PEDIATRICS Vol. 65 No. 5 May 1980, pp. 1036-1041
This Article
Right arrow Full Text (PDF)
Right arrow Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow E-mail this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via CrossRef
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Philip, A. G. S.
Right arrow Articles by Hewitt, J. R.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Philip, A. G. S.
Right arrow Articles by Hewitt, J. R.

Early Diagnosis of Neonatal Sepsis

Alistair G. S. Philip MB, FRCP(E), DCH1 and Jean R. Hewitt BS1

1 Department of Pediatrics, University of Vermont College of Medicine, Burlington

To better define the need for antibiotic therapy, several tests recommended as helpful in diagnosing neonatal sepsis were evaluated in 376 neonates during the first week after birth. The five most useful tests (with definitions of abnormality) were: band/total neutrophils ([unknown]0.2); leukocyte count (<5,000/cu mm); latex-C-reactive protein (positive >0.8 mg/100 ml); ESR ([unknown]15 mm for the first hour); and latex haptoglobin (positive >25 mg/100 ml). When these five tests were applied early (at the time infection was suspected and blood culture sent), 28 of 30 cases (93%) subsequently proven to have infection had two or more abnormal tests. This compares with only 24 of 320 babies (8%) with no subsequently documented evidence of infection. Of all babies who had two or more tests positive (n = 71), 39% had proven sepsis, and an additional 23% had "very probable" infection. The combination of leukopenia and an elevated band/total neutrophil ratio seems to be particularly predictive of sepsis (13 of 17 babies with this combination had proven sepsis). When less than two tests were positive, the probability that sepsis was not present was 99%. These simple, rapid tests require no special laboratory facilities and provide a valuable adjunct in the early detection of the neonate with sepsis.

Submitted on September 28, 1979
Accepted on November 15, 1979




This article has been cited by other articles:


Home page
 Mol. Cell. ProteomicsHome page
S. F. Kingsmore, N. Kennedy, H. L. Halliday, J. C. Van Velkinburgh, S. Zhong, V. Gabriel, J. Grant, W. D. Beavis, V. T. Tchernev, L. Perlee, et al.
Identification of Diagnostic Biomarkers for Infection in Premature Neonates
Mol. Cell. Proteomics, October 1, 2008; 7(10): 1863 - 1875.
[Abstract] [Full Text] [PDF]

Home page
 NeoReviewsHome page
A. G.S. Philip
Historical perspectives: Group B Streptococcus in Neonatal Sepsis: Emergence as an Important Pathogen
NeoReviews, November 1, 2004; 5(11): e467 - e470.
[Full Text] [PDF]

Home page
 Clin. Microbiol. Rev.Home page
D. Kaufman and K. D. Fairchild
Clinical Microbiology of Bacterial and Fungal Sepsis in Very-Low-Birth-Weight Infants
Clin. Microbiol. Rev., July 1, 2004; 17(3): 638 - 680.
[Abstract] [Full Text] [PDF]

Home page
 PediatricsHome page
A. R. Franz, K. Bauer, A. Schalk, S. M. Garland, E. D. Bowman, K. Rex, C. Nyholm, M. Norman, A. Bougatef, M. Kron, et al.
Measurement of Interleukin 8 in Combination With C-Reactive Protein Reduced Unnecessary Antibiotic Therapy in Newborn Infants: A Multicenter, Randomized, Controlled Trial
Pediatrics, July 1, 2004; 114(1): 1 - 8.
[Abstract] [Full Text] [PDF]

Home page
 Clin. Chem.Home page
C. Chiesa, A. Panero, J. F. Osborn, A. F. Simonetti, and L. Pacifico
Diagnosis of Neonatal Sepsis: A Clinical and Laboratory Challenge
Clin. Chem., February 1, 2004; 50(2): 279 - 287.
[Full Text] [PDF]

Home page
 Arch. Dis. Child. Fetal Neonatal Ed.Home page
A Maayan-Metzger, R Mazkereth, and J Kuint
Fever in healthy asymptomatic newborns during the first days of life
Arch. Dis. Child. Fetal Neonatal Ed., July 1, 2003; 88(4): F312 - F314.
[Abstract] [Full Text] [PDF]

Home page
 Clin. Chem.Home page
C. Chiesa, G. Pellegrini, A. Panero, J. F. Osborn, F. Signore, M. Assumma, and L. Pacifico
C-Reactive Protein, Interleukin-6, and Procalcitonin in the Immediate Postnatal Period: Influence of Illness Severity, Risk Status, Antenatal and Perinatal Complications, and Infection
Clin. Chem., January 1, 2003; 49(1): 60 - 68.
[Abstract] [Full Text] [PDF]

