Evaluation of hematological markers (TLC, neutrophil count) and CRP protein in early diagnosis of neonatal sepsis, taking blood culture as gold standard
DOI:
https://doi.org/10.61529/idjp.v34i1.340Abstract
Background: Neonatal sepsis is one of the major causes of neonatal mortality and morbidity. This study was done to determine the accuracy of TLC and Neutrophil count for early diagnosis of neonatal sepsis and to determine the diagnostic accuracy of C-Reactive protein (CRP) for early diagnosis of Neonatal sepsis.
Material and Methods: It was a cross-sectional study performed in Microbiology department, of a tertiary care Hospital, Lahore. A total of 241 blood samples were collected in the blood culture bottles, incubated and inoculated on blood and MacConkey agar plates. Final identification was performed using API and VITEK2. Antimicrobial susceptibility testing (AST) was performed according to CLSI 2024.
Results: Out of total 241 study subjects, 150(62%) were males and 91(38%) were females. 49 (20.3%) blood culture were positive. Among the isolated microorganisms, Acinetobacter baumannii 8(16.3%), Acinetobacter jhonsonii 3(6.1%), coagulase negative Staphylococci 15(30.6%), Methicillin resistant Staphylococci 3(6.1%), Enterococcus faecalis 3(6.1%), Klebsiella pneumoniae 8(16.3%), Listeria monocytogenes 1(2.0%), Pseudomonas aeruginosa 2(4.1%), and Serratia marcescens 6(12.2%) were seen. Majority of the gram-positive bacteria were resistant against penicillin, and sensitive to vancomycin and linezolid. Whereas, the gram-negative bacteria are most resistant to ampicillin, least resistant noted against carbapenems.
Conclusion: The present study aims to identify the role of hematological indicators as TLC, DLC and CRP, as early indicator of neonatal sepsis. The results of the hematological markers and serum CRP received in a much less time as compared to the blood culture that gives results after the delay of 4 days.
Keywords: Neonatal sepsis, TLC, CRP, Rapid diagnosis
References
Ansari S, Nepal HP, Gautam R, Shrestha S, Neopane P, Chapagain ML. Neonatal septicemia in Nepal: Early-onset versus late-onset. Int J Pediatr. 2015; 2015: 79806. DOI: https://doi.org/10.1155/2015/379806
Marks L, de Waal K, Ferguson JK. Time to positive blood culture in early onset neonatal sepsis: A retrospective clinical study and review of the literature. J Paediatr Child Health. 2020; 56(9): 1371-5. DOI: https://doi.org/10.1111/jpc.14934
Chacko B, Sohi I. Early onset neonatal sepsis. Indian J Pediatr. 2005; 72: 23-6. DOI: https://doi.org/10.1007/bf02760574
Beck C, Gallagher K, Taylor LA, Goldstein JA, Mithal LB, Gernand AD. Chorioamnionitis and risk for maternal and neonatal sepsis: A systematic review and meta-analysis. Obstet Gynecol. 2021; 137(6): 1007-22. DOI: https://doi.org/10.1097/aog.0000000000004377
Jehan I, Harris H, Salat S, Zeb A, Mobeen N, Pasha O, et al. Neonatal mortality, risk factors and causes: a prospective population-based cohort study in urban Pakistan. Bull World Health Organ. 2009; 87(2): 130-8. DOI: https://doi.org/10.2471/BLT.08.050963
Doronjski A, Barišić N, Stojanović V. Risk factors for neonatal sepsis and method for reduction of blood culture contamination. Malawi Med J. 2015; 27(1): 20-4. DOI: https://doi.org/10.4314/mmj.v27i1.6
Memar MY, Alizadeh N, Varshochi M, Kafil HS. Immunologic biomarkers for diagnostic of early-onset neonatal sepsis. J Matern Fetal Neonatal Med. 2019; 32(1): 143-53. DOI: https://doi.org/10.1080/14767058.2017.1366984
Kocabas E, Sarikcioglu A, Aksaray N, Seydaoglu G, Seyhun Y, Yaman A. Role of procalcitonin, C-reactive protein, interleukin-6, interleukin-8 and tumor necrosis factor-alpha in the diagnosis of neonatal sepsis. Turk J Pediatr. 2007; 49(1): 7. Available from: https://turkjpediatr.org/article/view/2503/2471
Dilli D, Ogˇuz ŞS, Dilmen Uu, Köker MY, Kızılgün M. Predictive values of neutrophil CD64 expression compared with interleukin‐6 and C‐reactive protein in early diagnosis of neonatal sepsis. J Clin Lab Anal. 2010; 24(6): 363-70. DOI: https://doi.org/10.1002/jcla.20370
Rafati M, Farhadi R, Nemati-Hevelai E, Chabra A. Determination of frequency and antibiotic resistance of common bacteria in late onset sepsis at the neonatal ward in Booali-Sina Hospital of Sari, Iran. J Babol Univ Med Sci. 2014; 16(6): 64-71. DOI: http://dx.doi.org/10.18869/acadpub.jbums.16.6.64
Masood MK, Butt N, Sharif S, Kazi Y. Clinical spectrum of early onset neonatal sepsis. Ann King Edward Med Univ. 2011;17(1): 27. DOI: https://doi.org/10.21649/akemu.v17i1.265
Ahmed Z, Ghafoor T, Waqar T, Ali S, Aziz S, Mahmud S. Diagnostic value of C-reactive protein and haematological parameters in neonatal sepsis. J Coll Physicians Surg Pak. 2005; 15(3): 152-6.
