EVALUATION OF IMMATURE GRANULOCYTES AS AN EARLY PREDICTOR OF NEONATAL SEPSIS AS COMPARED TO BLOOD CULTURE

Abstract

Neonatal sepsis is the commonest and important cause for morbidity and mortality of neonates in developing countries.Various studies have documented high level of immature granulocytes count in early stages of sepsis. The aim of this study was to assess sensitivity & specicity of immature granulocyte count % by automated hematology analyser (sysmex XN 550) in detecting culture proven neonatal sepsis at Assam Medical College Hospital.A total of 90 neonates were selected with clinical signs & symptoms associated with neonatal sepsis & with risk factors for sepsis.4 ml of peripheral venous blood was collected under aseptic conditions.1 ml blood was sent for estimation of serum CRP.2 ml blood was sent for estimation of TLC,ANC ,IG% by automated hematology analyser.1ml blood was sent for culture and sensitivity testing.Out of 90 cases studied,49 cases (54.44%) yielded positive blood culture & 41 cases (45.56%) were culture negative. The sensitivity and specicity of serum CRP in detecting neonatal sepsis were 73.47% and 65.85% respectively.32 cases with culture positivity had IG count >0.5% whereas 17 cases with culture positivity had IG count ≤ 0.5%.For an IG cut off 0.5% the sensitivity was 65.31% and specicity 75.61%. Immature granulocytes count % had signicant association (P value 0.00027) with onset of neonatal sepsis.It is a reliable indicator of culture proven neonatal sepsis & consumes less reporting time