Home page
 Arch Pediatr Adolesc MedHome page
J. C. Brown, J. L. Burns, and P. Cummings
Ampicillin Use in Infant Fever: A Systematic Review
Arch Pediatr Adolesc Med, January 1, 2002; 156(1): 27 - 32.
[Abstract] [Full Text] [PDF]

Home page
 PediatricsHome page
I. Nupponen, S. Andersson, A.-L. Jarvenpaa, H. Kautiainen, and H. Repo
Neutrophil CD11b Expression and Circulating Interleukin-8 as Diagnostic Markers for Early-Onset Neonatal Sepsis
Pediatrics, July 1, 2001; 108(1): e12 - 12.
[Abstract] [Full Text] [PDF]

Home page
 PediatricsHome page
K. Haspolat, S. Günbey, and O. Derman
A Randomized Trial of Granulocyte-Macrophage Colony-Stimulating Factor in Neonates With Sepsis and Neutropenia
Pediatrics, January 1, 2001; 107(1): 36 - 41.
[Abstract] [Full Text]

Home page
 PediatricsHome page
D.-S. Lin, S.-H. Huang, C.-C. Lin, Y.-C. Tung, T.-T. Huang, N.-C. Chiu, H.-A. Koa, H.-Y. Hung, C.-H. Hsu, W.-S. Hsieh, et al.
Urinary Tract Infection in Febrile Infants Younger Than Eight Weeks of Age
Pediatrics, February 1, 2000; 105(2): 20e - 20.
[Abstract] [Full Text]

Home page
 PediatricsHome page
A. R. Franz, G. Steinbach, M. Kron, and F. Pohlandt
Reduction of Unnecessary Antibiotic Therapy in Newborn Infants Using Interleukin-8 and C-Reactive Protein as Markers of Bacterial Infections
Pediatrics, September 1, 1999; 104(3): 447 - 453.
[Abstract] [Full Text] [PDF]

Home page
 Arch Pediatr Adolesc MedHome page
N. Kuppermann and E. A. Walton
Immature Neutrophils in the Blood Smears of Young Febrile Children
Arch Pediatr Adolesc Med, March 1, 1999; 153(3): 261 - 266.
[Abstract] [Full Text] [PDF]

Home page
 PediatricsHome page
W. E. Benitz, M. Y. Han, A. Madan, and P. Ramachandra
Serial Serum C-Reactive Protein Levels in the Diagnosis of Neonatal Infection
Pediatrics, October 1, 1998; 102(4): e41 - 41.
[Abstract] [Full Text] [PDF]

Home page
 PediatricsHome page
W. D. Engle, C. R. Rosenfeld, A. Mouzinho, R. C. Risser, F. Zeray, and P. J. Sanchez
Circulating Neutrophils in Septic Preterm Neonates: Comparison of Two Reference Ranges
Pediatrics, March 1, 1997; 99(3): e10 - e10.
[Abstract] [Full Text] [PDF]

Home page
 NEJMHome page
M. D. Baker, L. M. Bell, and J. R. Avner
Outpatient Management without Antibiotics of Fever in Selected Infants
N. Engl. J. Med., November 11, 1993; 329(20): 1437 - 1441.
[Abstract] [Full Text]

Home page
 CLIN PEDIATRHome page
D. M. Selby, G. Gautier, N. L.C. Luban, and J. M. Campos
Overwhelming Neonatal Septicemia Diagnosed Upon Examination of Peripheral Blood Smears
Clinical Pediatrics, December 1, 1990; 29(12): 706 - 709.
[PDF]

Home page
 CLIN PEDIATRHome page
C. W. Broner, S. A. Polk, and J. M. Sherman
Febrile Infants Less than Eight Weeks Old: Predictors of Infection
Clinical Pediatrics, August 1, 1990; 29(8): 438 - 443.
[Abstract] [PDF]

Home page
 Journal of Pharmacy PracticeHome page
S. Phillips and G. Kaplan
Drug Therapy in Neonatal Sepsis
Journal of Pharmacy Practice, January 1, 1989; 2(1): 28 - 35.
[Abstract] [PDF]

Home page
 CLIN PEDIATRHome page
A. G. S. Philip
Neonatal Sepsis Resulting from Possible Amniotic Fluid Infection: Risk and Detection
Clinical Pediatrics, April 1, 1982; 21(4): 210 - 214.
[Abstract] [PDF]

Home page
 CLIN PEDIATRHome page
S. A. Spector, W. Ticknor, and M. Grossman
Study of the Usefulness of Clinical and Hematologic Findings in the Diagnosis of Neonatal Bacterial Infections
Clinical Pediatrics, June 1, 1981; 20(6): 385 - 392.
[Abstract] [PDF]