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血液学参数在新生儿败血症临床病例早期检测中的作用:一项来自印度钦奈的基于医院的研究。

Role of hematological parameters in the early detection of clinical cases for septicemia among neonates: A hospital-based study from Chennai, India.

作者信息

S B Jeivanth, Baskar Shreemathee, Fareed Mohammad, Kumar K Santhosh, Mostafa Osama Elshahat, Bawazir Amen, AlQumaizi Khalid I

机构信息

Saveetha Medical College and Hospital, Saveetha Institute of Medical and Technical Sciences (SIMATS) Chennai, India.

Community Medicine Unit, Department of Basic Medical Sciences, College of Medicine, AlMaarefa University, Diriyah, Saudi Arabia.

出版信息

PLoS One. 2025 Mar 19;20(3):e0318802. doi: 10.1371/journal.pone.0318802. eCollection 2025.

Abstract

BACKGROUND

Neonatal sepsis, a leading cause of newborn mortality, arises from systemic infections due to an immature immune system. Its subtle early symptoms complicate timely diagnosis. Hematological parameters act as an indicator for early detection, crucial for prompt treatment, improving prognosis, and are not a challenging or cumbersome process.

AIM

The primary objective was to evaluate the significance of hematological parameters including red blood cell (RBC), WBC, and platelet counts in the context of neonatal sepsis.

METHODS

This hospital-based cohort study examined 73 neonates admitted to the neonatal intensive care unit (NICU) of Saveetha Medical College and Hospital, Chennai, India during the period of January 2023 to March 2024. All the new born patients were presented with blood culture-confirmed septicemia.

RESULTS

The investigation identified Klebsiella pneumoniae as the most prevalent etiological agent (26.02%), followed by Coagulase-Negative Staphylococci (CONS) and Acinetobacter baumannii (both 8.2%). Alterations in total leukocyte count and hematocrit were observed in 57% and 68.1% of cases, respectively, providing a prompt indication of infection status. Subsequent analyses revealed prominent leukocytosis, hematocrit irregularities, and thrombocytopenia, frequently manifesting in septic cases and demonstrating potential as early markers for neonatal sepsis.

CONCLUSION

The study highlights the diagnostic value of hematological alterations, such as leukocytosis and hematocrit distortion, in the prompt identification of septicemia among neonates. Based on the findings, it is recommended that routine hematological screening to be integrated as a standard component of neonatal sepsis diagnosis for rapid investigation of neonatal sepsis.

摘要

背景

新生儿败血症是新生儿死亡的主要原因,源于免疫系统不成熟导致的全身感染。其早期症状不明显,给及时诊断带来困难。血液学参数可作为早期检测的指标,对及时治疗、改善预后至关重要,且检测过程并不复杂或繁琐。

目的

主要目的是评估包括红细胞(RBC)、白细胞(WBC)和血小板计数在内的血液学参数在新生儿败血症中的意义。

方法

这项基于医院的队列研究对2023年1月至2024年3月期间入住印度钦奈萨维塔医学院和医院新生儿重症监护病房(NICU)的73名新生儿进行了检查。所有新生儿患者均经血培养确诊为败血症。

结果

调查发现肺炎克雷伯菌是最常见的病原体(26.02%),其次是凝固酶阴性葡萄球菌(CONS)和鲍曼不动杆菌(均为8.2%)。分别在57%和68.1%的病例中观察到总白细胞计数和血细胞比容的变化,这为感染状况提供了及时的指示。随后的分析显示,败血症病例中常出现明显的白细胞增多、血细胞比容异常和血小板减少,表明这些指标有可能作为新生儿败血症的早期标志物。

结论

该研究强调了血液学改变(如白细胞增多和血细胞比容异常)在新生儿败血症快速诊断中的诊断价值。基于这些发现,建议将常规血液学筛查作为新生儿败血症诊断的标准组成部分,以便快速排查新生儿败血症。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/11de/11922526/b7289dc23b10/pone.0318802.g001.jpg

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