Comparison of the percentage of NRBC/100 WBC in early onset sepsis and non-infectious premature infants
- Authors: Boskabadi H.1, Sadeghian M.H.1, Meshkani B.1, Zakerihamidi M.2
-
Affiliations:
- Mashhad University of Medical Sciences
- Islamic Azad University, Tonekabon Branch
- Issue: Vol 11, No 6 (2021)
- Pages: 1089-1094
- Section: ORIGINAL ARTICLES
- Submitted: 20.08.2020
- Accepted: 27.03.2021
- Published: 09.07.2021
- URL: https://iimmun.ru/iimm/article/view/1588
- ID: 1588
Cite item
Full Text
Abstract
Introduction. In spite of significant advances in medical care, neonatal sepsis remains an important risk factor for neonatal morbidity and mortality. Accordingly, the present study was conducted to compare the number of nucleated red blood cells per 100 white blood cells (NRBC/100WBC) in neonates with early onset sepsis and non-infectious neonates. Materials and methods. In this cross-sectional study of 154 neonates admitted to the NICU of Ghaem Hospital in Mashhad, Iran within the first three days of life, during 2014 to 2018, the characteristics of 44 neonates identified early onset sepsis (Case group) were compared with 110 non-infectious neonates (Control group). After the confirmation of sepsis in neonates based on positive blood culture and laboratory results, a researcher-made questionnaire containing neonatal characteristics (gestational age, weight, first minute Apgar scores, fifth minute Apgar score, duration of oxygen therapy, and mechanical ventilation duration) and neonatal laboratory profiles (routine blood culture, WBC, NRBC/100WBC, CRP, blood glucose, calcium and venous blood gas) was filled in. Results. The results of this study showed that the absolute number of NRBC/mm3 in control group was 56.07±86.65 and in case group was 592.70±1166.75 (p = 0.000). Also, the number of NRBC per 100 white blood cells in control group was 6.54±11.18 and in case group was 31.84±40.07 (p = 0.000). The absolute number of NRBC/mm3 for the detection of early onset sepsis had a good sensitivity (78%) and NRBC/100WBC was suitable specificity (68.2%). Conclusion. This study indicated that NRBC/100 WBC and absolute NRBC count/mm3 can be helpful in the diagnosis of early onset sepsis and have an acceptable sensitivity and specificity.
About the authors
H. Boskabadi
Mashhad University of Medical Sciences
Email: boskabadih@mums.ac.ir
Hassan Boskabadi - Professor, Department of Pediatrics, Faculty of Medicine, Mashhad University of Medical Sciences.
Mashhad.
ИранM. H. Sadeghian
Mashhad University of Medical Sciences
Email: sadeghianmh@mums.ac.ir
Mohammad Hadi Sadeghian - Associate Professor, Department of Hematopathology, Ghaem Hospital, Mashhad University of Medical Sciences.
Mashhad.
ИранB. Meshkani
Mashhad University of Medical Sciences
Email: meshkaniba@mums.ac.ir
Baratali Mashkani - Associate Professor, Department of Medical Biochemistry, School of Medicine, Mashhad University of Medical Sciences.
Mashhad.
ИранM. Zakerihamidi
Islamic Azad University, Tonekabon Branch
Author for correspondence.
Email: maryamzakerihamidi@yahoo.co.nz
Maryam Zakerihamidi - PhD (Reproductive Health), Assistant Professor of Reproductive Health, Department of Midwifery, Faculty of Medical Sciences, Islamic Azad University, Tonekabon Branch.
Tonekabon.
Phone: +98 0115 427-11-05
ИранReferences
- Abhishek M., Sanjay M. Diagnostic efficacy of nucleated red blood cell count in the early diagnosis of neonatal sepsis. Indian J. Pathol. Oncol., 2015, vol. 2, no. 4, pp. 182–185.
- Axt R., Ertan K., Hendrik J., Wrobel M., Mink D., Schmidt W. Nucleated red blood cells in cord blood of singleton term and post-term neonates. J. Perinat. Med., 1999, vol. 27, no. 5, pp. 376–381. doi: 10.1515/JPM.1999.051
- Boskabadi H., Maamouri G., Akhodian J., Zakerihamidi M., Sayedi S.J., Ghazvini K., Ali Kiani M., Boskabadi A., Reyhani T., Karbandi S., Vashani H.B., Razaghi N., Mollaei M.K., Parvini Z., Skandari T., Rezaeian A., Bagheri F. Neonatal infections: a 5-year analysis in a neonatal care unit in North East of Iran. Int. J. Pediatr., 2016, vol. 4, no. 36, pp. 3989–3998. doi: 10.22038/IJP.2016.7893
- Boskabadi H., Maamouri G., Mafinejad S. Neonatal complications related with prolonged rupture of membranes. Open Access Maced. J. Med. Sci., 2011, vol. 4, no. 1, pp. 93–98. doi: 10.3889/MJMS.1857-5773.2011.0159
- Boskabadi H., Maamouri G., Tavakol Afshari J., Mafinejad S., Hosseini G., Mostafavi-Toroghi H., Saber H., Ghayour-Mobarhan M., Ferns G. Evaluation of serum interleukins-6, 8 and 10 levels as diagnostic markers of neonatal infection and possibility of mortality. Iran J. Basic Med. Sci., 2013, vol. 16, no. 12, pp. 1232–1237.
