Rapid diagnosis of neonatal septicemia by buffy coat smear examination and c-reactive protein test in correlation with blood culture

Abstract

Objective: To isolate the organism responsible for neonatal septicemia from blood and to correlate the blood culture results with rapid diagnostic methods like buffy coat smear examination (BCS) and C-reactive protein (CRP) test. Methods: Study was done over a period of 2 years at a tertiary care hospital in a rural set up in Karnataka State, South India. Blood samples from 200 clinically suspected neonatal septicemia cases were subjected to aerobic culture and rapid diagnostic methods like buffy coat smear examination by Gram’s stain and C-reactive protein test. The blood culture results were correlated with these rapid methods. Results : Of the 200 cases studied, 95 (47.5%) were blood culture positive. Gram negative isolates were 70.53% and Gram positive 29.47%. Enterobacter cloacae and Staphylococcus aureus were the commonest organisms isolated ( 20% and 11.58% of cases respectively). Buffy coat had specificity of 86.1% and sensitivity of 55.3%. CRP test had 87.37% sensitivity and 71.43% specificity . Conclusion: Rapid diagnostic methods like buffy coat smear examination and C-reactive protein test needs to be evaluated with other sepsis screening methods. Blood culture remains the gold standard for the diagnosis of neonatal septicemia . Rapid diagnostic methods certainly helps in early diagnosis but has to be correlated with blood culture report.