Nabi S N, Basak A K, Kamruzzaman M, Pervez A F, Musharraf M, Sultana N, Moniruzzaman A M, Majumder B K, Mostakim M A
Dr SM Nurun Nabi, Junior Consultant (Paediatrics), Department of Paediatrics, Rangpur Medical College Hospital (RMCH), Rangpur, Bangladesh; E-mail:
Mymensingh Med J. 2019 Jan;28(1):193-199.
Neonatal sepsis is one of the major health problems throughout the world and major cause of morbidity and mortality in developing countries. Positive blood culture considers the gold standard for confirmation of neonatal sepsis, but it does not provide rapid diagnosis. So this study was designed to find out the performance of haematological parameters in early diagnosis of neonatal sepsis. The objective of the study was to evaluate the performance of haematological parameters individually and in combination in early diagnosis of neonatal sepsis. It was a cross-sectional study conducted at neonatal ward, SCANU and obstetric ward of Rangpur Medical College Hospital from January 2014 to December 2015. A total of 70 neonates clinically suspected to have features of sepsis were included in this study. Another 70 healthy term neonates were included in the study as reference group. Blood sample were obtained to estimate TLC, ANC, immature neutrophil count, degenerative changes in PMNs, platelet count, I/T and I/M ratio. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of the individual test and tests combination were calculated. Among the haematological parameters, performance of combined tests had high sensitivity, specificity, with PPV and NPV. Among the individual tests I/T and I/M ratio had high sensitivity (95%), specificity (85%, 90%), PPV (90%, 75%) and NPV (90%). There were 22 out of 70 neonates (31.42%) who had culture proven sepsis. Among 22 culture proven sepsis most commonly found organism were Escherichia Coli 12(54.5%) followed by Klebsiella 3(13.63%), Proteus 3(13.63%), Staphylococcus aureus 2(9.9%) and Salmonella 2(9.9%). There is no ideal test for diagnosis of early diagnosis of neonatal sepsis haematological parameters is useful adjunct test in identifying clinically suspected neonatal sepsis.
新生儿败血症是全球主要的健康问题之一，也是发展中国家发病和死亡的主要原因。血培养阳性被认为是确诊新生儿败血症的金标准，但它不能提供快速诊断。因此，本研究旨在探讨血液学参数在新生儿败血症早期诊断中的表现。本研究的目的是评估血液学参数单独及联合应用在新生儿败血症早期诊断中的表现。这是一项横断面研究，于2014年1月至2015年12月在朗布尔医学院医院的新生儿病房、SCANU和产科病房进行。本研究共纳入70例临床疑似有败血症特征的新生儿。另外70例健康足月儿作为参照组纳入研究。采集血样以估算白细胞总数、中性粒细胞绝对值、未成熟中性粒细胞计数、中性粒细胞的退行性变化、血小板计数、I/T及I/M比值。计算单项检测及联合检测的敏感性、特异性、阳性预测值（PPV）和阴性预测值（NPV）。在血液学参数中，联合检测具有较高的敏感性、特异性、PPV和NPV。在单项检测中，I/T及I/M比值具有较高的敏感性（95%）、特异性（85%、90%）、PPV（90%、75%）和NPV（90%）。70例新生儿中有22例（31.42%）血培养证实为败血症。在22例血培养证实为败血症的患儿中，最常见的病原体是大肠埃希菌12例（54.5%），其次是克雷伯菌3例（13.63%）、变形杆菌3例（13.63%）、金黄色葡萄球菌2例（9.9%）和沙门菌2例（9.9%）。对于新生儿败血症的早期诊断，目前尚无理想的检测方法，血液学参数是识别临床疑似新生儿败血症的有用辅助检测方法。
