seen in 46.15% of neonates with positive blood culture compared to 35.25% of neonates with negative blood culture (p&lt;0.0001). Thus, elevated RDW had a sensitivity of 44.4% and specificity of 57.97% in the diagnosis of EONS. Conclusion: Increased RDW can be a diagnostic as well as a prognostic marker in neonates with EONS. Such observation indicates it may serve as a simple and easily available marker for EONS in resource-limited settings. However, these findings need to be confirmed in a larger sample. Doi: 10.28991/SciMedJ-2021-0303-7 Full Text: PDF

Efficacy of Cranial Doppler ultrasound in Diagnosis of Early-onset neonatal sepsis

Background: Neonatal sepsis is considered a major neonatal issue and associated with a high rate of mortality in newborns. Because there is a lack of studies concerning early hemodynamic changes of cerebral circulation in neonatal sepsis, so our research aims to assess the cerebral blood flow (CBF) changes in newborns with early-onset neonatal sepsis (EONS) and to clarify the role of cranial Doppler Ultrasound in EONS diagnosis. Objective: To evaluate cerebral hemodynamic changes using transcranial Doppler in newborns with EONS. Methods: This cross-sectional study with 50 neonates involved in the study. The neonates were classified into 2 groups: Case Group (25 neonates) with a diagnosis of early-onset neonatal sepsis and control group (25 neonates) without clinical manifestations of sepsis. Examination of all neonates using Transcranial Doppler (TCD) was performed within seventy-two hours after birth. Measurement of cerebral blood flow velocity (CBFV) in two major cerebral vessels: The anterior cerebral artery (ACA) and middle cerebral artery (MCA) with documentation of doppler data: The peak systolic velocity (PSV), pulsatility index (PI), and resistive index (RI). Data were statistically analyzed followed by calculation of specificity, sensitivity, positive and negative predictive value at selected cut-off values of CBFV parameters. Results: Sepsis group showed statistically significant changes in doppler indices with increased PSV and deceased PI and RI in both arteries. Conclusion: the present study demonstrates changes in CBFV measured by transcranial Doppler in newborns with EONS which can be used as noninvasive bedside investigation.

Latamoxef for Neonates With Early-Onset Neonatal Sepsis: A Study Protocol for a Randomized Controlled Trial.

Early-onset neonatal sepsis (EONS), a bacterial infection that occurs within 72 h after birth, is associated with high likelihood of neonatal mortality. Latamoxef, a semi-synthetic oxacephem antibiotic developed in 1980s, has been brought back into empirical EONS treatment in recent years. In the preliminary work, we established a population pharmacokinetics (PPK) model for latamoxef in Chinese neonates. Moreover, in order to better guide clinical treatment, we conducted dose simulation and found that ascending administration frequency could improve the target rate of 70% of patients having a free antimicrobial drug concentration exceeding the MIC during 70% of the dosing interval (70% fT > MIC). Accordingly, this study is aimed to compare the 70% fT > MIC, efficacy and safety between conventional regimen and PPK model regimen for rational use of latamoxef in EONS treatment. A single-blind, multicenter randomized controlled trial (RCT) for latamoxef will be conducted in Chinese EONS patients. Neonates (≤3 days of age, expected number = 114) admitted to the hospital with the diagnosis of EONS and fulfilling inclusion and exclusion criteria will be randomized (ratio of 1:1) to either a conventional regimen (30 mg/kg q12h) or model regimen (20 mg/kg q8h) latamoxef treatment group for at least 3 days. Primary outcome measure will be 70% fT > MIC and secondary outcome indicators will be the latamoxef treatment failure, duration of antibiotic therapy, changes of white blood cell count (WBC), C-reactive protein (CRP) and procalcitonin (PCT), blood culture results during administration and incidence of adverse event (AE)s. Assessments will be made at baseline, initial stage of latamoxef treatment (18–72 h) and before the end of latamoxef treatment. Ethical approval of our clinical trial has been granted by the ethics committee of the Beijing Children’s Hospital (ID: 2020-13-1). Written informed consent will be obtained from the parents of the participants. This trial is registered in the Chinese Clinical Trial Registry (ChiCTR 2000040064).It is hoped that our study will provide a clinical basis for the rational clinical use of latamoxef in EONS treatment.

