Use of the Complete Blood Cell Count in Late-onset Neonatal Sepsis
The Pediatric Infectious Disease Journal, 07/27/2012
Hornik CP et al. – No complete blood cell count index possessed adequate sensitivity to reliably rule out late–onset sepsis in this population.Methods
- Using a cohort of all infants with cultures and complete blood cell count data from a large administrative database, they 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.
- 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/mm3 and >50,000/mm3 (>99%).
- Positive likelihood ratios were highest for white blood cell counts <1000/mm3 (4.1) and platelet counts <50,000/mm3 (3.5).