Micro ESR in the evaluation of neonatal sepsis

Abstract

Introduction: Neonatal sepsis is a major cause of neonatal morbidity and mortality in the developing countries like Nepal. Early diagnosis and treatment is crucial for the outcome but it is difficult in many situations especially in places with limited resources. Objective of this study is to evaluate the role of micro ESR in the diagnosis of neonatal sepsis

Methods: A prospective analytical study was done where newborns with suspected sepsis admitted for septic work up and IV antibiotics were included in the study. Micro ESR was measured with relevant septic screening investigations. The micro ESR value was compared to age specific normal values and the results were compared with various clinical presentations, laboratory findings and outcome variables.

Results: Out of 111 babies micro ESR was elevated in 63 babies and blood culture was positive in 15 cases and meningitis was present in 8 cases. Total proven cases were 16 and probable sepsis were 34. Correlation of elevated micro ESR was statistically significant with PROM >18 hours, presence of clinical symptoms, clinical and systemic signs. It had significant clinical association with blood culture and CSF findings. The sensitivity, specificity, positive and negative predictive value compared with blood culture was 100%, 47.5%, 15.6% and 20.8%, comparing with proven or no sepsis cases was 70.5%, 48.1%, 36.9% and 50% respectively.

Conclusions: Micro ESR is simple cheap and relatively sensitive, specific with good negative predictive value in the prediction of neonatal sepsis and can be useful test in settings with limited resources.