Utility of C-reactive protein in early neonatal sepsis

The low sensitivity and specificity of diagnostic aids and the low isolation in cultures make it difficult to recognize early-onset bacterial sepsis in neonates. Determine the diagnostic validity of C reactive protein (CRP) in early neonatal sepsis. The role of CRP in the diagnosis of early-onset neonatal sepsis was evaluated. Levels were measured at 12 and 48 hours of life in patients with suspected sepsis. When evaluating the sensitivity and specificity of the CRP, the result was used quantitatively, using a non-parametric ROC curve to estimate sensitivity and specificity, likelihood ratios and percentage of correct classification for each possible cut-off point. The study included 198 patients. The sensitivity, specificity, positive predictive value, negative predictive value, positive probability index and negative probability index of CRP, were 72.2 - 82.4 - 45.2 - 93.7 - 4.1, and 0.3, respectively with area under the curve of 0.78. CRP is particularly useful to rule out infection. Two negative serial CRP in the absence of clinical symptoms and positive blood cultures have a high negative predictive value and a negative probability index in favor of excluding infection with high certainty and/or discontinuing antibiotic therapy.

The value of interleukin-6 (IL-6) within 6 hours after birth in the prompt diagnosis of early-onset neonatal sepsis.

BackgroundTo investigate the value of interleukin-6 (IL-6) for neonates within 6 hours after birth in the prompt diagnosis of early-onset neonatal sepsis (EONS).MethodsThe clinical and laboratory data of 129 neonates in the neonatal intensive care unit (NICU) of our center from March 31, 2017, to February 29, 2020, were retrospectively analyzed. These patients were divided into two groups on their disease conditions: the EONS group (n=66) and the healthy control group (n=63). All enrolled patients were born in our hospital’s Obstetrics Department and were admitted to the NICU within 2 hours after birth. The first session of the blood test was conducted within 4–6 hours after birth for the measurements of IL-6, C-reactive protein (CRP1), serum amyloid A1 (SAA1), and serum immunoglobulin M (IgM). The second session of the blood test was performed 12–24 hours after birth for procalcitonin (PCT), CRP2, and SAA2. All the tests were completed in our clinical laboratory. The non-parametric test (Mann-Whitney U test) was used to compare all parameters between these two groups. The receiver operating characteristic (ROC) curves were drawn to compare the diagnostic sensitivities and specificities. The pairwise comparisons of the ROC curves were on the MedCalc18.2.1 software. A P value of <0.05 was considered statistically significant.ResultsGender, birth weight, and gestational age were matched between the EONS group and the control group (all P>0.05). The differences of IL-6, CRP2, PCT, and SAA2 were statistically significant between these two groups (all P<0.05), while there was no significant difference in CRP1, SAA1, and IgM (all P>0.05). The area under the ROC curve (AUC) is 1 (95% CI: 0.918–1.000), 1 (95% CI: 0.918–1.000), 1 (95% CI: 0.918–1.000), and 0.977 (95% CI: 0.878–0.999), respectively, for IL-6, CRP2, PCT, and SAA2. Pairwise comparisons among four biomarkers showed the diagnostic specificity and sensitivity of IL-6 were not significantly different from those of CRP2, PCT, and SAA2 (all P>0.05).ConclusionsIL-6 is a quick and independent diagnostic biomarker for EONS, and its sensitivity and specificity are inferior to the conventional inflammation markers, including CRP, PCT, and SAA.

Diagnostic Value of Neutrophil to Lymphocyte Ratio and Mean Platelet Volume on Early Onset Neonatal Sepsis on Term Neonate

By setting out from increased neutrophil count, decreased lymphocyte count, and increased mean platelet volume (MPV), which is a result of the effect of inflammation on blood cells, we aimed to investigate whether neutrophil to lymphocyte ratio (NLP) and MPV can be used as an auxiliary parameter for the diagnosis of early-onset neonatal sepsis (EOS). This study was conducted by analyzing term neonates with EOS and physiological jaundice who were admitted to the neonatal intensive care unit of Izmir Katip Celebi University Ataturk Training and Research Hospital. A total of 63 neonate files were examined to include 30 term neonates with EOS, and 77 neonate files were examined to include 30 term neonates with physiological jaundice as a control group. NLR had an area under the curve (AUC) of 0.891 for prediction of EOS. At a cut-off level of 1.42, NLR had a likelihood ratio (LR) of 5.5, sensitivity of 88%, a specificity of 84%, a positive predictive value (PPV) of 84.6%, and a negative predictive value (NPV) of 87.5%. MPV had an AUC of 0.666 for the prediction of EOS and at a cut-off level of 9.3 fL, MPV had an LR of 1.23, sensitivity of 84%, a specificity of 32%, a PPV of 55.2%, and an NPV of 66.6%. In conclusion, this study provides evidence that NLR and MPV can be used in addition to conventional parameters in the diagnosis of EOS.