Sadiq HS, Ali S, Ullah H, Aaraj S, Khan A, Atif MM. Diagnostic accuracy of combination of abnormal total leukocyte count, platelet count and C-reactive protein for diagnosis of neonatal sepsis taking blood culture as gold standard. Rawal Med J. 2021; 46(4): 862-5.
Available from: https://www.rmj.org.pk/fulltext/27-1617710737.pdf?1740650109
Ahmed M, Yasrab M, Khushdil A, Qamar K, Ahmed Z. Neonatal sepsis in a tertiary care hospital: bacteriological profile and its antimicrobial sensitivity. Pak Armed F Med J. 2018; 68(6): 1654-58. Available from: https://pafmj.org/PAFMJ/article/view/2566
Manzar N, Manzar B, Yaqoob A, Ahmed M, Kumar J. The study of etiological and demographic characteristics of neonatal mortality and morbidity-a consecutive case series study from Pakistan. BMC Pediatr. 2012; 12: 1-6. DOI: https://doi.org/10.1186/1471-2431-12-131
Qadeer S, Javed I, Mushtaq S, Anwar MS. Trends in etiology and antimicrobial patterns in neonatal sepsis. a descriptive study in a tertiary care hospital, Lahore. Pak J Pathol. 2017; 28(2): 69-76. Available from: https://pakjpath.com/index.php/Pak-J-Pathol/article/view/400/370
Khan QA, Iqbal H, Rehman H. Trends in patterns of resistance among micro organisms causing neonatal sepsis in Peshawar. JPMI. 2012;26(2): 165-9. DOI:https://www.jpmi.org.pk/index.php/jpmi/article/view/1261/1236
Chharra S, Khan S, Shukur A, Hossain MR, Haque S, Faruque S. Bacteriological profile of neonatal septicaemia and Antibiotic susceptibility pattern of the isolates admitted in SCANU of a tertiary levels hospital of North Bengal, Bangladesh. Saudi J Med Pharm Sci. 2023; 9(4): 248-53. Available from: https://saudijournals.com/media/articles/SJMPS_94_248-253_c.pdf
Shah AJ, Mulla SA, Revdiwala SB. Neonatal sepsis: high antibiotic resistance of the bacterial pathogens in a neonatal intensive care unit of a tertiary care hospital. J Clin Neonatol. 2012; 1(2): 72-5. DOI: https://doi.org/10.4103/2249-4847.96753
Sharma CM, Agrawal RP, Sharan H, Kumar B, Sharma D, Bhatia SS. Neonatal sepsis: Bacteria & their susceptibility pattern towards antibiotics in neonatal intensive care unit. J Clin Diagn Res. 2013; 7(11): 2511-3. DOI: https://doi.org/10.7860/jcdr/2013/6796.3594
Worku M, Aynalem M, Biset S, Woldu B, Adane T, Tigabu A. Role of complete blood cell count parameters in the diagnosis of neonatal sepsis. BMC Pediat. 2022; 22(1): 411. DOI: https://doi.org/10.1186/s12887-022-03471-3
Agnello L, Giglio RV, Bivona G, Scazzone C, Gambino CM, Iacona A, et al. The value of a complete blood count (CBC) for sepsis diagnosis and prognosis. Diagn. 2021; 11(10): 1881.
DOI: https://doi.org/10.3390/diagnostics11101881
Shoukry LR, Mohamed AN, Sharaf AE, Osman OB. Diagnostic markers for early detection of neonatal sepsis. J Sci Res Med Biolog Sci. 2021;2(3):13-26. DOI: https://doi.org/10.47631/jsrmbs.v2i3.319
Seyedeh Zohreh Jalali, Shayan Pourkazem, Roghayeh Hojjat Ansari, et al. Diagnostic values of complete blood count parameters and C-reactive protein in neonatal sepsis workup. Authorea. 2024. DOI: https://doi.org/10.22541/au.172959308.84991155/v1
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