OBJECTIVE: To assess the utility of the hematologic scoring system (HSS) of Rodwell et al for the early detection of neonatal sepsis. DESIGN: Analysis of the peripheral smear findings according to the HSS by a pathologist blinded to the infection status of the neonate. SUBJECTS: One hundred and three high risk neonates having predisposing perinatal factors or clinical suspicion of sepsis. RESULTS: Analysis of the hematologic profiles in the light of the HSS found that an abnormal immature to total neutrophil (1:T) ratio followed by an abnormal immature to mature neutrophil (1:M) ratio were the most sensitive indicators in identifying infants with sepsis. These two criteria along with thrombocytopenia (< 1,50,000/cm3) had a high negative predictive value over 94%. The study also found that the higher the score the greater the certainty of sepsis being present. CONCLUSION: The HSS is simple, quick, cost effective and readily available tool in the early-diagnosis of neonatal sepsis and could provide a guideline to decisions regarding antibiotic therapy.
OBJECTIVE: To assess the utility of the hematologic scoring system (HSS) of Rodwell et al for the early detection of neonatal sepsis. DESIGN: Analysis of the peripheral smear findings according to the HSS by a pathologist blinded to the infection status of the neonate. SUBJECTS: One hundred and three high risk neonates having predisposing perinatal factors or clinical suspicion of sepsis. RESULTS: Analysis of the hematologic profiles in the light of the HSS found that an abnormal immature to total neutrophil (1:T) ratio followed by an abnormal immature to mature neutrophil (1:M) ratio were the most sensitive indicators in identifying infants with sepsis. These two criteria along with thrombocytopenia (< 1,50,000/cm3) had a high negative predictive value over 94%. The study also found that the higher the score the greater the certainty of sepsis being present. CONCLUSION: The HSS is simple, quick, cost effective and readily available tool in the early-diagnosis of neonatal sepsis and could provide a guideline to decisions regarding antibiotic therapy.