Use of the complete blood cell count in late-onset neonatal sepsis.

Journal Article (Journal Article)

BACKGROUND: Late-onset sepsis is an important cause of morbidity and mortality in infants. Diagnosis of late-onset sepsis can be challenging. The complete blood cell count and differential have been previously evaluated as diagnostic tools for late-onset sepsis in small, single-center reports. OBJECTIVE: We evaluated the diagnostic accuracy of the complete blood cell count and differential in late-onset sepsis in a large multicenter population. STUDY DESIGN: Using a cohort of all infants with cultures and complete blood cell count data from a large administrative database, we calculated odds ratios for infection, as well as sensitivity, specificity, positive and negative predictive values and likelihood ratios for various commonly used cut-off values. RESULTS: High and low white blood cell counts, high absolute neutrophil counts, high immature-to-total neutrophil ratios and low platelet counts were associated with late-onset sepsis. Associations were weaker with increasing postnatal age at the time of the culture. Specificity was highest for white blood cell counts <1000/mm and >50,000/mm (>99%). Positive likelihood ratios were highest for white blood cell counts <1000/mm (4.1) and platelet counts <50,000/mm (3.5). CONCLUSION: No complete blood cell count index possessed adequate sensitivity to reliably rule out late-onset sepsis in this population.

Full Text

Duke Authors

Cited Authors

  • Hornik, CP; Benjamin, DK; Becker, KC; Li, J; Clark, RH; Cohen-Wolkowiez, M; Smith, PB

Published Date

  • August 2012

Published In

Volume / Issue

  • 31 / 8

Start / End Page

  • 803 - 807

PubMed ID

  • 22531232

Pubmed Central ID

  • PMC3399981

Electronic International Standard Serial Number (EISSN)

  • 1532-0987

Digital Object Identifier (DOI)

  • 10.1097/INF.0b013e31825691e4


  • eng

Conference Location

  • United States