DIAGNOSIS OF TWO TYPES OF NEONATAL SEPSIS USING A PRETESTED AND VALIDATED HEMATOLOGICAL SCORING SYSTEM AMONG THE NEONATES BORN IN A TERTIARY CARE HOSPITAL

Abstract

Background:preterm , low birth weight, and perinatal infections are some of the notable causal factors associated with  early (EONS) and late-onset (LONS) subtypes. Early diagnosis is vital, in order to increase the survival rates among the newborn babies .In order to detect the subtypes for an early intervention Hematological scoring systems (HSS) has emerged as a lifesaving boon for early diagnosis of both EONS and LONS.

Objective: To ascertain the diagnostic efficiency of the modified hematological scoring system in detection of early and late onset neonatal sepsis.

Methods: In this prospective observational study,(n-100 neonates) were enrolled over 12 months. Clinical data and hematological parameters (including total White Blood Cell count, neutrophil count, immature-to-total neutrophil ratio, platelet count, and other relevant markers) were recorded at admission. The scoring system was applied, and its performance was analyzed by comparing the score with blood culture confirmation as the reference standard. Data were stratified by sepsis onset (early vs. late) and various parameters determining diagnostic efficiency such as sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated.

Results:Out of 100 newborn babies that were assessed – 50 belonged to early clinical sepsis and 50 had late clinical sepsis.Also in the second group,more severe hematological abnormalities—elevated IT ratios, abnormal PMN counts, and increased immature PMNs were seen. Degenerative PMN changes were more common in EONS. Klebsiella pneumoniae was thestrongest and powerful pathogen determining the infectivity rate in both groups, and a thrombocyte count ≤150,000/mm³ remained the most reliable diagnostic marker with an accuracy of 81.7%.

Conclusion: This multifaceted index will serves as an important requisite in timely screening as well as confirming the provisional diagnosis for both the types of neonatal sepsis.