INTRODUCTION: Over past two decades neonatal morbidity associated with sepsis has increased due to changing microbial spectrum. To establish early diagnosis of neonatal sepsis is a challenge because of varied clinical presentations. For definite diagnosis of sepsis culture results are gold standard which are time consuming.The other recent available markers are sensitive but expensive. Hence they have limited use in financially constrained setup. Therefore there is always a need for an infallible cost-effective test to detect bacteremia that could be easily performed .In this study we have evaluated the effectiveness of the hematological scoring system (HSS) of Rodwell et al suggested in 1988 which is based on CBC report
MATERIAL AND METHODS:A prospective study was conducted in NICU of Liaquat National Hospital from October 2015 to march 2016. All Neonates with predisposing perinatal risk factors for sepsis or clinical indexof suspicion were enrolled in the study .A baseline CBC and blood C/S were sent. The hematological findings were analyzed according to the hematologic scoring system (HSS) of Rodwell et al . A score of 2 or above out of 7 was consider to be indicative of sepsis
RESULTS: 109 neonates were enrolled in the study, 63 were male and 46 were female. Of total 62(56.8) % were culture positive, in which 45 (41.2%) had positive blood culture, 13 (11.9%) had positive urine culture only 4 (3.6%) with positive tracheal culture isolated . The sensitivity of HSS detecting neonatal sepsis is 90.3%, specificity is 85.1%, positive predictive value (PPV) is 88.89% and negative predictive value (NPV) is 86.96%.
CONCLUSION: Rodwells’ hematological scoring system is a feasible and cost effective method in detecting early neonatal sepsis for the resource limited countries. However the emphasis for a well equipped laboratory and a trained hematologist is of much value