Diagnostic Test of The Hematologic Scoring System in Neonatal Sepsis

Abstract

Neonatal sepsis remains a major challenge in neonatal care, particularly because early detection and clinical severity categorization are not always effectively achieved. The hematologic scoring system (HSS) has been proposed as a useful tool for assessing the presence or absence of infection. This study aimed to compare the HSS with blood culture in diagnosing neonatal sepsis. A cross-sectional study was conducted at Ulin Hospital, Banjarmasin, in September 2019, involving 43 neonates aged 0–30 days with clinical or suspected neonatal sepsis. Neonatal sepsis was assessed using HSS, supported by a hematology analyzer. The Leishman-stained peripheral blood smear was evaluated according to Rodwell’s hematological criteria. Diagnostic performance was evaluated by calculating sensitivity, specificity, positive predictive value, and negative predictive value using blood culture as the reference standard. The chi-square test was used to assess the association between HSS and blood culture results. The HSS results did not associate with blood culture results in patients (p = 0.850). The HSS demonstrated a sensitivity of 59.09%, a specificity of 38.10%, a positive predictive value of 50%, and a negative predictive value of 47.06%. The HSS showed limited diagnostic performance and should not replace blood culture. However, it may be considered as an adjunctive tool in the initial assessment of neonatal sepsis.