Neonatal Sepsis: Likelihood Ratios

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 likelihood ratios of findings for Neonatal Sepsis are listed below. See the left navigation bar to change the display.

Good Positive and Negative Likelihood Ratios

Finding	+LR	-LR	Comments, Study
Serial CRP Duplicate	44.5	0.1	8 hours apart. For early-onset sepsis Study: Adv Neonatal Care. 2003 Feb;3(1):3-13. PMID: 12882177
Serial CRP and IL-8	4.7	0.1	both elevated Study: Adv Neonatal Care. 2003 Feb;3(1):3-13. PMID: 12882177
Serial CRP Duplicate	3.4	0.1	8 hours apart. For late-onset sepsis. Study: Adv Neonatal Care. 2003 Feb;3(1):3-13. PMID: 12882177
Elevated CRP Duplicate	7.8	0.4	inital CRP, for late-onset sepsis Study: Adv Neonatal Care. 2003 Feb;3(1):3-13. PMID: 12882177

Good Negative Likelihood Ratio

Finding	+LR	-LR	Comments, Study
Elevated I/T Ratio	1.6	0.5	immature / total polys Study: Mymensingh Med J. 2009 Jan;18(1):56-61. PMID: 19182751

Good Positive Likelihood Ratio

Finding	+LR	-LR	Comments, Study
Elevated CRP Duplicate	3.5	0.7	initial, for early-onset sepsis Study: Adv Neonatal Care. 2003 Feb;3(1):3-13. PMID: 12882177

Poorly Diagnostic Findings

Finding	+LR	-LR	Comments, Study
Elevated ESR	1.6	0.6	"micro-ESR" Study: Mymensingh Med J. 2009 Jan;18(1):56-61. PMID: 19182751