All issues > Volume 36(1); 1993

Original Article

J Korean Pediatr Soc. 1993;36(1):49-56. Published online January 15, 1993.

A Clinical Study on Early Diagnosis in Neonatal Sepsis

Jong Kwang JK Lee¹, Hae Won HW Cheon¹, Jee Hee JH Park¹, Jung Hwa JH Lee¹, Joo Won JW Lee¹, Soon Kyum SK Kim¹

¹Department of Pediatircs, College of Medicine, Korea University, Seoul, Korea

Abstract

Neonatal sepsis is a major contributing factor for increased mortality and morbidity in the newborn and its successful outcome depends on early detection and prompt institution of an effective antimicrobial therapy. Accurate diagnosis of the neonatal septicemia, however, is quite difficult because its early signs and symptoms are rather subtle. This study was conducted in an attempt to search for useful early markers for the clinical entity. A total of 224 newborns, over a 17-month period (1/90-5/91), who were evaluated for probable neonatal sepsis were analysed. The laboratory parameters that showed highest correlation with bacteriologically proves sepsis were as follows: Total WBC counts(<5,000/mm3), Band/Total neutrophils(0.2), elevated ESR(>15mm/hr), CRP(>6ng/ml). Of the 224 study subjects, 41 had two or more parameters of which 12 subjects had positive blood cultures (positive predictive value: 29%), Only 4 of the 183 newborns who had less than 2 parameters had positive blood cultures (false negative:2%). It is concluded that the presence of two or more of the above parameters can be used as a strong indicator for neonatal sepsis and its sensitivity is 75% while specificity is 86%.

Keywords :Neonatal Sepsis, Early diagnosis