بررسي علايم باليني و آزمايشگاهي در نوزادان مشكوك به سپسيس

The Study of Clinical Symptoms and Laboratory Signs in Neonates

Background: Neonatal sepsis, a major cause of death of neonates worldwide, is diagnosed by obtaining positive blood culture. The aim of this study was to determine common laboratory and clinical findings in the neonates who are suspected of sepsis. Method: The medical records of 200 infants, aged <30 days, with suspected. infection, who were admitted in Mostafa Khomeini & Hazrate Zeynab hospitals in Tehran, were reviewed retrospectively. Based on clinical and biological findings, diagnosis was classified into 3 groups as follows: A: Proven sepsis with positive blood culture. B: Probable sepsis with negative blood culture but laboratory consistant with sepsis. C. Clinical sepsis without any positive culture or laboratory abnormalities. The validity of laboratory tests, which had been performed as sepsis work-up, was compared with positive blood culture as gold standard test. Results: Of 200 infants 19 (9.5%) had positive blood culture. The most common causative organisms were klebsiella (5) staphylococous aureus (5) and staph Coagolase negative (5). Among laboratory tests, CRP with the specifity of 85% had the best sensitivity (79%) and negative predictive value (97%), but poor positive predictive value (36%). Conclusion: No laboratory tests can be used alone accurately as an early detection of septicemia.