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

Publication ,  Journal Article
Hornik, CP; Benjamin, DK; Becker, KC; Li, J; Clark, RH; Cohen-Wolkowiez, M; Smith, PB
Published in: Pediatr Infect Dis J
August 2012

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.

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Published In

Pediatr Infect Dis J

DOI

EISSN

1532-0987

Publication Date

August 2012

Volume

31

Issue

8

Start / End Page

803 / 807

Location

United States

Related Subject Headings

  • Sepsis
  • Risk Factors
  • ROC Curve
  • Prospective Studies
  • Pediatrics
  • Odds Ratio
  • Infant, Newborn, Diseases
  • Infant, Newborn
  • Humans
  • Cohort Studies
 

Citation

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Hornik, C. P., Benjamin, D. K., Becker, K. C., Li, J., Clark, R. H., Cohen-Wolkowiez, M., & Smith, P. B. (2012). Use of the complete blood cell count in late-onset neonatal sepsis. Pediatr Infect Dis J, 31(8), 803–807. https://doi.org/10.1097/INF.0b013e31825691e4
Hornik, Christoph P., Daniel K. Benjamin, Kristian C. Becker, Jennifer Li, Reese H. Clark, Michael Cohen-Wolkowiez, and P Brian Smith. “Use of the complete blood cell count in late-onset neonatal sepsis.Pediatr Infect Dis J 31, no. 8 (August 2012): 803–7. https://doi.org/10.1097/INF.0b013e31825691e4.
Hornik CP, Benjamin DK, Becker KC, Li J, Clark RH, Cohen-Wolkowiez M, et al. Use of the complete blood cell count in late-onset neonatal sepsis. Pediatr Infect Dis J. 2012 Aug;31(8):803–7.
Hornik, Christoph P., et al. “Use of the complete blood cell count in late-onset neonatal sepsis.Pediatr Infect Dis J, vol. 31, no. 8, Aug. 2012, pp. 803–07. Pubmed, doi:10.1097/INF.0b013e31825691e4.
Hornik CP, Benjamin DK, Becker KC, Li J, Clark RH, Cohen-Wolkowiez M, Smith PB. Use of the complete blood cell count in late-onset neonatal sepsis. Pediatr Infect Dis J. 2012 Aug;31(8):803–807.

Published In

Pediatr Infect Dis J

DOI

EISSN

1532-0987

Publication Date

August 2012

Volume

31

Issue

8

Start / End Page

803 / 807

Location

United States

Related Subject Headings

  • Sepsis
  • Risk Factors
  • ROC Curve
  • Prospective Studies
  • Pediatrics
  • Odds Ratio
  • Infant, Newborn, Diseases
  • Infant, Newborn
  • Humans
  • Cohort Studies