Comparison of Hematological Indices Against Blood Culture and Biomarkers- C-Reactive Protein, Endotoxin and Endotoxin Binding Protein in Screening Late-Onset Neonatal Sepsis

To the Editor: Isolation of bacteria from sterile fluids like blood, CSF and pleural fluids remains as gold standard for diagnosing neonatal sepsis. However, the time taken by the blood culture for reporting is long enough for spreading the infection and resulting in fatal outcomes [1]. Hence an ideal and accurate screening parameter is required for identifying late-onset neonatal sepsis (LONS). In case of neonatal sepsis, leukocytosis, thrombocytopenia, anemia and shortened coagulation time are the common hematological irregularities [2]. In our detailed study of identifying the diagnostic accuracy of endotoxin and endotoxin binding protein (EBP) in detecting LONS, both the markers have shown a good diagnostic value [3]. Thus, we compared hematological parameters with these novel biomarkers. Out of 160 suspected sepsis cases, 73 were culture positive. Seven had leukopenia in whom culture, CRP and endotoxin were positive in 3 and EBP in 2 cases. Five had abnormal ANC in whom culture, CRP and EBP were positive in 3 and endotoxin in 2 cases. Seven showed elevated I:T ratio in whom culture, CRP and endotoxin were positive in 4 and EBP in 3 cases. Sixty-five had thrombocytopenia in whom culture was positive in 43, CRP in 58 and endotoxin & EBP in 39 cases. …