A prospective study of haematological parameters in neonatal sepsis

Introduction: Neonatal sepsis is defined as a clinical syndrome ofbacteraemia with systemic signs and symptoms of infectionin the first 4 weeks of life. When pathogenic bacteria gainaccess into the blood stream, they may cause overwhelminginfection without much localization or may getpredominantly localized to the lung or the meninges. Materials and Methods: This was a prospective study done in the departments of Department of Pathology, Hazaribag Medical College, Hazaribag, Jharkhand, India from July 2019 to July 2020. A total of 220 neonates in the department of pediatrics and neonatology were included in the study. Informed consent was taken from the parents of all the neonates. Taking all aseptic precautions, 2 ml of blood was withdrawn from suspected neonates within 24 h of admission. One milliliter of sample was anticoagulated with EDTA and using Sysmex XS-800i automated hematology analyzer, values of TLC and platelet count were noted and counter checked. Another 1 ml of blood was collected in red Vacutainer and allowed to rest for 30 min. It was then centrifuged and the serum was obtained for CRP estimation. Results: A total of 220 neonates were classified into three categories, sepsis (n=92), probable infection (n=44), and normal (n=84), based on the clinical examination and laboratory findings. The total number of culture positive cases was 92 (41.84%) and culture was bacteriologically negative in 128 (58.18%) cases.The total number of preterm babies was 124 (56.36%) while 96 (43.63%) were term babies. Preterm babies were more affected by sepsis than term babies. There were 132 (60%) males and 88 (40%) females. Conclusion: Diagnosis of neonatal septicemia may be difficult as the early signs of sepsis may be subtle and different at different gestational ages. The HSS is a simple, quick, and cost-effective tool which can be used as screening test for early diagnosis of neonatal sepsis. It is applicable to all infants, including those who have received antibiotic therapy before evaluation and simplifies the interpretation of hematologic profile