Role of sepsis screen in the diagnosis of neonatal sepsis

• Main Authors: Rabindra N Misra, Savita V Jadhav, Purbasha Ghosh, Nageswari Gandham, Kalpana Angadi, Chanda Vyawahare
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2013-01-01
• Series: Medical Journal of Dr. D.Y. Patil University
• Subjects: Blood culture; sepsis screen; methicillin sensitive Staphylococcal aureus; neonatal sepsis
• Online Access: http://www.mjdrdypu.org/article.asp?issn=0975-2870;year=2013;volume=6;issue=3;spage=254;epage=257;aulast=Misra

Background: Neonatal sepsis is the single most important cause of neonatal deaths globally. The incidence of neonatal sepsis in India is 30/1000 live births. Though blood culture is the gold standard, but it is not always positive even if clinical features of sepsis are present in the neonate. Materials and Methods: Blood cultures and sepsis screen was carried out on 115 neonates. Out of 115 neonates with clinical features of sepsis, 75 were blood culture positive. Sepsis screen was carried out with total leucocytes count, absolute neutrophils count, ratio of immature neutrophils (band forms) to total neutrophil count, C-reactive protein. The identification of the causative organism was carried out by standard identification tests and antibiotic sensitivity testing as per Clinicaland Laboratory Standards Institute (CLSI) guidelines. Results: In this study, out of 115 cases of clinical neonatal sepsis 75 (65.2%) were culture positive. Among isolates, number of gram negative bacilli were 39 (52%) was more than gram positive cocci 36 (34.8%). However, Staphylococcus aureus 24 (32%) was most predominant. Forty (34.8%) were culture negative out of which 15(13%) neonates were positive for two or more sepsis screen tests. Conclusion: Blood culture and sepsis screen should be carried out in neonates suspected of sepsis; however, an immediate institution of empirical antibiotic therapy should be considered as culture positive and sepsis screen may not be positive in all the clinical sepsis cases to save lives.