EARLY DIAGNOSIS OF NEONATAL INFECTION WITH A SCORING SYSTEM

A need exists for a rapid method of identifying neonatal sepsis. Of 444 babies admitted to our ICN, 140 were clinically suspected of having sepsis. A two phase evaluation score was used. A “rapid” score was obtained (within 1 hour) with WBC and Dlff., mini-ESR, and latex determinations of haptoglobin (Hp), C-reactive protein and IgM. A “complete” score (within 24 hours) added α1-acid glycoprotein, Hp by hemoglobin binding capacity, and IgM by electrophoresis. Table I shows the scoring: In Table II, none, clin+ and cult+ represent no apparent infection, infection strongly suspected clinically and blood culture positive, respectively. All cases with documented infection had elevated scores. There were 16 other elevated scores which would have indicated a need for antibiotic treatment, while 102 babies may not have required antibiotics. This rapid assessment was superior to using any one test alone.