The diagnosis of sepsis is often a difficult issue for the neonatologist. Clinical signs and symptoms are poorly specific, and the quest for the optimal laboratory assay is still open. C-reactive protein (CRP) requires serial determinations to be of practical value,1 interleukins have not yet entered the routine clinical use, total white blood cells or absolute neutrophil counts alone have not enough sensitivity or specificity. Current hematology analyzers can determine white blood cell subpopulations based on their physical characteristics (eg, volume and granularity). In particular, mean neutrophil volume (MNeV) and its standard deviation (neutrophil distribution width) have been previously used to diagnose sepsis in an adult population with encouraging results.We investigated these same parameters in screening for late-onset neonatal sepsis, defined as a systemic infection, validated by a positive blood culture, diagnosed beyond the third day of life. When taken together, CRP and MNeV represent a powerful rapid combination both to suspect or exclude late onset sepsis. Neutrophil distribution width did not prove to be of any practical help in our neonatal series, possibly because the resting neutrophil population in the newborn is already more heterogeneous in size and shape than in the adult.
Automated determination of neutrophil volume as screening test for late-onset sepsis in very low birth infants / Raimondi, Francesco; Ferrara, Teresa; Capasso, Letizia; Sellitto, M; Landolfo, F; Romano, A; Grimaldi, E; Scopacasa, FRANCESCO UMBERTO VITTOR. - In: THE PEDIATRIC INFECTIOUS DISEASE JOURNAL. - ISSN 0891-3668. - ELETTRONICO. - (2010), pp. 288-288.
Automated determination of neutrophil volume as screening test for late-onset sepsis in very low birth infants.
RAIMONDI, FRANCESCO;FERRARA, TERESA;CAPASSO, LETIZIA;SCOPACASA, FRANCESCO UMBERTO VITTOR
2010
Abstract
The diagnosis of sepsis is often a difficult issue for the neonatologist. Clinical signs and symptoms are poorly specific, and the quest for the optimal laboratory assay is still open. C-reactive protein (CRP) requires serial determinations to be of practical value,1 interleukins have not yet entered the routine clinical use, total white blood cells or absolute neutrophil counts alone have not enough sensitivity or specificity. Current hematology analyzers can determine white blood cell subpopulations based on their physical characteristics (eg, volume and granularity). In particular, mean neutrophil volume (MNeV) and its standard deviation (neutrophil distribution width) have been previously used to diagnose sepsis in an adult population with encouraging results.We investigated these same parameters in screening for late-onset neonatal sepsis, defined as a systemic infection, validated by a positive blood culture, diagnosed beyond the third day of life. When taken together, CRP and MNeV represent a powerful rapid combination both to suspect or exclude late onset sepsis. Neutrophil distribution width did not prove to be of any practical help in our neonatal series, possibly because the resting neutrophil population in the newborn is already more heterogeneous in size and shape than in the adult.File | Dimensione | Formato | |
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