Early Onset Neonatal Sepsis; Diagnostic Value of Some Laboratory Tests

Early Onset Neonatal Sepsis; Diagnostic Value of Some Laboratory Tests

Main Article Content

Tania Licona
German Fajardo
Rubén Ferrera
Alejandra Mazariegos


Early Onset Neonatal Sepsis (EONS) is a clinical situation resulting from the invasion and proliferation of bacteria, fungi or viruses in the newborn (NB) bloodstream, which occurs within the first 72 hours of life. To determine the diagnostic usefulness of laboratory tests performed on infants with suspicion of early neonatal sepsis at the Santa Barbara Integrated Hospital, Honduras. A case-control study was carried out during 2016; the cases were 20 infants with early onset neonatal sepsis, and the controls were 40 infants who were admitted as potentially septic, but the blood culture result was negative. Sensitivity, specificity, positive predictive value (PPV) and negative (NPV) of leukocytosis, platelets, initial C-reactive protein (CRP) and control were calculated. Data were analyzed with SPSS version 19. It was found that 17 (28.3 %) NB were women and 43 (71.7 %) were men. The VPP of the initial PCR was 5 %, increasing to 85 % in the control study. The isolated microorganism was enterobacter in 6 (30 %) of the RNs. Of the 23 (38.3 %) neonates who presented complications; 11 (48 %) had positive blood culture and 12 (52 %) had negative blood cultures. The discharge condition was medical discharge in 55 (92 %) and referred to a more complex hospital 5 (8 %) of the neonates. The VPP of the C-reactive protein increases considerably when doing a laboratory control,between 24-48 hours.


Adib, M.; Bakhshiani, Z.; Navaei, F.; Saheb Fosoul, F.; Fouladi, S. & Kazemzadeh, H. Procalcitonin: a reliable marker for the diagnosis of neonatal sepsis. Iran. J. Basic Med. Sci., 15(2):777-82,2012.

Arunachalam, A. R. & Pammi, M. Biomarkers in earlyonset neonatal sepsis: An update. Ann. Clin. Med. Microbiol., 1(2):1007, 2015.

Bhandari, V. Effective biomarkers for diagnosis of neonatal sepsis. J. Pediatr. Infect. Dis. Soc., 3(3):234-45, 2014.

Birju, B. A. & Padbury, J. F. Neonatal sepsis: an old problem with new insights. Virulence, 5(1):170- 8, 2014.

Chiesa, C.; Pacifico, L.; Osborn, J. F.; Bonci, E.; Hofer, N. & Resch, B. Early-onset neonatal sepsis: Still room for improvement in procalcitonin diagnostic accuracy studies. Medicine (Baltimore), 94(30):e1230, 2015.

Fernández, D. N.; de Estrada, R. J. D. & Díaz, C. F. Morbilidad y mortalidad por sepsis neonatal precoz. Rev. Cuba. Pediatr., 82(2), 2010. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S0034-75312010000200003

Mally, P.; Xu, J. & Hendricks-Munoz, K. D. Biomarkers for neonatal sepsis: Recent developments. Res. Rep. Neonatol., 4:157-68, 2014.

Hofer, N.; Zacharias, E.; Müller, W. & Resch, B. An update on the use of C-reactive protein in earlyonset neonatal sepsis: current insights and new tasks. Neonatology, 102(1):25-36, 2012.

Licona, R. T. S.; Fajardo, D. G. E.; Ferrera, G. R. A. & Hernández, O. A. G. Clinical and epidemiological characteristics in newborns with early sepsis. Integrated Santa Bárbara Hospital. Int. J. Med. Surg. Sci., 3(3):903-8, 2016.

Pérez, R. O.; Lona, J. C.; Quiles, M.; Verdugo, M. A.; Ascencio, E. P. & Benítez, E. A. Sepsis neonatal temprana, incidencia y factores de riesgo asociados en un hospital público del occidente de México. Rev. Chil. Infectol., 32(4):447-52, 2015.

Roig, A. T.; Martínez, E. A.; Santurio, G. A. & Fernández, R. A. J. Valor predictivo de algunos exámenes de laboratorio clínico en la infección neonatal bacteriana precoz. Rev. Cuba. Pediatr., 81(2), 2009. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S0034-75312009000200001&lng=es&nrm=iso

Schrag, S. J.; Farley, M. M.; Petit, S.; Reingold, A.; Weston, E. J.; Pondo, T.; Hudson Jain, J. & Lynfield, R. Epidemiology of invasive early-onset neonatal sepsis, 2005 to 2014. Pediatrics, 138(6):e20162013, 2016.

Secretaria de Salud de Honduras. Normas Nacionales para la Atención Materno-Neonatal. Tegucigalpa, Secretaria de Salud de Honduras, 2010.

Simonsen, K. A.; Anderson-Berry, A. L.; Delair, S. F. & Davies, H. D. Early-onset neonatal sepsis. Clin. Microbiol. Rev., 27(1):21-47, 2014.

Stoll, B. J.; Hansen, N. I.; Sánchez, P. J.; Faix, R. G.; Poindexter, B. B.; Van, Meurs, K. P.; Bizzarro, M. J.; Goldberg, R. N.; Frantz, I. D. 3rd; Hale, E. C.; Shankaran, S.; Kennedy, K.; Carlo, W. A.; Watterberg, K. L.; Bell, E. F.; Walsh, M. C.; Schibler, K.; Laptook, A. R.; Shane, A. L.; Schrag, S. J.; Das, A.; Higgins, R. D. & Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network. Early onset neonatal sepsis: the burden of group B Streptococcal and E. coli disease continues. Pediatrics, 127(5):817-26, 2011.

Swarnkar, K. & Vagha, J. Sepsis biomarkers in early onset neonatal infections: A review. Internet J. Infect. Dis., 11(1):1-9, 2013.