Neonatal Sepsis: Sensitivity and Specificity

Introduction: 90% of neonatal sepsis occurs within 24 hours of delivery. Mostly from group B Streptococcus. If there is suspicion of neonatal sepsis, infants should get blood cx, LP, and CBC, CRP, etc.

If mom has risk factors, then mom should be given ampicillin 1g at least 4 hours prior to delivery. Infants at risk should be monitored for at least 48 hours.

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Prevalence

The sensitivity and specificity of findings for Neonatal Sepsis are listed below. See the left navigation bar to change the display.

Sensitive and Specific Findings

Finding	Sensitivity	Specificity	Comments, Study
Serial CRP Duplicate	89%	98%	8 hours apart. For early-onset sepsis Study: Adv Neonatal Care. 2003 Feb;3(1):3-13. PMID: 12882177

Specific Findings

Finding	Sensitivity	Specificity	Comments, Study
Elevated CRP Duplicate	62%	92%	inital CRP, for late-onset sepsis Study: Adv Neonatal Care. 2003 Feb;3(1):3-13. PMID: 12882177
Elevated CRP Duplicate	35%	90%	initial, for early-onset sepsis Study: Adv Neonatal Care. 2003 Feb;3(1):3-13. PMID: 12882177

Sensitive Findings

Finding	Sensitivity	Specificity	Comments, Study
Serial CRP Duplicate	96%	72%	8 hours apart. For late-onset sepsis. Study: Adv Neonatal Care. 2003 Feb;3(1):3-13. PMID: 12882177
Serial CRP and IL-8	93%	80%	both elevated Study: Adv Neonatal Care. 2003 Feb;3(1):3-13. PMID: 12882177

Poorly Diagnostic Findings

Finding	Sensitivity	Specificity	Comments, Study
Elevated ESR	63%	60%	"micro-ESR" Study: Mymensingh Med J. 2009 Jan;18(1):56-61. PMID: 19182751
Elevated I/T Ratio	70%	56%	immature / total polys Study: Mymensingh Med J. 2009 Jan;18(1):56-61. PMID: 19182751