engleski

Diagnostic accuracy of C-reactive protein, total leukocyte count, platelet count and diffrential blood count in newborn sepsis

Determination of C-reactive protein (CRP), total leukocyte count, platelet count (PLT) and differential blood count (DBC) repre sents a „ sepsa-sc reen“ diagnostic approach in newborns clini cally suspected of sepsis. The aim of the study was to assess diagnostic acc uracy of these pa rameters in newborns with sepsis. Materials and methods. The study inclu ded 58 newborns with sepsis and 328 healthy newborns. CRP concentration was determined by particle enhanced immunoturbidimetric assay (Olympus AU2700). Complete blood count was determined on an automated blood counter (Cell-Dyn 3200, Abbott Diagnostics). DBC was determined by microscopic method in stained periphera l blood smear. Di agnostic accuracy was evaluated using the receiver opera ting characteristic (ROC) analysis. Results. ROC analysis showed excellent discriminating powe rof CRP (AUC=0.970, sensitivity (Se)=89.7%, specificity (Sp)=96%, cut-off >11.5 mg/L. Among the parameters of DBC, acceptable diagnostic accuracy was obtained for immature to total neutrophil ratio (I/T ratio, AUC=0.789, Se=77 .2%, Sp=73.2%, cut-ff>0.11), immature t o mature neutrophil ratio (I/M ratio, AUC=0.774, Se=75%, Sp=73.6%, cut-off>0.13) and percentage of band cells (AUC=0.784, Se=82.8%, Sp=66.2%, cut-off>5%). Absolute neutrophil count (AUC=0.607, Se=54.7%, Sp=66.1%), lymphocyte count (AUC=0.659, Se=82.5%, Sp=47.9%), total leukocyte count (AUC=0.629, Se=65.5%, Sp=56.9%) and platlet count (AUC=0.542, Se=62.1%, Sp=49.2%) showed unacceptable discriminating power in the diagnosis of neonata l sepsis. Conclusions. The concentration of CRP showed the best diagnostic accuracy in the diagnosis of neonatal sepsis. Acceptable discriminating power i n the diagnosis of neonatal sepsis showed I/T and I/M ratios and percentage of band cells. Total leukocyte count and platele t count are not reliable diagnostic indicators of neonatal sepsis.

C-reactive protein; Leukocyte count; Platelet count; Newborn; Sepsis

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