Diagnostic efficacy of nucleated red blood cell count in neonatal sepsis: a prospective comparative study

Abstract

Objectives: Neonatal sepsis accounts for early-half of all neonatal deaths in India. Although the gold standard for diagnosis is by blood culture, there is a need for a test that is cheap, accurate and easily performed with quick availability of reports. In this study we have analysed the diagnostic value of nucleated red blood cells to correctly predict neonatal sepsis. Materials and Methods: A time bound, prospective comparative study was done on neonates with suspected neonatal sepsis for a 2 year period. Neonates were then analysed in three groups depending on their blood culture and septic parameter results as no sepsis, probable sepsis and proven sepsis. Nucleated red blood cells were analysed in all three groups with a cutoff value of 40cells/cumm. Results: 245 neonates were included in the study. The mean value of NRBC was 38.84, 26.45 and 5.06 in proven sepsis, probable sepsis and clinical sepsis group respectively. Nucleated RBCs had a sensitivity of 33.3%, Specificity of 95.6%, Positive predictive value of 75% and a negative predictive value of 78.5% in detecting sepsis. Conclusion: NRBC is a simple and cost effective test in early diagnosis of neonatal sepsis. It will help the clinicians in early diagnosis and treatment thereby reducing the neonatal morbidity and mortality.