Meconium microbiota predicts clinical early-onset neonatal sepsis in preterm neonates

Background Early-onset neonatal sepsis (EONS) remains one of the leading causes of morbidity and mortality related to premature birth, and its diagnosis remains difficult. Our goal was to evaluate the intestinal microbiota of the first meconium of preterm newborns and ascertain whether it is associated with clinical EONS. Methods In a controlled, prospective cohort study, samples of the first meconium of premature infants with a gestational age (GA) ≤32 weeks was obtained at Hospital de Clínicas de Porto Alegre and DNA was isolated from the samples. 16S rDNA based microbiota composition of preterm infants with a clinical diagnosis of EONS was compared to that of a control group. Results 40 (48%) premature infants with clinical diagnosis of EONS and 44 (52%) without EONS were included in the analysis. The most abundant phylum detected in both groups, Proteobacteria, was more prevalent in the sepsis group (p = .034). 14% of variance among bacterial communities (p = .001) correlated with EONS. The genera most strongly associated with EONS were Paenibacillus, Caulobacter, Dialister, Akkermansia, Phenylobacterium, Propionibacterium, Ruminococcus, Bradyrhizobium, and Alloprevotella. A single genus, Flavobacterium, was most strongly associated with the control group. Conclusion These findings suggest that the first-meconium microbiota is different in preterm neonates with and without clinical EONS.

Role of neutrophil CD11b expression in diagnosis of earlyonset neonatal sepsis in full-term infant

Role of neutrophil CD11b expression in diagnosis of earlyonset neonatal sepsis in full-term infant

Progranulin as a novel biomarker in diagnosis of early-onset neonatal sepsis

BackgroundInfections are leading causes of morbidity and mortality in neonates and may also have severe long-term consequences. As early diagnosis of neonatal sepsis improves prognosis, identification of new or complementary biomarkers is of great importance. In this study, we have evaluated the diagnostic value of progranulin (PGRN) in early-onset neonatal sepsis (EOS) and compare its effectiveness with other commonly used biomarkers, such as procalcitonin (PCT) and C-reactive protein (CRP). MethodsA total of 121 infants with gestational age of >34 weeks admitted with suspected EOS were included in this study. Before initiating therapy, blood samples for whole blood count, CRP, PCT and PGRN were obtained from all neonates. Receiver-operating characteristic (ROC) curve and multivariate logistic regression analyses were performed. ResultsSerum PGRN level of infected group was significantly higher than uninfected group (median 47.72 vs. 37.86 ng/ml, respectively; Mann-Whitney p < 0.0001). The ROC area under the curve (AUC) was 0.786 [95% confidence interval (CI) 0.706–0.867; p < 0.0001] for PGRN, 0.699 (95% CI 0.601–0.797; p = 0.0001) for age adjusted PCT, and 0.673 (95% CI 0.573–0.773; p = 0.0007) for CRP. With a cut-off value of 37.89 ng/ml, the diagnostic sensitivity and negative predictive value of PGRN were 94.34% and 91.7%, respectively. PGRN could significantly predict EOS independently of PCT (p < 0.0001), and the combined use of PGRN and PCT could significantly improve diagnostic performance for EOS (0.806; 95% CI 0.73–0.88; p < 0.0001), with a specificity of 89.06% and a positive predictive value of 81.10%. ConclusionsPGRN may be used as a promising biomarker for the diagnosis of EOS, and the combined use of PGRN and PCT could improve the diagnosis of sepsis.

Hematologic Profiles of Ethiopian Preterm Infants With Clinical Diagnoses of Early-Onset Sepsis, Perinatal Asphyxia, and Respiratory Distress Syndrome.

Objective. To determine the hematologic profile of preterm infants with regard to different diseases. Methods. A prospective, cross-sectional, observational study, conducted in 5 hospitals in Ethiopia from July 2016 to May 2018. Preterm babies <7 days of age were included and investigated with complete blood counts (CBC) and other investigations, accordingly. Results. Out of 4919 preterms, 3852 (78.3%) were admitted to a newborn intensive care unit, and of these, 68.3% had a CBC performed. The mean values of hemoglobin, white blood cell (WBC) and platelet counts were 17.9 mg/dL; 12 685 cells/mm3, and 159 340 cells/mm3, respectively. Early onset neonatal sepsis (EONS) 1433 (37%), asphyxia 266 (6.9%), and respiratory distress syndrome (RDS) 1738 (45.3%) were common reasons for admission. The WBC count was <5000 cells/mm3 for 8.8%, 9.0%, and 11.1% of neonates with EONS, asphyxia and RDS, respectively. The hemoglobin value was <7 mg/dL for 0.6%, 1.7%, and 0.4% of preterm infants with EONS, asphyxia, and RDS, respectively. The platelet count was <50 000 cells/mm3 for 16.8%, 17.7%, and 19.8% of preterms admitted with a diagnosis of EONS, asphyxia, and RDS, respectively. Conclusion. WBC and platelet counts were the most common to be associated with EONS, asphyxia, and RDS. Further study is recommended to determine the effect of abnormal hematologic profile on the outcome of preterm babies.