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Hematologic Scoring System (HSS); a simple diagnostic tool to detect Early Neonatal Sepsis in a Resource Limited Setup.

Abstract

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

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DOI :
Volume & Issue : 2018: Volume 2 Issue 5
Page No.:

Citation

Asif, D. F. (2018). Hematologic Scoring System (HSS); a simple diagnostic tool to detect Early Neonatal Sepsis in a Resource Limited Setup. Journal of Medical Practice and Review, 2(05). Retrieved from http://jmpr.info/index.php/jmpr/article/view/59



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