Comparison of Clinical Features and Hematological Parameters Between Culture Positive and Negative Neonatal Sepsis

Rowshon Jahan Akhter1, MAK Azad Chowdhury2, BH Nazma Yasmeen3, Kanta Chowdhury1,
Ayesha Noor1

Introduction
Neonatal sepsis is the most important cause of morbidity and mortality especially among low birth weight and preterm babies in developing countries. Neonatal sepsis is diagnosed when generalized systemic features are associated with pure growth of bacteria from one or more sites. When clinical and laboratory findings are consistent with bacterial infection but blood culture is sterile, infant is labeled to have “probable sepsis”. According to pooled hospital data based on NNPD survey, the incidence of neonatal sepsis is around 30 per 1000 live births.1 The burden of neonatal septicaemia has remained high worldwide and even more severe in the developing countries like ours. Clinical manifestation is variable and non-specific thereby resulting in delay in diagnosis. Blood culture which is the gold standard for diagnosis of neonatal septicaemia (NNS) has many drawbacks due to long waiting time for culture process, low yield, improper inoculation adding to the problem of late diagnosis. Haematological parameters have been utilized in rapid and early diagnosis of NNS and prompt treatment thus circumventing problems associated with drawbacks in blood culture.2 Sepsis in neonates may be difficult to differentiate from other conditions because the clinical signs are non specific. The hematological response to inflammation in neonates includes many changes in the form of an abnormal total count, morphological changes, thrombocytopenia and various inflammatory markers in serum.

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