Home Print this page Email this page Small font sizeDefault font sizeIncrease font size
Users Online: 87
 
About us Editorial board Search Ahead of print Current issue Archives Submit article Instructions Subscribe Contacts Advertise Login 
     
ORIGINAL ARTICLE
Year : 2016  |  Volume : 5  |  Issue : 3  |  Page : 193-198

Correlation of blood culture results with the sepsis score and sepsis screen in the diagnosis of early-onset neonatal septicemia


Department of Pediatrics, Government Medical College, Bhavnagar, Gujarat, India

Correspondence Address:
Dr. Rajeshri Rajendra Mehta
Room No. 801, PG-3 Building, Dhanvantari Hostel, Sir T. Hospital, Bhavnagar, Gujarat
India
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2249-4847.191263

Rights and Permissions

Background and Objectives: The objective was to study the correlation of blood culture with the sepsis screen (based on six laboratory parameters) and Takkar and Bhakoo sepsis score (based on six perinatal risk factors) in the diagnosis of early-onset neonatal septicemia. Materials and Methods: In this prospective study, blood samples from 100 clinically suspected early-onset neonatal septicemia cases were selected randomly during the primary observer's study period, i.e., from January 2013 to August 2013, and subjected to blood culture and sepsis screen tests such as C-reactive protein (CRP), micro erythrocyte sedimentation rate (m-ESR), white blood cell count, absolute neutrophil count, I/T ratio, and platelet count. The culture results were correlated with the sepsis score and the sepsis screen tests. Results: Of the 100 cases studied, 63 were blood culture-positive. Higher proportions of septic babies were male (63.4%), preterm (65.1%), low birth weight (76.2%), inborn (52.4%), and those delivered spontaneously (80.9%). Gram-negative organisms (84.13%) were predominant such as Klebsiella (54%), followed by Pseudomonas (15.9%) and Escherichia coli (11.1%). Sepsis screen laboratory parameters such as CRP and m-ESR were significantly associated with culture-proven sepsis. CRP followed by thrombocytopenia and I/T ratio had more sensitivity and high negative predictive value. Leukopenia followed by m-ESR and neutropenia had high specificity and positive predictive value. On applying sepsis risk score, 81.3% were found to be culture-positive in the high-risk category; however, 49% of those with low sepsis risk score were also culture-positive. Conclusion: High-risk newborns identified on the basis of perinatal history by Takkar and Bhakoo sepsis score should be started on antibiotic treatment early. However, the present study illustrates less reliability of this score in low- and moderate-risk categories. A negative septic laboratory screen, in addition to low or moderate sepsis risk score, would be more justifiable in withholding antibiotics in such patients. Blood culture remains the definitive deciding factor.


[FULL TEXT] [PDF]*
Print this article     Email this article
 Next article
 Previous article
 Table of Contents

 Similar in PUBMED
  Search Pubmed for
  Search in Google Scholar for
Related articles
 Citation Manager
 Access Statistics
 Reader Comments
 Email Alert *
 Add to My List *
 * Requires registration (Free)
 

 Article Access Statistics
    Viewed3787    
    Printed37    
    Emailed0    
    PDF Downloaded611    
    Comments [Add]    

Recommend this journal