A Study of Hematological Changes in Neonatal Sepsis

  • Khushbu Dalasukhbhai Makadia Govt. Medical College, Bhavnagar, Gujarat, India.
  • Pragnesh Shah Govt. Medical College, Bhavnagar, Gujarat, India.
Keywords: Neonatal sepsis, hematological scoring system, blood culture, C- reactive protein


Background: Neonatal sepsis is one of the major causes of morbidity and mortality in the newborn. Early diagnosis and treatment are crucial in the management of neonatal sepsis. Blood culture, the gold standard, takes long time and lack sensitivity. Hematological sepsis score is a simple score obtained by combining routinely available tests and is rapid, non-expensive and has shown good correlation with blood culture. With this background the study was carried out to evaluate hematological changes in neonatal sepsis and to analyse the diagnostic utility of hematological scoring system (HSS) and its correlation with C- reactive protein and blood culture in neonatal sepsis. Methods: The study included 200 neonates admitted to Neonatal Intensive Care Unit with clinical suspicion of neonatal sepsis. CBC, Peripheral blood smear, CRP and Blood culture were obtained from all the neonate. Hematological sepsis score was calculated, and its sensitivity and specificity were obtain using blood culture as gold standard. Result: We screened 200 neonates with suspected neonatal sepsis. Blood culture was positive in 101 (50.5%) and HSS score >2 was found in 80 (40%) neonates. CRP and HSS had sensitivity of 84.15% and 72.27% and specificity of 68.68% and 92.92% respectively. Conclusion: Our study shows that HSS had fairly good sensitivity and specificity for neonatal sepsis screening and HHS can be utilized for neonatal sepsis screening.

Author Biographies

Khushbu Dalasukhbhai Makadia, Govt. Medical College, Bhavnagar, Gujarat, India.
Department of Pathology
Pragnesh Shah, Govt. Medical College, Bhavnagar, Gujarat, India.
Department of Pathology


1. Chaurasia S, Sivananda S, Agarwal R, Ellis S, Sharland M, Sankar MJ. Neonatal sepsis in South Asia: huge burden and spiralling antimicrobial resistance. BMJ 2019;364:K5314.
2. Gengaimuthu K, Karthikeyan V. Towards an ideal neonatal sepsis screen panel - A review Karthikeyan. Indian J. Child Health 2017;4:614–8.
3. Mondal SK, Nag DR, Bandyopadhyay R. Neonatal sepsis : Role of a battery of immunohematological tests in early diagnosis. Int. J. Appl. Basic Med. Res. 2012;2:43–8.
4. Pal K, Samanta AK. Evaluation Of Hematological Parameters In Early Onset Neonatal Sepsis. NJIRM 2013;4:29–34.
5. Vandana G, Lokesh S, Kavita B. Haematological Profile in Neonatal Septiceamia. IOSR J. Dent. Med. Sci. 2017;16:11–7.
6. Ms S, Alva SR, Vs S, Tm K. Research article evaluation of neonatal septicaemia using hematological parantelers. Int. J. Recent Sci. Res. 2015;6:2775–8.
7. Bs V, Girish GN, Adhikari S, Hugara S. Evaluation of Septic Screen as a Diagnostic Tool for Neonatal Sepsis in a Tertiary Hospital at Mysore. Sch. J. Appl. Med. Sci. 2015;3:1005–10.
8. Bhale CP, Kale AV, Kale SS, Mahajan M, Smulay S. Utility of Sepsis Screen in the Early Diagnosis of Neonatal Sepsis. Indian J. Neonatal Med. Res. 2016;4:1–7.
9. Makkar M, Gupta C, Pathak R, Garg S, Mahajan NC. Performance Evaluation of Hematologic Scoring System in Early Diagnosis of Neonatal Sepsis. J. Clin. Neonatol. 2013;2:25–9.
10. Bhalodia M, Surekha B, Hippargi M, Patil M. Role of Hematological Scoring System in Diagnosis of Neonatal Sepsis. J. Clin. Neonatol. 2017;6:1–4.
11. Manroe BL, Weinberg AG, Rosenfield CR, Browne R. The neonatal blood count in health and disease . L Reference values for neutrophilic cells. Fetal Neonatal Med. 1979;95:89–98.
12. Sriram R. Correlation of Blood culture results with the Sepsis score and the Sepsis screen in the diagnosis of Neonatal Septicemia . Int J Biol Med Res 2011;2:360–8.
13. Misra RN, Jadhav S V, Ghosh P, Gandham N, Angadi K. Role of sepsis screen in the diagnosis of neonatal sepsis. Med. J. Dr. D.Y. Patil Univ. 2013;6:254–8.
Original Article