- Boskabadi H., Moudi A., Parvini Z., Barati T. Evaluation of the cause and related factors of neonatal mortality in Qaem hospital 1388–1389. Iran J. Obstet. Gynecol. Infertil., 2012, vol. 14, no. 7, pp. 21–26.
- Boskabadi H., Sadeghian M.H. Investigation of changes in nucleated red blood cells in neonatal infection. Iran J. Neonatol., 2017, vol. 8, no. 4, pp. 26–32. doi: 10.22038/ijn.2017.14811.1227
- Boskabadi H., Zakerihamidi M., Sadeghian M.H., Avan A., Ghayour-Mobarhan M., Ferns G.A. Nucleated red blood cells count as a prognostic biomarker in predicting the complications of asphyxia in neonates. J. Matern. Fetal Neonatal Med., 2017, vol. 30, no. 21, pp. 2551–2556. doi: 10.1080/14767058.2016.1256988
- Buonocore G., Perrone S., Gioia D., Gatti M.G., Massafra C., Agosta R., Bracci R. Nucleated red blood cell count at birth as an index of perinatal brain damage. Am. J. Obstet. Gynecol., 1999, vol. 181, no. 6, pp. 1500–1505. doi: 10.1016/s0002-9378(99)70396-0
- Dulay A.T., Buhimschi I.A., Zhao G., Luo G., Abdel-Razeq S., Cackovic M., Rosenberg V.A., Pettker C.M., Thung S.F., Bahtiyar M.O., Bhandari V., Buhimschi C.S. Nucleated red blood cells are a direct response to mediators of inflammation in newborns with early-onset neonatal sepsis. Am. J. Obstet. Gynecol., 2008, vol. 198, no. 4, pp. 426.e1–426.e9. doi: 10.1016/j.ajog.2008.01.040
- Farhat A.S., Mohammadzadeh A., Mirzaie F., Khademi G., Nasab M.N. Clinical manifestation and laboratory findings of positive blood culture in neonatal septicemia. Iran J. Neonatol., 2014, vol. 5, no. 3, pp. 13–17. doi: 10.22038/IJN.2014.4143
- Green D.W., Hendon B., Mimouni F.B. Nucleated erythrocytes and intraventricular hemorrhage in preterm neonates. Pediatrics, 1995, vol. 96, no. 3, pp. 475–478.
- Haque K.N. Neonatal sepsis in the very low birth weight preterm infants: Part 1: Review of patho-physiology. J. Med. Sci., 2010, vol. 3, no. 1, pp. 12–27. doi: 10.2174/1996327001003010001
- Hermansen M. Nucleated red blood cells in the fetus and newborn. Arch. Dis. Child Fetal Neonatal Ed., 2001, vol. 84, no. 3, pp. F211–F215. doi: 10.1136/fn.84.3.F211
- Hornik C.P., Benjamin D.K., Becker K.C., Benjamin D.K. Jr, Li J., Clark R.H., Cohen-Wolkowiez M., Smith P.B. Use of the complete blood cell count in early-onset neonatal sepsis. Pediatr. Infect. Dis. J., 2012, vol. 31, no. 8, pp. 799–802. doi: 10.1097/INF.0b013e318256905c
- Klein J.O. Bacterial sepsis and meningitis. In: Infectious diseases of the fetus and newborn infant. Philadelphia: WB Saunders, 2000, pp. 943–998.
- Leikin E., Garry D., Visintainer P., Verma U., Tejani N. Correlation of neonatal nucleated red blood cell counts in preterm infants with histologic chorioamnionitis. Am. J. Obstet. Gynecol., 1997, vol. 177, no. 1, pp. 27–30. doi: 10.1016/s0002-9378(97)70433-2
- Panah Y. Neonatal intensive care unit nosocomial bacterial infections. Tehran University Med. J., 2008, vol. 66, no. 5, pp. 349–354.
- Ranganathan D., Khoshnood B., Boonlayangoor S., Meadow W. Nucleated red blood cells (NRBCs): an unheralded marker of early-onset neonatal sepsis. Pediatric Res., 1999, vol. 45. doi: 10.1203/00006450-199904020-01623
- Ravishankar V., Buhimschi C.S., Booth C.J., Bhandari V., Norwitz E., Copel J., Buhimschi I.A. Fetal nucleated red blood cells in a rat model of intrauterine growth restriction induced by hypoxia and nitric oxide synthase inhibition. Am. J. Obstet. Gynecol., 2007, vol. 196, no. 5, pp. 482.e1–482.e8. doi: 10.1016/j.ajog.2006.12.020
- Salafia C.M., Ghidini A., Pezzullo J.C., Rosenkrantz T.S. Early neonatal nucleated erythrocyte counts in preterm deliveries: clinical and pathologic correlations. J. Soc. Gynecol. Investig., 1997, vol. 4, no. 3, pp. 138–143. doi: 10.1016/s1071-5576(97)00022-1
- St Geme J.W. 3rd, Polin R.A. Neonatal sepsis. Advances in pediatric infectious diseases. Drugs, 1988, vol. 36, pp. 784–800. doi: 10.2165/00003495-198836060-00007
- Stachon A., Bolulu O., Holland-Letz T., Krieg M. Association between nucleated red blood cells in blood and the levels of erythropoietin, interleukin 3, interleukin 6, and interleukin 12p70. Shock, 2005, vol. 24, no. 1, pp. 34–39. doi: 10.1097/01.shk.0000164693.11649.91