Diagnostic Evaluation of Non-specific Indicators in Neonatal Septicemia

Objective:To evaluate the routine blood test and C-reactive protein in diagnosis of neonatal septicemia.Methods:A retrospective analysis of 81 cases of confirmed sepsis,61 cases of the clinical diagnosed sepsis and 172 cases of non-sepsis group from January 2008 to June 2009 was performed to make diagnostic evaluation of white cell count,platelet count,ratio of immature neutrophils to total neutrophils and C-reactive protein and their different thresholds.Results:CRP,PLT,I/T,WBC were significantly different(P0.05)in confirmed sepsis group and non-sepsis group.In all indicators of different diagnostic cutoff,when the CRP8 mg/L,I/T≥0.16,PLT≤100×10 9 /L,WBC increased(≤3 d by WBC25×109/L;3 d by WBC20×109/L)or WBC reduction(7×109/L),the sensitivities of each index were 34.6%,18.5%,8.6%,21.8%;specificities were 80.7%,85.8%,87.1%,83.3%;positive predictive values were 38.4%,31.3%,18.9%,33.3%;negative predictive values were 78.0%,75.2%,73.3%,73.6%;Youden indexes were 1.53,0.043,-0.043,0.051.Combined two or more non-specific targets,the specificity was above 90%.Conclusions:CRP,PLT,I/T,WBC are meaningful in diagnosis of neonatal septicemia and CRP is of the highest diagnostic value.WBC increased(≤3 d were WBC25×109/L;3 d were WBC20×109/L)or WBC reduction(7×109/L),CRP8 mg/L,I/T≥0.16,PLT ≤100×10 9 /L are the higher diagnostic cutoff of neonatal septicemia.The higher specificity of each index,the lower the rate of misdiagnosis,therefore,they are the ideal targets in the diagnosis of neonatal septicemia.