DIAGNOSTIC VALUE OF HEMATOLOGICAL PARAMETERS IN NEONATAL SEPSIS

Abstract

Background: Neonatal infections, mainly sepsis, constitute an extremely important cause of morbidity and mortality in newborns, particularly in developing countries. Early diagnosis is important for receiving proper treatment and better prognosis.

Objective: To assess the diagnostic ability of different hematological parameters in neonatal sepsis taking blood culture as a gold standard.

Methods: A total of 102 neonates admitted to NICU, at PAEC General Hospital, Islamabad, between Feb, 2023 to April, 2024, with clinical suspicion for sepsis were included in the study. Each patient was subjected to lab investigations which included WBC, ANC, Platelets, CRP and blood culture. Neonates were categorized as Group A (culture-positive sepsis, n=48) and Group B (culture-negative sepsis, n=54). The diagnostic performance of these hematological indices was evaluated on the basis of comparison with culture report.

Results: The percentage of neonates was 54.2% for the Group A and 57.4% for the Group B, no statistically significant difference (p = 0.756). Likewise, there was no statistically significant difference in the average gestational age and birth weight between Group A (36.8 ± 2.4 weeks; 2.65 ± 0.58 kg) and Group B (37.1 ± 2.2 weeks; 2.72 ± 0.62 kg) (p = 0.530 and p = 0.620, respectively). Leukocytosis was recorded in 25.0% of the neonates in group A compared to 9.3% of the babies in group B (p=0.032). Thrombocytopenia was observed in 58.3% of culture- positive neonates compared to that in 31.5% culture negatives cases (p = 0.011). Significantly higher proportions of neonates from Group A had elevated CRP levels (> 10 mg/L) compared to those from Group B (79.2% vs. 22.2%, p < 0.001).

Conclusion: Hematological parameters, especially CRP levels, ANC and thrombocytopenia are useful markers for diagnosis of neonatal sepsis. CRP, in particular, showed the best sensitivity and specificity as a sepsis biomarker for neonates.