Role of Micro- ESR in the Evaluation of Suspected Sepsis in Neonates

Aims In a developing country like India, where proper medical care and obstetrical facilities are still scarce in the rural areas, Neonatal sepsis is a major cause of neonatal morbidity and mortality. With limited resources, early diagnosis and treatment, if crucial, may not be achieved. Objective of this study is to evaluate the role of Micro ESR in the diagnosis of suspected neonatal sepsis. Materials and Methods A prospective cross-sectional hospital based descriptive study was done in the NICU of Yenepoya Medical College Hospital, Mangalore, Karnataka, India, Between 1st January 2015 to 15th July 2015.50 Newborns with suspected sepsis admitted for septic work up and IV antibiotics were included in the study. Micro ESR was measured with relevant septic screening investigations. The micro ESR value results were compared with Blood culture taken as gold standard and hematological factors such as CRP. Results Out of 50 babies, micro ESR was elevated in 19 (38 %) babies out of which Blood culture was positive in 16 cases. Total proven sepsis cases were 16 (32 %) and probable sepsis were 34 (68 %). Correlation of elevated micro ESR was statistically significant with blood culture positive cases and CRPgreater than6 with a p-value of 0.004 and 0.043 respectively. The sensitivity, specificity, positive and negative predictive value compared with blood culture was 68.8 %, 76.5 %, 57.9 % and 83.9 % respectively with a diagnostic accuracy of 74 %. Conclusion Micro ESR is simple and cheap bedside evaluation test and relatively sensitive in the prediction of neonatal sepsis and can be a useful test in the early detection of sepsis and can be used as a screening tool for detecting suspected Neonatal Sepsis.