Professional Documents
Culture Documents
DOI 10.1007/s12288-010-0050-2
ORIGINAL ARTICLE
Received: 11 December 2009 / Accepted: 10 December 2010 / Published online: 1 January 2011
Ó Indian Society of Haematology & Transfusion Medicine 2010
Abstract Neonates are easily prone for bacterial infec- organisms and partly because the signs of these infections
tion. Diagnosis of neonatal septicemia may be difficult as may be absent or minimal and hard to detect. Thus fatal
the early signs of sepsis may be subtle and different at septicemia may occur with little warning [2]. Hence the
different gestational ages. The present study was under- timely diagnosis of sepsis in neonates is critical as the
taken to assess the significance of the hematological scor- illness can be rapidly progressive and in some instances
ing system (HSS) for early detection of neonatal sepsis. fatal [3].
About 50 peripheral blood smears of all newborns col- The current study was undertaken to assess the signifi-
lected were analysed for neonatal sepsis using the HSS of cance of the hematological scoring system (HSS) for early
Rodwell et al. (J Pediatr 112:761–767, 1988). Analysis in detection of neonatal sepsis.
our study found that an abnormal immature to total neu-
trophil ratio (I:T) followed by an abnormal immature to
mature neutrophil ratio (I:M) were the most sensitive
indicators in identifying infants with sepsis. The HSS is a Materials and Methods
simple, quick, cost effective tool which can be used as a
screening test for early diagnosis of neonatal sepsis. The present study is a prospective analysis of the hema-
tologic profiles of 50 neonates admitted in the neonatal care
Keywords Hematological scoring system Neonatal unit of our hospital. Infants were enrolled in the study if
sepsis Peripheral blood smears Infections there were predisposing perinatal factors or if there was
clinical suspicion of sepsis.
The study included three groups:
Introduction Group 1—infants with sepsis with positive blood cul-
tures. Group 2—infants with probable infection with strong
Early diagnosis of neonatal septicemia is a vexing problem clinical history but negative blood cultures. Group
because of its nonspecific clinical picture [1]. Bacterial 3—normal infants without any evidence of sepsis. The
infection in the newborn still account for a considerable blood samples were collected in non-siliconized Vaccu-
morbidity and mortality. This is because the newborn tainer tubes with tripotassium EDTA as an anticoagulant.
especially the premature are prone to serious infections by Peripheral blood smears were be prepared within 1–2 h of
venipuncture, stained with Leishman stain and examined
under oil immersion light microscopy at a final magnifi-
A. Narasimha M. L. Harendra Kumar
Department of Pathology, Sri Devaraj Urs Medical College, cation of 91000. The sepsis work up included blood and
Tamaka, Kolar, India CSF culture and routine blood counts along with the
hematologic score. Total leucocyte count was obtained
A. Narasimha (&) using micros 60 autoanalyzer and corrected for nucleated
No. 22, ‘‘Moyenvilla’’, Moyenville Road, Langford Town,
Bangalore 565025, India red blood cells. Differential counts were performed on
e-mail: aparna_patho@yahoo.com Leishman stained smears and about 200 cells were counted.
123
Indian J Hematol Blood Transfus (Jan-Mar 2011) 27(1):14–17 15
123
16 Indian J Hematol Blood Transfus (Jan-Mar 2011) 27(1):14–17
123
Indian J Hematol Blood Transfus (Jan-Mar 2011) 27(1):14–17 17
Table 6 Performance of
Sensitivity (%) Specificity (%) Positive predictive Negative predictive
individual hematologic findings
value (PPV) (%) value (NPV) (%)
123